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Blood flow rate: An independent risk factor of mortality in Chinese hemodialysis patients

Xinju Zhao1, Qingyu Niu1, Liangying Gan1

  • 1Department of Nephrology, Peking University People's Hospital, Beijing, China.

Seminars in Dialysis
|September 22, 2021
PubMed

Insights

Higher blood flow rate (BFR) in hemodialysis patients is linked to reduced mortality risk. This association is particularly strong in specific patient groups, suggesting BFR is an independent predictor of outcomes.

Area of Science:

  • Nephrology
  • Clinical Medicine
  • Cardiovascular Research

Background:

  • Emerging evidence suggests blood flow rate (BFR) in hemodialysis (HD) may influence mortality beyond dialysis adequacy.
  • Understanding BFR's independent predictive value for clinical outcomes in HD patients is crucial.

Purpose of the Study:

  • To investigate if BFR independently predicts clinical outcomes, specifically all-cause mortality and hospitalization, in Chinese HD patients.
  • To explore the relationship between BFR and patient survival in a large cohort.

Main Methods:

  • Utilized data from the China Dialysis Outcomes and Practice Patterns Study (DOPPS) Phase 5.
  • Included patients with recorded BFR, collecting demographic, comorbidity, hospitalization, and mortality data.
  • Employed Cox regression models to analyze associations between BFR and clinical outcomes.

Main Results:

  • A total of 1412 patients were analyzed, with most having BFR < 300 ml/min.
  • Each 10 ml/min increase in BFR was associated with a 6.4% reduced risk of all-cause mortality (HR: 0.936) after full adjustment.
  • No significant association was found between BFR and first hospitalization (HR: 0.987).

Conclusions:

  • Increased BFR (200-300 ml/min) is independently linked to lower all-cause mortality risk in hemodialysis patients.
  • This mortality benefit of higher BFR is more pronounced in male, nondiabetic patients with albumin < 4.0 g/dL and hemoglobin ≥ 9.0 g/dL.
Abstract

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