Baxter Renal Care Services- Fundación Cardioinfantil, Bogotá, Colombia
Baxter Renal Care Services Latin-America, Bogotá, Colombia
Baxter Renal Care Services-Colombia, Bogotá, Colombia
Universidad Nacional de Colombia, Clinical Research Institute, School of Medicine, Universidad Nacional de Colombia., Bogotá, Colombia
Baxter Healthcare Corporation, Deerfield, IL, United States of America
Background and Aims According to emerging evidence, medium cut-off membrane improves clearance of molecules larger than 25 kDa, including larger uremic toxins. There is growing evidence on clinical effectiveness outcomes associated with the use of these membranes. Our aim was to evaluate clinical effectiveness of medium cut-off (HDx) versus high flux (HF-HD) dialyzers in terms of hospitalization rate and duration, cardiovascular event rate and survival in a HD prevalent cohort in Colombia through an observational, multicenter retrospective cohort analysis. Method Adult Prevalent HD patients (> 90 days in HD) at Baxter Renal Care Services Colombia were included between September 1st, 2017 to November 30th, 2017 (follow-up until 2 years). Socio-demographic and clinical characteristics of all patients were summarized descriptively. Inverse probability of treatment weighting on the propensity score was used to balance comparison groups on indicators of baseline socio-demographic and clinical characteristics. Weighted incidence rate ratios (IRRs) and rates and duration of hospitalization and cardiovascular events according to dialyzer type were obtained using binomial negative regression with the weighting sample. Results We evaluated 1098 patients (37.7% women): 534 in HF-HD vs 564 in HDx (Table 1), median age was 60.6 years. Mean time on HD was 5.6 years (SD 5.51) for HF-HD and 5.88 for HDX (SD 5.48) We observed lower hospitalization rates in HDx group, (IRR HDx/HF-HD: 0.82 95% CI 0.69 to 0.98; p=0.03); and cardiovascular events rate, (IRR HDx/HF-HD: 0.65 95% CI 0.47 to 0.91; p=0.01) see Table 2. Main cause of hospitalization was cardio-cerebrovascular (Table 3). We observed no differences in hospitalization duration or survival. Conclusion We evaluated 1098 patients (37.7% women): 534 in HF-HD vs 564 in HDx (Table 1), median age was 60.6 years. Mean time on HD was 5.6 years (SD 5.51) for HF-HD and 5.88 for HDX (SD 5.48) We observed lower hospitalization rates in HDx group, (IRR HDx/HF-HD: 0.82 95% CI 0.69 to 0.98; p=0.03); and cardiovascular events rate, (IRR HDx/HF-HD: 0.65 95% CI 0.47 to 0.91; p=0.01) see Table 2. Main cause of hospitalization was cardio-cerebrovascular (Table 3). We observed no differences in hospitalization duration or survival.
中文翻译：
背景和目的 根据新出现的证据，中等截断膜可提高大于 25 kDa 的分子的清除率，包括较大的尿毒症毒素。越来越多的证据表明与使用这些膜相关的临床有效性结果。我们的目的是通过一项观察性多中心回顾性研究，在哥伦比亚一个 HD 流行队列中评估中等截止 (HDx) 与高通量 (HF-HD) 透析器在住院率和持续时间、心血管事件发生率和生存率方面的临床有效性队列分析。方法 2017 年 9 月 1 日至 2017 年 11 月 30 日期间（随访至 2 年）期间，Baxter Renal Care Services Colombia 的成人流行 HD 患者（HD 超过 90 天）被纳入研究。描述性地总结了所有患者的社会人口统计学和临床特征。倾向得分上的治疗加权逆概率用于平衡比较组的基线社会人口统计学和临床特征指标。使用加权样本的二项式负回归获得加权发病率比 (IRR) 以及根据透析器类型的住院率和持续时间以及心血管事件。结果 我们评估了 1098 名患者（37.7% 的女性）：HF-HD 患者 534 人，HDx 患者 564 人（表 1），中位年龄为 60.6 岁。HF-HD 的平均 HD 时间为 5.6 年 (SD 5.51)，HDX 为 5.88 年 (SD 5.48) 我们观察到 HDx 组的住院率较低 (IRR HDx/HF-HD: 0.82 95% CI 0.69 to 0.98; p= 0.03); 和心血管事件发生率，（IRR HDx/HF-HD：0.65 95% CI 0.47 至 0.91；p=0.01）见表 2。住院的主要原因是心脑血管疾病（表 3）。我们观察到住院时间或生存率没有差异。结论 我们评估了 1098 名患者（37.7% 的女性）：HF-HD 患者 534 人，HDx 患者 564 人（表 1），中位年龄为 60.6 岁。HF-HD 的平均 HD 时间为 5.6 年 (SD 5.51)，HDX 为 5.88 年 (SD 5.48) 我们观察到 HDx 组的住院率较低 (IRR HDx/HF-HD: 0.82 95% CI 0.69 to 0.98; p= 0.03); 和心血管事件发生率，（IRR HDx/HF-HD：0.65 95% CI 0.47 至 0.91；p=0.01）见表 2。住院的主要原因是心脑血管疾病（表 3）。我们观察到住院时间或生存率没有差异。48) 我们观察到 HDx 组的住院率较低（IRR HDx/HF-HD：0.82 95% CI 0.69 至 0.98；p=0.03）；和心血管事件发生率，（IRR HDx/HF-HD：0.65 95% CI 0.47 至 0.91；p=0.01）见表 2。住院的主要原因是心脑血管疾病（表 3）。我们观察到住院时间或生存率没有差异。48) 我们观察到 HDx 组的住院率较低（IRR HDx/HF-HD：0.82 95% CI 0.69 至 0.98；p=0.03）；和心血管事件发生率，（IRR HDx/HF-HD：0.65 95% CI 0.47 至 0.91；p=0.01）见表 2。住院的主要原因是心脑血管疾病（表 3）。我们观察到住院时间或生存率没有差异。
