MP483DOSE DIALYZER MEMBRANE MATERIAL AND PERFORMANCE HAVE ANY IMPACT ON THE SURVIVAL OF ELDER DIALYSIS PATIENTS?

Abstract

Introduction and Aims: Several recent reports warned that high efficient hemodialysis with polysulfone (PS) membrane occasionally led to the deterioration of nutritional status in elder patients. Ethylene vinyl alcohol (EVAL) membrane has high biocompatibility and a broad solute removal property but efficacy of uremic solute is less than that of PS. In the prior studies, EVAL membrane improved the deteriolated nutritional status caused by PS membrane. The E‐HOPOED‐Study Group was established in 2010 to determine the best dialyzer choice for elder dialysis patients with early dialysis stage. Methods: The E‐HOPED‐Study is a open‐label, dynamically allocated, central registrated, randomized control trial being performed in 325 dialysis facilities in Japan. The patients who accept the enrollment to the study will be randomly divided into the next two groups; Group A, treated by EVAL membrane; Group B, treated by several high flux membrane such as PS. The entry criteria of the patients are the age more than 70 years old, the dialysis vintage less than 180 days. The patient registration has just finished on Dec. 31st 2013. Finally 795 patients; 398 patients in Group A and 397 in Group B, were enrolled into the study. The 5 year‐survival, changes in the nutritional status, occurrence of complications and others are the end points. Dimographic data of all 795 patients and an interim analysis at 36 months after enrollment for 501 patients whose case reports could be received were included into this study. Results: The interim analyses were done. For analyses patients, number of patients were 454, the mean age of the patients was 80.8 years old (245 patients for 80 years of age or older, 209 patients for less than 80 years of age). Mean survival months of the patients was 28.7 in Group A and 30.0 in Group B at 36 months and there were no statistical significant differences ( p=0.407, with log‐rank) between Group A and B. As sub‐analyses data, the length of hospital stay in Group A were shorter that in Group B (n.s.), and mean of treatment hour with dialyzer in Group A were shorter that in Group B, significantly (P<0.05). Conclusions: Based on this interim analysis the dialyzer material and performance didn't have any impact on the survival of new elder dialysis patients. Further data collection and analyses were needed to figure out the best dialyzer choice for the elder patients.