Relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients: a single-center study
The association between blood flow rate (BFR) and clinical outcomes in patients undergoing maintenance hemodialysis (MHD) is inconclusive. This retrospective study included 175 patients undergoing MHD treatment between July 2015 and March 2022, divided into two groups based on time-averaged effectiv...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2344655 |
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| author | Zhoucang Zhang Jiarui Li Jiaxiang Ding Shenglei Zhang Mei Wang Jinsheng Xu |
| author_facet | Zhoucang Zhang Jiarui Li Jiaxiang Ding Shenglei Zhang Mei Wang Jinsheng Xu |
| author_sort | Zhoucang Zhang |
| collection | DOAJ |
| description | The association between blood flow rate (BFR) and clinical outcomes in patients undergoing maintenance hemodialysis (MHD) is inconclusive. This retrospective study included 175 patients undergoing MHD treatment between July 2015 and March 2022, divided into two groups based on time-averaged effective blood flow rate (eBFR) median value. We investigated arteriovenous fistula (AVF) outcomes and the association of eBFR with all-cause mortality and new major adverse cardiovascular events (MACE). Mean ± SD and median time-averaged eBFR values were 276 ± 24 and 275 mL/min, respectively. After adjusting for relevant factors including age, sex, vintage, diabetes, CVD, receiving hemodiafiltration (HDF) treatment and spKt/V, Cox models indicated a low time-averaged eBFR (≤ 275 ml/min) was associated with increased risks of all-cause mortality (hazard ratio [HR] 14.18; 95% confidence interval [CI], 3.14–64.1) and new MACE (HR 3.76; 95% CI, 1.91–7.40) in MHD patients. Continuous Cox models demonstrated each 20 ml/min increase in eBFR linked to a 63% decrease in the risk of all-cause mortality (HR: 0.37, 95% CI: 0.23–0.59) and a 38% decrease in the occurrence of new MACE (HR: 0.62, 95% CI: 0.46–0.84). There was no significant difference in AVF outcomes between the two groups. Our study noted higher eBFR (>275 mL/min) is associated with lower risks of both all-cause mortality and new MACE compared with low eBFR (≤275 mL/min). Increased eBFR is not associated with a higher risk of AVF failure. |
| format | Article |
| id | doaj-art-7ee508a0180c4fd3b82eb61ed03396ad |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-7ee508a0180c4fd3b82eb61ed03396ad2025-01-23T04:17:47ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2024.2344655Relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients: a single-center studyZhoucang Zhang0Jiarui Li1Jiaxiang Ding2Shenglei Zhang3Mei Wang4Jinsheng Xu5Department of Nephrology, The Fourth Hospital of Hebei Medical University, Hebei Clinical Research Center for Chronic Kidney Disease, Hebei Key Laboratory of Vascular Calcification in Kidney Disease, Shijiazhuang, P.R. ChinaDepartment of Nephrology, Peking University International Hospital, Beijing, ChinaDepartment of Nephrology, Peking University International Hospital, Beijing, ChinaDepartment of Nephrology, The Fourth Hospital of Hebei Medical University, Hebei Clinical Research Center for Chronic Kidney Disease, Hebei Key Laboratory of Vascular Calcification in Kidney Disease, Shijiazhuang, P.R. ChinaDepartment of Nephrology, Peking University People’s Hospital, Beijing, ChinaDepartment of Nephrology, The Fourth Hospital of Hebei Medical University, Hebei Clinical Research Center for Chronic Kidney Disease, Hebei Key Laboratory of Vascular Calcification in Kidney Disease, Shijiazhuang, P.R. ChinaThe association between blood flow rate (BFR) and clinical outcomes in patients undergoing maintenance hemodialysis (MHD) is inconclusive. This retrospective study included 175 patients undergoing MHD treatment between July 2015 and March 2022, divided into two groups based on time-averaged effective blood flow rate (eBFR) median value. We investigated arteriovenous fistula (AVF) outcomes and the association of eBFR with all-cause mortality and new major adverse cardiovascular events (MACE). Mean ± SD and median time-averaged eBFR values were 276 ± 24 and 275 mL/min, respectively. After adjusting for relevant factors including age, sex, vintage, diabetes, CVD, receiving hemodiafiltration (HDF) treatment and spKt/V, Cox models indicated a low time-averaged eBFR (≤ 275 ml/min) was associated with increased risks of all-cause mortality (hazard ratio [HR] 14.18; 95% confidence interval [CI], 3.14–64.1) and new MACE (HR 3.76; 95% CI, 1.91–7.40) in MHD patients. Continuous Cox models demonstrated each 20 ml/min increase in eBFR linked to a 63% decrease in the risk of all-cause mortality (HR: 0.37, 95% CI: 0.23–0.59) and a 38% decrease in the occurrence of new MACE (HR: 0.62, 95% CI: 0.46–0.84). There was no significant difference in AVF outcomes between the two groups. Our study noted higher eBFR (>275 mL/min) is associated with lower risks of both all-cause mortality and new MACE compared with low eBFR (≤275 mL/min). Increased eBFR is not associated with a higher risk of AVF failure.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2344655Hemodialysiseffective blood flow rateall-cause mortalitymajor adverse cardiovascular eventsarteriovenous fistula |
| spellingShingle | Zhoucang Zhang Jiarui Li Jiaxiang Ding Shenglei Zhang Mei Wang Jinsheng Xu Relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients: a single-center study Renal Failure Hemodialysis effective blood flow rate all-cause mortality major adverse cardiovascular events arteriovenous fistula |
| title | Relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients: a single-center study |
| title_full | Relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients: a single-center study |
| title_fullStr | Relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients: a single-center study |
| title_full_unstemmed | Relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients: a single-center study |
| title_short | Relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients: a single-center study |
| title_sort | relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients a single center study |
| topic | Hemodialysis effective blood flow rate all-cause mortality major adverse cardiovascular events arteriovenous fistula |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2344655 |
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