The Effect of Ultrapure Dialysate on Clinical Outcomes and Mortality During One Year Follow-up in Patients Undergoing Hemodialysis Treatment

Abstract

Objective: We investigated the relationship between mortality and clinical status in patients with hemodialysis using ultrapure dialysate and standard dialysate. Materials and Methods: The study included 81 patients using ultrapure dialysate (Group 1) and 72 patients using standard dialysate (Group 2). Mortality rates, anemia, phosphorus, albumin, parathormone, and C-reactive protein (CRP) values were calculated as 1-year averages. Factors affecting mortality were evaluated by logistic regression analysis. Results: In Group 1, potassium, phosphorus, uric acid, CRP, and hemoglobin levels were significantly higher (p<0.001, p=0.023, p=0.010, p=0.003, p<0.001, respectively), and transferrin saturation, ferritin, and HCO3? levels were significantly lower (p=0.007, p<0.001, p=0.001, respectively) than Group 2. The erythropoietin-stimulating agent’s usage dose of Group 1 was 0.60 (0.11-1.00) ?g/kg/month and 1.30 (0.80-2.17) ?g/kg/month in Group 2 (p<0.001). Iron usage doses of Group 1 and Group 2 were 800 (425-1,275) mg/year and 1,300 (750-2,000) mg/year, respectively (p=0.002). There was no significant difference in mortality rates for the 1-year follow-up period (mortality rate in 12 patients [14.8%] in Group 1, 6 patients in Group 2 [8.9%], p=0.214). In the univariate and multivariate logistic regression analyses, age, serum Na, total protein, and CRP levels were found to be independent variables to determine mortality. Conclusion: After 1 year of short-term follow-up, Group 1 had better anemia control than Group 2 but no positive effect on mortality.