The association between ultrafiltration rate and mortality in a co- hort of chronic hemodialysis patients with and without diabetes mellitus: a 7-year retrospective observational study.

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Abstract

Background: The ultrafiltration rate (UFR) is one of the important factors involved in long-term mortality in hemodialysis (HD) patients. Presence of diabetes mellitus often affects UFR due to abrupt hypotension during dialysis. In this study, we aimed to find the optimal UFR to improve the mortality in this population with and without diabetes mellitus (DM). Methods: The effect of the UFR on mortality was retrospectively evaluated in 707 patients un- dergoing regular HD from 1 June 2010 to 30 June 2017. The relationship between the UFR and mortality in patients in the non-DM group and those in the DM group was evaluated. Logistic regression analyses were used to select the determinants of mortality. Receiver operating char- acteristic (ROC) curve analyses and survival analysis were used to determine the optimal cutoff points of UFR for mortality. Results: The cutoff UFR values of the non-DM and DM groups were 12.07 ml/hr/kg and 9.66 ml/ hr/kg, respectively. A survival curve showed that in the non-DM group, the 7-year survival rate of patients with a UFR <12.07 ml/hr/kg was 72.6% and that in those with a UFR ≥12.07 ml/hr/kg was 19.6% (p<0.0001). In the DM group, the 7-year survival rate of those with a UFR <9.66 ml/ hr/kg was 66.7%, and it was 33.4% in those with a UFR ≥9.66 ml/hr/kg (p<0.0001). Conclusion: Lower UFR is essential for the long-term mortality of HD patients, and optimal UFR would be different between patients with and without DM.

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