Kidney Week

Abstract: PUB160

Hemodiafiltration: Impact of Private Health Insurance on Mortality

Session Information

• Publication Only

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Luciano, Eduardo De paiva, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil

Eduardo De paiva Luciano, MD

• Rocha, Érica Pires da, Universidade Estadual Paulista Julio de Mesquita Filho, Sao Paulo, Brazil

Érica Pires da Rocha, PhD

• Borges, Cynthia Moura, Universidade Estadual de Campinas, Campinas, SP, Brazil

Cynthia Moura Borges, PhD

• Kojima, Christiane, Universidade Estadual Paulista Julio de Mesquita Filho, Sao Paulo, Brazil

Christiane Kojima, MD

• Reis, Sandra, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil

Sandra Reis, MD

• Rosa, Maria G., Universidade Estadual de Campinas, Campinas, SP, Brazil

Maria G. Rosa, MD, PhD

• Cordeiro, Aline, Universidade de Taubate, Taubate, Brazil

Aline Cordeiro

• Rocha, Whelington Figueiredo, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil

Whelington Figueiredo Rocha, MBA

• Silva, Adolfo Martin da, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil

Adolfo Martin da Silva

• Magalhães, Andréa Olivares, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil

Andréa Olivares Magalhães, MD, PhD

• Elias, Rosilene M., Universidade de Sao Paulo, Sao Paulo, sao paulo, Brazil

Rosilene M. Elias, MD, PhD

Group or Team Name

• Nefrostar.

Background

High-volume hemodialfiltration (HDF) is associated with an improved survival. However, in Brazil, HDF is allowed only for patients with private insurance (approximately 20% of population). It is not known whether the better survival rate observed in patients with private health insurance is related to the dialysis therapy or to the global care associated with a better economic situation. We had the opportunity to evaluate the impact of HDF on mortality rate in patients with private and public health insurance.

Methods

all patients who received HDF in both clinics were included (private, N=83, 35.3% with diabetes, age 53± 17 years) and public (N=40, 51.2% with diabetes, age 61± 2 years). Patients were followed until death, withdraw from dialysis or end of the study (May-9-2024). The nephrology team was the same in both facilities.

Results

during a median follow-up of 16.9 months there were 11 deaths (5 from the public and 6 from the private facility). In a Cox survival analysis revealed a not significant difference between public and private facilities (p=0.099, HR=0.336) after adjustments for age (p=0.047, HR=1.065) and diabetes (p=0.775, HR=1.202)

Conclusion

Despite the differences in global care and economic status, HDF confers similar survival rate for patients with private and public insurance. Whether this benefit will be confirmed in a larger population deserves further evaluation.