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Kidney Week

Abstract: TH-PO236

Hemodiafiltration Is Associated with Lower Hospitalization Rates Compared with Hemodialysis in a Singapore Cohort

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Chan, Cindy, Fresenius Medical Care AG, Hong Kong, Hong Kong
  • Zhang, Yan, Fresenius Medical Care AG, Bad Homburg, Hessen, Germany
  • Cheung, Yan Yi, Fresenius Medical Care AG, Singapore, Singapore
  • Mooppil, Nandakumar, Fresenius Medical Care AG, Singapore, Singapore
  • Singh, Tripti, Fresenius Medical Care AG, Singapore, Singapore
  • Winter, Anke, Fresenius Medical Care AG, Bad Homburg, Hessen, Germany
  • Maddux, Franklin W., Fresenius Medical Care AG, Bad Homburg, Hessen, Germany
  • Hymes, Jeffrey L., Fresenius Medical Care AG, West Nashville, Tennessee, United States
  • Nikam, Milind, Fresenius Medical Care AG, Singapore, Singapore
Background

Hemodialysis (HD) patients suffer from high rates of hospitalization leading to significant morbidity, mortality, and costs. Hemodiafiltration (HDF) has been shown to improve patient outcomes.

Methods

A retrospective cohort analysis was conducted on patients receiving HD at Fresenius Kidney Care clinics in Singapore between 2019 and 2023. Clinical data were extracted from the electronic information system – EuCliD® to assess the association of dialysis modality with hospitalization outcomes. Patients were classified into 3 groups, i.e., HD and HDF groups, comprising of patients receiving ≥75% of treatments with HD or HDF, respectively, and others as the mixed group. Negative binomial regression was applied to estimate the incident rate ratio (IRR) of hospitalization and length of stay (LOS), adjusted for confounders.

Results

A total of 3298 patients were included, with 59% males. The mean age was 64(±13) years, and dialysis vintage as 26(±48) months. The modality group distribution was: HD: 75%, HDF: 16% and mixed: 9%.

The HDF group had a lower hospitalization rate per person-year compared to the mixed and HD groups (HDF: 1.18, Mixed: 1.40, HD: 1.76), with a significantly lower IRR of 0.80 [95% CI: 0.72, 0.88] compared to the HD group (Table 1). Also, the HDF group had a lower number of hospitalization days per person-year than the other groups (HDF: 8.99, Mixed: 11.38, HD: 15.13; IRR, 0.73 [95% CI: 0.63, 0.84]).

Conclusion

In this cohort, HDF showed significantly lower hospitalization rates and shorter LOS compared to conventional HD and the mixed modality groups.

Funding

  • Commercial Support – Fresenius Medical Care