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The main cause of mortality in patients on renal therapy is cardiovascular, the risk factors are diabetes, dyslipidemia, uncontrolled hypertension, advanced age, uncontrolled anemia, inefficient elimination of certain toxins, accumulation of cytokines, malnutrition syndrome and secondary hyperparathyroidism, which are present in the majority of dialysis patients and carry a high risk of mortality, multiple studies indicate that High volume online Hemodiafiltration (OL-HDF) reduces the risk of mortality compared to High flow Hemodialysis (HD).
Objective: Determine all-cause and cardiovascular mortality, causes of hospitalization, factors that influence mortality, nutritional parameters, body composition and hemodynamic behavior used in patients on OL-HDF versus HD.
Descriptive, retrospective, multicenter, observational study carried out in 14 FMC clinics, a Propensity score matching was applied, obtaining 4281 patients, 853 in HDF-OL and 3428 in HD, during the period between September 3, 2018, until April 30, 2022. In the mortality analysis, it was divided into 3 categories: 1. HD exclusively or HDF-OL less than 6 months. 2. HDF-OL for 6 – 12 months, 3. HDF-OL for more than 12 months.
12.7% died in HDF-OL and 21.9% in HD (p ≤0.05). When dividing the groups, we observed that this trend is maintained in HDF-OL for 6 to 12 months and more than 12 months, the mortality rates from all causes were 19.3% and 10.7% respectively, compared to 21.9% in HD (OR: 0.58, 95% CI: 0.48;0.69, p ≤0.05).
The results found confirm that OL-HDF > 6 months reduces the risk of mortality by 42% from all causes, cardiovascular by 24%, compared to high-flow HD.