Relationship between effective blood flow rate and clinical outcomes in maintenance hemodialysis patients: a single-center study

• Published in: Renal failure Vol. 46; no. 1; p. 2344655
• Main Authors: Zhang, Zhoucang, Li, Jiarui, Ding, Jiaxiang, Zhang, Shenglei, Wang, Mei, Xu, Jinsheng
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Ltd 01.12.2024; Taylor & Francis; Taylor & Francis Group
• Subjects: Aged; all-cause mortality; arteriovenous fistula; Arteriovenous Shunt, Surgical - adverse effects; Blood flow; Blood Flow Velocity; Cardiovascular diseases; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Clinical outcomes; Diabetes mellitus; effective blood flow rate; Female; Hemodiafiltration - adverse effects; Hemodiafiltration - methods; Hemodialysis; Hemodialysis and Peritoneal Dialysis; Humans; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - therapy; major adverse cardiovascular events; Male; Middle Aged; Mortality; Patients; Proportional Hazards Models; Renal Dialysis; Retrospective Studies; Treatment Outcome; effective blood flow rate; major adverse cardiovascular events; Hemodialysis; arteriovenous fistula; all-cause mortality
• ISSN: 0886-022X; 1525-6049
• DOI: 10.1080/0886022X.2024.2344655

The association between blood flow rate (BFR) and clinical outcomes in patients undergoing maintenance hemodialysis (MHD) is inconclusive. This retrospective study included 175 patients undergoing MHD treatment between July 2015 and March 2022, divided into two groups based on time-averaged effective blood flow rate (eBFR) median value. We investigated arteriovenous fistula (AVF) outcomes and the association of eBFR with all-cause mortality and new major adverse cardiovascular events (MACE). Mean ± SD and median time-averaged eBFR values were 276 ± 24 and 275 mL/min, respectively. After adjusting for relevant factors including age, sex, vintage, diabetes, CVD, receiving hemodiafiltration (HDF) treatment and spKt/V, Cox models indicated a low time-averaged eBFR (≤ 275 ml/min) was associated with increased risks of all-cause mortality (hazard ratio [HR] 14.18; 95% confidence interval [CI], 3.14-64.1) and new MACE (HR 3.76; 95% CI, 1.91-7.40) in MHD patients. Continuous Cox models demonstrated each 20 ml/min increase in eBFR linked to a 63% decrease in the risk of all-cause mortality (HR: 0.37, 95% CI: 0.23-0.59) and a 38% decrease in the occurrence of new MACE (HR: 0.62, 95% CI: 0.46-0.84). There was no significant difference in AVF outcomes between the two groups. Our study noted higher eBFR (>275 mL/min) is associated with lower risks of both all-cause mortality and new MACE compared with low eBFR (≤275 mL/min). Increased eBFR is not associated with a higher risk of AVF failure.