Comparison of mortality on hemodiafilter materials in online hemodiafiltration

Abstract Background Although mortality is significantly lower with polyethersulfone (PES) membrane compared with polysulfone (PS) membrane in hemodialysis patients, no studies have investigated mortality in patients undergoing online hemodiafiltration (OHDF) according to the types of membrane materials. Methods The retrospective observational study included 411 patients who were receiving OHDF with PES membrane ( n = 190), PS membrane ( n = 121), and asymmetric triacetate (ATA) membrane ( n = 100) at our facilities on 1 July 2017. The 3-year all-cause mortality on PES membrane was compared with PS and ATA membranes using a propensity score matching model and Cox regression analysis with adjustments. Results The mortality was significantly lower in PES membrane compared with PS membrane ( P = 0.012, log-rank test; hazard ratio 0.265, 95% confidence interval [CI] 0.087–0.806). However, Cox regression analysis with adjustments revealed no significant difference. On the other hand, the mortality was not significantly different between PES and ATA membranes. Conclusion These findings suggest that the mortality on PES membrane was not significantly different to mortality on PS and ATA membranes in OHDF patients. Trial registration UMIN Clinical Trials Registry, UMIN000050953. Registered 28 April 2023, Prospectively registered, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000058078 and UMIN000051791 Registered 2 August 2023, Prospectively registered, https://center6.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000059102 .