COMPARATIVE STUDY ON HIGH FLUX AND LOW FLUX DIALYSIS ENHANCING DIALYSIS ADEQUACY AND SURVIVAL RATE

Abstract

Background: Kidney failure in its final stage, end-stage renal disease (ESRD), leaves patients completely dependent on haemodialysis just to stay alive. The type of dialysis membrane used in this process is not a small detail. Objective: This study set out to compare dialysis adequacy and patient survival outcomes between those on maintenance haemodialysis using high-flux dialyzers and those using low-flux dialyzers. Methods: An observational, analytical study was carried out over four months at Muhammad Sulman Khalid (MSK) Hospital, Lahore. The patients who were recruited were 27 in total and they had ESRD and were on maintenance haemodialysis for 3 months or more, via purposive sampling. The inclusion criteria were that patients had to be older than 18 years and have good conditions of health and informed consent, and that they were excluded if they were in active infections, recent hospitalizations, cancer or severe medical complications. Data was collected through a Literature-based and expert-developed structured questionnaire as well as the patient's medical records. Dialysis adequacy was measured through Kt/V, and associations between dialyzer type and eleven clinical variables were tested using Chi-square and Fisher's Exact tests, with the latter applied wherever expected cell counts dropped below five. Results: The sample of 27 patients was split nearly evenly, with 14 on low-flux dialyzers (51.9%) and 13 on high-flux (48.1%). All of the patients were diagnosed with hypertension and diabetes mellitus was documented in 81.5%, while approximately 48% of them had cardiovascular disease. Most patients had access via arteriovenous fistula (77.8%) and serum albumin levels were normal in 96.3%. Of the seven variables tested with regards to the dialysis adequacy (Kt/V) (p < .05); cardiovascular disease, session time, blood flow rate, urea, creatinine, and potassium (p < .05) emerged as statistically significant variables among the associations considered. The strongest signal came from blood flow rate, p < .001. Conclusion: High-flux dialysis produced significantly better dialysis adequacy and solute clearance compared to low-flux dialysis among ESRD patients in this sample. Keywords: haemodialysis, high-flux dialyzer, low-flux dialyzer, end-stage renal disease.