Abstract
Abstract
Background
Kt/V is the most widely used index for assessing dialysis adequacy in maintenance hemodialysis. Because it normalizes urea clearance to the urea distribution volume, its numerical value is influenced by body size and composition. Whether the association between Kt/V and mortality differs according to sex and age remains uncertain. We therefore investigated this association using a nationwide dialysis registry.
Methods
We conducted a prospective cohort study using the 2010 Japanese Renal Data Registry linked to one-year outcomes in 2011. A total of 169,963 adults receiving HD or HDF three times weekly were included. Single-pool Kt/V (spKt/V) was analyzed as both a categorical and continuous variable. Associations with all-cause mortality and interactions with sex and age group (
Results
Among 169,963 patients, 11,866 deaths occurred. Women had higher mean spKt/V than men in every age group. Compared with spKt/V 1.2–P
Conclusions
The association between spKt/V and all-cause mortality varied according to sex and age. These findings suggest that sex and age provide relevant context when interpreting spKt/V, but they do not establish subgroup-specific treatment targets or a causal effect of increasing dialysis dose.