Comparison of survival for super high-flux hemodialysis (SHF-HD) with high albumin leakage versus online hemodiafiltration or SHF-HD with low albumin leakage: the SUPERB study

Abstract Background Survival is equivalent between super high-flux hemodialysis (SHF-HD) and online hemodiafiltration (OHDF) with similar albumin leakage. According to the 2013 Japanese dialyzer performance classification, survival on HD optimal when a type II (β 2 -microglobulin clearance ≥ 70 mL/min) used. Here, we investigated whether could be improved by SHF-HD using II-b (sieving coefficient for 0.03) high leakage compared OHDF or II-a < low Methods This 3-year retrospective observational propensity score-matched study included 738 patients receiving ( n = 310) 428) at our institution April 1 July 1, 2017. Three-year all-cause mortality was estimated (EAL) versus EAL. Kaplan–Meier curves were log-rank test hazard ratios calculated Cox regression analysis. Results Mortality in EAL significantly lower than (each 52 after matching; P 0.007, test). All dialyzers used polyethersulfone (PES) membrane, whereas none of hemodiafilters had PES membrane. In SHF-HD, 3.0 g/session 115 matching, 0.004, test) rather 133 0.001, Conclusions These findings suggest that better dialyzers. The may also have beneficial effect survival.