The influence of mortality rate from membrane flux for end-stage renal disease: A meta-analysis

To evaluate the influence of the high-flux hemodialysis (HFHD) and the low-flux hemodialysis (LFHD) on mortality rate for end-stage renal disease (ESRD). Four electronic databases including PubMed, EMBASE, the Cochrane Library, and ClinicalTrails were searched to identify relevant randomized clinical trials up to 31 August 2015. Seven studies enrolling a total of 4412 patients were included in this meta-analysis. For all-cause mortality comparing with LFHD, the result showed that there were significant difference (RR = 0.75; 95% CI [0.60-0.94]; I2 = 84%; P < 0.00001). For death due to infection comparing with LFHD, the result showed that there was no significant difference (RR = 0.92; 95% CI [0.75-1.13]; I2 = 0%; P = 0.86). For cardiovascular mortality, the overall meta-analysis result showed that there was a significant difference between the HFHD versus the LFHD (RR = 0.75; 95% CI [0.60-0.94]; I2 = 55%; P = 0.11). Publication bias was not detected by funnel plot. Based on these results, our study suggests that the HFHD has superior effectiveness over LFHD for long-term survival in ESRD.