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논문분류	춘계학술대회 초록집
제목	Time-Varying Ultrafiltration Rate and Mortality in Hemodialysis Patients: a Nationwide Prospective Cohort in Korea
저자	You Hyun Jeon
출판정보	2026; 2026(1):
키워드	cardiovascular mortality, hemodialysis, mortality, ultrafiltration rate
초록	Objectives: Patients undergoing maintenance hemodialysis experience markedly elevated mortality, predominantly driven by cardiovascular disease. Higher ultrafiltration rate (UFR) may represent a potentially modifiable determinant of adverse outcomes. Therefore, we examined its association with mortality in an Asian hemodialysis cohort. Methods: We analyzed incident hemodialysis patients from a nationwide prospective cohort in Korea and categorized participants into five groups according to baseline UFR. The primary outcome was all-cause mortality, with cardiovascular and non-cardiovascular mortality as secondary outcomes. Associations between UFR and mortality were evaluated using time-dependent Cox regression and marginal structural models to account for time-varying exposure. Sensitivity analyses using alternative modeling approaches and subgroup analyses were performed to assess the consistency of the findings. Results: Among 2,411 hemodialysis patients, 943 deaths (39.1%) occurred. In time-dependent competing risk models, UFR >14.5 mL/kg/h was associated with higher all-cause mortality (adjusted harard ratio [aHR] 1.494, 95% confidence interval [CI] 1.001–2.227, P = 0.049) and cardiovascular mortality (aHR 2.190, 95% CI 1.090–4.400, P = 0.028), but not non-cardiovascular mortality (Table 1). The association persisted after accounting for time-varying confounding using marginal structural models (all-cause mortality. aHR 1.587, 95% CI 1.075–2.343, P = 0.020; cardiovascular mortality, aHR 2.013, 95% CI 1.008–4.020, P = 0.047; Table 2). Similar patterns were observed across multiple sensitivity analyses and clinically relevant subgroups. Conclusion: In this nationwide cohort of Asian patients undergoing hemodialysis, higher UFR was independently associated with increased all-cause and cardiovascular mortality, particularly above 14.5 mL/kg/h. Further studies are warranted to determine whether modification of UFR improves clinical outcomes.
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