The authors investigated the influence of Kt/V and protein catabolic rate (PCR) on dialysis failure for 689 hemodialysis (HD) outpatients treated at the seven dialysis facilities in Aichi Prefecture, Japan. Dialysis failure was defined as death or hospitalization for reasons other than blood access, accident, wound, or mental disease. Patients were followed for 2 years. The rate of patients who developed dialysis failure during the observation period relative to the total patient population was defined as the dialysis failure rate. A total of 123 patients developed dialysis failure, which was fatal in 33 cases. In patients with Kt/V values of 1.6 or higher, the mean dialysis failure rate was significantly lower at 12.0% than that (19.2%) of patients with Kt/V values between 0.8 and 1.6 (p < 0.04). In patients that had PCR values under 0.8 g/kg/day, the dialysis failure rate was significantly higher at 32.5% than that (15.8%) of patients with PCR values between 0.8 and 1.4 g/kg/day (p < 0.0001).
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