{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:10:35Z","timestamp":1791612635511,"version":"4.3.4"},"reference-count":34,"publisher":"S. Karger AG","issue":"12","license":[{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Blood Purif"],"abstract":"<jats:p>&lt;p&gt;Introduction: Survival is a core outcome of hemodialysis (HD) therapy. Expanded hemodialysis (HDx) enabled by Theranova dialyzer increases clearance of medium-sized molecules and was reported to improve various patient-reported outcomes compared to HD using high-flux membranes, but the impact on survival is unclear. Herein, we evaluated the risk of death for HDx versus high-flux HD over a 4-year follow-up period. Methods: This is a multicenter, retrospective cohort study in adult prevalent chronic HD at Renal Care Services \u2013 Colombia starting between September 1, 2017, and November 30, 2017, with follow-up for up to 4 years. The sociodemographic and clinical characteristics of all patients were summarized descriptively. The Fine-Gray subdistribution hazard model was employed to evaluate the sub-hazard ratio of factors associated with time to death from causes other than COVID-19; death attributable to COVID-19 was considered as a competing risk. Sensitivity analyses included Cox proportional hazards model, extended Cox regression, and Cox regression after adjusting for imbalances between cohorts using the inverse probability of treatment weighting method. Results: We evaluated 1,092 patients, 559 in HDx cohort and 533 in high-flux HD cohort; the mean age 61 years; 42% had diabetes, and 19% had cardiovascular disease. HDx using the Theranova dialyzer had a protective effect with reduction of mortality risk when controlling for confounding variables, SHR = 0.79 [95% CI: 0.62\u20130.98, p = 0.035]. Sensitivity analyses also showed a statistically significant beneficial effect of HDx versus high-flux HD. Conclusions: HDx enabled by Theranova dialyzer was associated with an approximately 21% reduction in mortality risk compared to treatment with high-flux HD in patients followed for up to 4 years. It would be desirable for these very promising results to be corroborated by a randomized controlled trial, with sufficient follow-up time to investigate the effect described in this study. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000548158","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T16:01:04Z","timestamp":1756396864000},"page":"772-781","source":"Crossref","is-referenced-by-count":4,"title":["Survival Differences in Patients with High-Flux Hemodialysis versus Expanded Hemodialysis: A Cohort Study"],"prefix":"10.1159","volume":"54","author":[{"given":"Juan 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