Abe M, Masakane I, Wada A, et al. - Findings indicate that a reduction in mortality might be achieved with the use of super high-flux dialyzers in patients receiving hemodialysis. To clarify if these type V dialyzers can improve prognosis, randomized controlled trials are warranted.

• This is a nationwide prospective cohort study utilizing data from Japanese Society for Dialysis Therapy Renal Data Registry.

• Participants were 242,467 patients receiving maintenance hemodialysis, divided into 5 groups based on dialyzer type.

• The estimated hazard ratios (HRs) for mortality were significantly higher for type I, II, and III dialyzers vs type IV dialyzer (reference) post-adjustment for basic factors and further adjustment for dialysis-linked factors.

• There was significantly higher HR for type I, but significantly lower for type V, following further adjustment for nutrition- and inflammation-associated factors.

• These significant revelations were also evident following propensity score matching.