Abstract: Objective To explore the impact of blood flow rate(BFR) on all-cause mortality in chronic hemodialysis(HD) patients.Methods A total of 405 HD patients were selected from CNRDS(Chinese National Renal Data System).According to the median value of BFR,they were assigned into two groups of BFR≤213.7 mL/min and ＞213.7 mL/min.The primary endpoint was all-cause mortality.Results Among them,341(84.2%) patients had BFR of 200-250 mL/min.The mortality of patients was 49(24.3%) in BFR≤213.7 mL/min and 26(12.8%) in BFR＞213.7 mL/min.BFR was an independent risk factor of mortality.Higher BFR was associated with a decline in all-cause mortality risk(HR:0.974,95%CI:0.957-0.992,P=0.004).Optimal cut-off BFR was 211.35 mL/min.According to multivariate Cox regression analyses,the impact of BFR on mortality was more prominent in patients on a high flux dialyzer,nondiabetic and age＜60 year.Conclusion Within a range of 180-250 mL/min,higher BFR is independently associated with a lower risk of all-cause mortality in chronic HD patients.