Daily HD does not harm accesses – a prospective, controlled study

A 4-year study was done of 51 on standard HD (3x4 hours) vs 23 on daily HD (6x3 hours). The standard HD group had 543.2 access procedures/1000 patient years; the daily group had 400.8. Adjusting for age, gender, diabetes, phosphorus level, and anemia, there were no significant differences in number of procedures or time to first access revision.

Read the abstract » | (added 2013-04-29)

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Long-term effects of daily HD on vascular access

Does more frequent use of a vascular access create problems for those who do short daily HD? A new 4-year prospective, randomized study of 77 people says NO. Patients did six 3-hour HD sessions per week (n=26) or three 4-hour sessions (n=51). There were fewer access procedures in the daily group (543.2 per 1000 patient years, vs. 400.8), though this difference was not significant. There was also no difference in time to first access revision or access failure.

Read the abstract » | (added 2012-10-25)

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A prospective study of 4 vs. 8 hours of HD in-center 3 times a week

Which is better, standard HD or more HD? A new study matched 247 people who agreed to try nocturnal in-center HD with people on standard HD. A year later, survival rates were 3.5 times higher (and hospital stays were lower) with more HD. Heart health and cognitive function were far better with more HD, too, while quality of life dropped in the standard HD group. (Now, why are we NOT surprised?)

Read the abstract » | (added 2011-05-23)

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High ultrafiltration (UF) rates stress the heart

Standard in-center HD requires high UF rates to remove fluid. A 5-year prospective study of 287 dialyzors from 2007 found this is a BAD idea. During the study, 149 patients died—69% due to heart problems. Survival was better with UF less than 12.37 ml/h/kg—which is much more doable at home.

Read the abstract » | (added 2011-02-24)

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Does dialysis time matter? YES!

Perhaps if in-center folks got more HD, they would see that they feel better—and think about home. Per Drs. Lacson and Lazarus from Fresenius, "Compelling rationale and recent outcome data support use of longer Td [dialysis time]...Until such time that results from prospective randomized trials are available, we believe that physicians should prescribe and exert all efforts to convince thrice-weekly hemodialysis patients to accept 4 h as minimum Td."

Read the abstract » | (added 2011-02-24)

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