Doubling Frequency of Hemodialysis Improves Survival Rates
Wednesday January 5, 2011
Daily hemodialysis improves survival rates and other health outcomes compared with receiving hemodialysis three days a week, according to a recent paper in the New England Journal of Medicine.
The Frequent Hemodialysis Network Daily Trial assigned 225 chronic hemodialysis patients to receive hemodialysis either three days a week, as is customary, or six days a week.
The study authors measured death plus change in left ventricular mass, as measured by cardiac MRI; and death plus change in the physical health composite outcome score of the 36-item RAND health survey.
Among patients receiving frequent hemodialysis, five died and 11 underwent a kidney transplant. Those numbers compared with nine deaths and 13 transplants in the conventional hemodialysis group.
Patients in the frequent hemodialysis group scored better in both primary measures, indicating that frequent hemodialysis reduces the risk of death, increased left ventricular mass and deteriorating physical health. They also had better control of hypertension and phosphate levels.
However, patients in the conventional hemodialysis group fared better in the rate of interventions related to vascular access. The authors write that the overall effects of frequent hemodialysis must be placed in the context of the added costs and burden on patients before anyone can make formal recommendations for changes in practice.
To comment, e-mail editorNTL@gannetthg.com.
http://news.nurse.com/article/20110105/ALL01/110106004/-1/frontpage