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Quantifying daily hemodialysis.

Authors: Thomas A, Depner; Adarsh, Bhat;

Quantifying daily hemodialysis.

Abstract

Nearly all published reports and clinical studies of hemodialysis solute kinetics are confined to thrice-weekly dialysis schedules. Over the past 40 years, clinical experience with dialysis treatments given three times per week has expanded enormously, but it was not until the Hemodialysis (HEMO) study results were revealed that nephrologists became fully aware of the limits of usefulness of infrequent dialysis. In light of continued reports of improved quality of life and survival with daily dialysis, it appears that the limits of thrice-weekly dialysis may be extended when treatments are given more often. Analysis of solute kinetics during and between dialyses supports the notion that a more frequent schedule delivers more efficient dialysis and that methods can be developed to allow a comparison of risks among patients treated 3-7 days per week. One such method, based on the concept of solute seclusion, suggests that at the currently established minimum standard dose, approximately 50% of the improvement in solute control afforded by seven treatments per week is achieved by increasing the frequency to four treatments per week. The same model shows that seven treatments per week afford an improvement in solute control that is approximately 80% as effective as continuous dialysis. These conclusions are similar to those derived from a completely different model based on peak concentration toxicity. Neither of these models has been clinically tested, so caution must be advised when treating individual patients.

Related Organizations
Keywords

Appointments and Schedules, Renal Dialysis, Quality of Life, Humans, Kidney Failure, Chronic, Hemodialysis Solutions

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Found an issue? Give us feedback
selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
30
Average
Top 10%
Top 10%
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