NDT Advance Access originally published online on September 16, 2005
Nephrology Dialysis Transplantation 2006 21(1):166-175; doi:10.1093/ndt/gfi116
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Original Articles: Dialysis and Transplantation
A crossover study of short daily haemodialysis
1 University of Utah School of Medicine, Salt Lake City, UT, USA, 2 Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA and 3 Emory University School of Medicine, Atlanta, GA, USA
Correspondence and offprint requests to: Alexander S. Goldfarb-Rumyantzev, Division of Nephrology and Hypertension, University of Utah Health Sciences Center, 85 North Medical Drive, East Rm 201, Salt Lake City, UT 84112, USA. Email: alex.goldfarb{at}hsc.utah.edu
Background. The benefits of daily haemodialysis (DHD) compared to conventional three times per week haemodialysis (CHD) have been described in a number of observational studies. Most of these previous studies however have not been performed with rigorous controls.
Methods. We performed a crossover study following an A-B-A design: phase A was 4 weeks of thrice weekly dialysis, 3–4 h per treatment (CHD); phase B was 8 weeks of six times/week dialysis, each session being one-half of the usual time (DHD) and phase A with 4 weeks of thrice weekly dialysis (CHD) was repeated. Patients characteristics: n = 12, six males; age 52±18 years, six diabetics.
Results. Weekly single-pool Kt/V, equilibrated Kt/V and standard Kt/V of urea, and ß-2-microglobulin clearance values were greater during DHD. Eight of 12 patients who completed the study reported symptomatic benefits from DHD that partially or completely disappeared during the second period of CHD. Quality of life of patients improved during DHD. Three patients had problems with arteriovenous access during DHD. Average blood pressure was lower during DHD (systolic 139.5±22.7 mmHg) compared to the initial (147.7±21.4 mmHg, P<0.001) and last (146.4±20.0 mmHg, P<0.005) CHD periods. No significant changes in predialysis haemoglobin and the serum concentration of albumin, phosphate, ß-2-microglobulin or B-type natriuretic peptides (BNP) were observed, although BNP trended downward during DHD and returned to baseline level during the second period of CHD. The dose of erythropoietin did not change significantly. Patient compliance with the dialysis schedule was lower during DHD. Dialysis staff perceived an increased workload but felt that the patients benefited medically from DHD.
Conclusions. The results of this cross-over study suggest symptomatic benefits and decrease in blood pressure, but there are potential problems with compliance and vascular access during DHD.
Keywords: blood pressure; daily haemodialysis; outcome; quality of life; quotidian haemodialysis; urea kinetics
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Vartia Effect of treatment frequency on haemodialysis dose: comparison of EKR and stdKt/V Nephrol. Dial. Transplant., September 1, 2009; 24(9): 2797 - 2803. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Okuno, E. Ishimura, K. Kohno, Y. Fujino-Katoh, Y. Maeno, T. Yamakawa, M. Inaba, and Y. Nishizawa Serum {beta}2-microglobulin level is a significant predictor of mortality in maintenance haemodialysis patients Nephrol. Dial. Transplant., February 1, 2009; 24(2): 571 - 577. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Punal, L. V. Lema, D. Sanhez-Guisande, and A. Ruano-Ravina Clinical effectiveness and quality of life of conventional haemodialysis versus short daily haemodialysis: a systematic review Nephrol. Dial. Transplant., August 1, 2008; 23(8): 2634 - 2646. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. G. Achinger and J. C. Ayus Left Ventricular Hypertrophy: Is Hyperphosphatemia among Dialysis Patients a Risk Factor? J. Am. Soc. Nephrol., December 1, 2006; 17(12_suppl_3): S255 - S261. [Abstract] [Full Text] [PDF]
|
|