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NDT Advance Access originally published online on December 22, 2004
Nephrology Dialysis Transplantation 2005 20(2):278-284; doi:10.1093/ndt/gfh304
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Nephrol Dial Transplant Vol. 20 No. 2 © ERA–EDTA 2004; all rights reserved

Personal Opinion

The HEMO Study: applicability and generalizability

Michael V. Rocco1, Alfred K. Cheung2, Tom Greene3 and Garabed Eknoyan4 for the Hemodialysis (HEMO) Study Group5

1 Wake Forest University School of Medicine, Winston-Salem, North Carolina, 2 Veterans Affairs Salt Lake City Health Care System and University of Utah, Salt Lake City, Utah, 3 Cleveland Clinic Foundation, Cleveland, Ohio, 4 Baylor College of Medicine, Houston, Texas and 5 National Institutes of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland, USA

Correspondence and offprint requests to: Michael V. Rocco, MD, MSCE, Wake Forest University School of Medicine, Department of Internal Medicine/Nephrology, Medical Center Boulevard, Winston-Salem, NC 27157-1053, USA. E-mail: mrocco@wfubmc.edu

Keywords: clinical trial; dialysis dose; dialysis flux; haemodialysis; hospitalizations; mortality

The first 150 words of the full text of this article appear below.



   Introduction
 
The 2002 Lasker Clinical Medical Research Award honoured Willem Kolff and Belding Scribner, whose seminal work changed kidney failure from a fatal to a treatable disease. What began as exploratory efforts to sustain life and relieve uraemic symptoms in selected patients now provides chronic life-saving replacement therapy to millions of people worldwide. Continued improvements in clinical expertise, accrued scientific information and technical advances have improved dialytic therapy and outcomes. Unfortunately, despite this encouraging trend, there remain significant differences in clinical practice and less than optimal patient outcomes. The annual mortality rate of dialysed patients, albeit variable among different countries, remains unacceptably high. Although medical comorbidities and late referral of patients to nephrologists may contribute to this high mortality rate, the dialytic prescription can also influence mortality. To address this latter concern, national guidelines for dialysis therapy have been developed, but are based, to a great extent, on observational studies and . . . [Full Text of this Article]



   Study design and conduct
 


   Generalizability
 


   Inclusion of prevalent patients
 


   Implications for other interventions
 


   Dose by flux interaction
 


   Statistical power
 


   Conclusions
 

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