NDT Advance Access published online on April 21, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl171
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1 Department of Internal Medicine, Division of Nephrology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
* To whom correspondence should be addressed. Background. In conventional haemodialysis (CHD), the morbidity and mortality rate is unacceptably high; consequently, variations in the length and frequency of the haemodialysis sessions have been studied to reduce the complications of dialysis treatment. In this sense, high-efficiency short daily haemodialysis (SDHD) has been proposed as an alternative for patients on renal replacement therapy. In this study, we have related our experience with this dialysis modality. Methods. Twenty-six patients (16 males, mean age 35.6 ± 14.7 years) were treated by SDHD for 33.6 ± 18.5 months (range 6-57 months). The mean time on CHD before the switch to SDHD was 25.5 ± 31.9 months (range 1-159 months). In 23 (88.5%) patients, native arteriovenous fistulae were used for vascular access. SDHD was performed six times a week, 1.5-2 h per session, and high flux polysulfone dialysers (surface area: 1.8 m2) were employed. The blood flow and dialysate flow rate were 350 and 800 ml/min, respectively. Results. In this trial, the patient survival was 100%. The vascular access survival after 12, 24, 36 and 48 months on SDHD was 100, 89, 89 and 80%, respectively. There were three failures of vascular access in 72.7 patient-years (0.04 failures/patient-year). In 15 patients on SDHD during 36 consecutive months, the vascular access survival after 12, 24, 36 and 48 months was 100, 93, 93 and 84%, respectively. Also, in this group of patients, there were 0.27 hospitalizations/patient-year and 1.24 days of hospitalizations/patient-year. Conclusions. We concluded that in a long-time study of patients on SDHD the morbidity and mortality rate is very low. Furthermore, we observed that failures of vascular access are not a significant problem. Consequently, we believe that SDHD is a powerful renal replacement therapy for treatment of patients on maintenance haemodialysis.
Received December 5, 2005
Accepted March 15, 2006
Original Article
High-efficiency short daily haemodialysis--morbidity and mortality rate in a long-term study
Manuel Carlos Martins Castro 1 *,
Cláudio Luders 1,
Rosilene Motta Elias 1,
Hugo Abensur 1,
and
João Egidio Romão Junior 1
Manuel Carlos Martins Castro, E-mail: crica.dialise{at}hcnet.usp.br
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