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Reported February 8, 2013

The Risk of Frequent Dialysis


(Ivanhoe Newswire) -- Approximately two million patients in the world, receive dialysis treatments. Compared with standard dialysis, frequent dialysis can cause complications related to repeated access to the blood, requiring patients to undergo more repair procedures to the site through which blood is removed and returned.
To investigate, Rita Suri, MD (Western University and Lawson Health Research Institute, in London, Canada) and her colleagues conducted two separate 12-month clinical trials in which they randomly assigned 245 patients to receive either in-center daily hemodialysis (6 days/week) or conventional hemodialysis (3 days/week) and 87 patients to receive either home nocturnal hemodialysis (6 nights/week) or conventional hemodialysis. Three access events were recorded: repair, loss, and access-related hospitalizations.
In the Daily Trial, 77 (31%) of 245 patients experienced one of these events, with the daily group having 33 repairs and 15 losses and the conventional group having 17 repairs, 11 losses, and 1 hospitalization.
Overall, the risk for an access event was 76% higher with daily hemodialysis compared with conventional hemodialysis.
Similar trends were seen in the Nocturnal Trial, although the results were not statistically significant.
"Our study is the first randomized trial to show that dialyzing more frequently may have potential harmful effects on the hemodialysis vascular access. This has important implications for patients and physicians considering or performing frequent hemodialysis," said Dr. Suri.
SOURCE: Journal of the American Society of Nephrology (JASN), February, 2013

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