Shortening of the hemodialysis procedure and mortality in "healthy" dialysis patients.
The influence of shortening chronic hemodialysis on mortality was studied by following cumulative survival in "ideal" nondiabetic dialysis patients, who had no other diseases besides their renal disease when beginning dialysis. It was hoped that thereby problems of shortening dialysis could be separated from problems inherent in the patient. Otherwise healthy dialysis patients (n = 556) were divided into age groups (less than 50, 51-75, and greater than 75 years) and studied during four periods, 1966-75, 1976-82, 1983-85, and 1986-88. Dialysis time was shortened from 17 to 2.7 hr per treatment during that time, but a Kt/V of 1.3 maintained. Generally, both first- and four-year cumulative survival improved as dialysis was shortened, and four-year cumulative survival was best in all age groups during 1986-88 when dialysis was shortest. During this time, the four-year cumulative survival was no different from that of the age-matched total U.S. population. Shortening of dialysis time and increasing efficiency while keeping at least a 4.0, stable, weekly Kt/V has not been harmful to healthy patients on dialysis, but has led to continued improvement on cumulative survival.
Collins
A J
AJ
Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota 55415.
Kjellstrand
C M
CM
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D015996:Survival Rate; D013997:Time Factors