Daily hemodialysis: a dialysis provider perspective.
Regardless of size, ownership or corporate structure, the goal of the dialysis provider is to deliver the best renal substitution therapy in the safest and most convenient manner, at a cost commensurate with reimbursement. This paper reviews the available data on daily hemodialysis, focusing on its ability to satisfy this goal. In addition, it examines the potential influence of frequency, time, and dose of dialysis on clinical outcomes of various series over the last 3 decades. The available data strongly suggest the clinical benefits of daily hemodialysis, but are not sufficient to show statistically better outcomes. Under the present reimbursement system, daily hemodialysis is not economically feasible in the United States. Prospective clinical trials designed to prove the benefits of these therapies and justify their reimbursement are needed.
Diaz-Buxo
J A
JA
Fresenius Medical Care North America, Charlotte, NC, USA. jose.diaz-buxo@fmc-na.com
Lacson
E
E
D001071:Appointments and Schedules; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D006435:Renal Dialysis