Early clinical, quality-of-life, and biochemical changes of "daily hemodialysis" (6 dialyses per week).
BACKGROUND
Advantages associated with an increased frequency of hemodialysis have been reported previously. However, previous studies were either small or not controlled and did not detail early clinical, biochemical, quality-of-life, urea kinetic, and dynamic changes when patients switched from a conventional (3 times/wk) dialysis regimen to "daily" (6 times/wk) dialysis therapy when total weekly dialysis time was unchanged.


METHODS
A prospective sequential study with 21 patients as their own controls was performed. A 4-week period of conventional thrice-weekly dialysis (N = 240 treatments) was followed immediately by a 4-week period of daily (ie, 6 times/wk) dialysis (N = 480 treatments), in which each treatment was half the length of a conventional dialysis treatment session. Clinical parameters and symptoms during and between dialysis treatments were graded, and urea-related parameters, blood chemistry results, and nutritional data were determined.


RESULTS
Within 4 weeks of switching to this daily dialysis regimen, there were improvements in blood pressure, dialysis "unphysiology," intradialytic and interdialytic symptoms, and urea kinetics and dynamics. There were fewer machine alarms and less need for nursing interventions during dialysis. Nutrition and quality of life began to improve. There was no increase in blood access complications and no significant changes in blood chemistry results, hematologic parameters, or use of medications.


CONCLUSIONS
In this short-term study, daily dialysis appears to be a safe, better, and more physiological method to deliver dialysis care to patients with end-stage renal disease.
Williams
Amy W
AW
Mayo Clinic, Rochester, MN 55905, USA. amy.williams@mayo.edu
Chebrolu
Srivasa B
SB
Ing
Todd S
TS
Ting
George
G
Blagg
Christopher R
CR
Twardowski
Zbylut J
ZJ
Woredekal
Yalem
Y
Delano
Barbara
B
Gandhi
Vasant C
VC
Kjellstrand
Carl M
CM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001774:Blood Chemical Analysis; D001806:Blood Urea Nitrogen; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D006435:Renal Dialysis; D013997:Time Factors