title: Association of initial twice-weekly hemodialysis treatment with preservation of residual kidney function in ESRD patients.
abstract: BACKGROUND
  Residual kidney function (RKF) has consistently been a predictor of greater survival in maintenance hemodialysis (MHD) patients. The relationship between hemodialysis (HD) treatment frequency and RKF preservation has not been well examined. We hypothesized that initial twice-weekly HD helps in maintaining a longer RKF.
  
  
  METHODS
  In a dialysis center in Shanghai, 168 ESRD patients were screened and finally 85 patients were identified for this main cohort study. We first examined these 85 MHD patients; 30 of them were initiated with twice-weekly HD for 6 months or longer and 55 patients were started and maintained on thrice-weekly HD treatment. Then a subcohort study in 48 incident MHD patients was implemented to assess the independent risk factors responsible for RKF decline during the first year of HD therapy. Multivariate logistic regression analysis was then employed to examine the odds ratio of RKF loss.
  
  
  RESULTS
  The main cohort study showed that the clinical outcomes were almost the same between the two groups in 85 patients, but the percent of patients with RKF loss was significantly lower in the twice-weekly group compared with the thrice-weekly group, especially during the first year of HD initiation. In the 48 incident MHD patients, we found no significant differences between the two groups except for variations in the HD frequency, weekly Kt/V. The multivariate analysis showed that factors such as the male gender, HD frequency, URR and intradialytic hypotension episode were associated with RKF loss, and the odds ratio of RKF loss for each additional HD treatment per week was 7.2.
  
  
  CONCLUSIONS
  Twice-weekly HD during the first year of dialysis therapy appears to be associated with better RKF preservation.
authors.affiliation: Division of Nephrology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Minmin
authors.initials: M
authors.lastname: Zhang
authors.forename: Mengjing
authors.initials: M
authors.lastname: Wang
authors.forename: Haiming
authors.initials: H
authors.lastname: Li
authors.forename: Ping
authors.initials: P
authors.lastname: Yu
authors.forename: Li
authors.initials: L
authors.lastname: Yuan
authors.forename: Chuanming
authors.initials: C
authors.lastname: Hao
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
mesh_terms: D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy* / Q000652:urine; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D014508:Urea / Q000097:blood; D014556:Urine
chemical_list: D014508:Urea