title: The Association Between Conversion to In-centre Nocturnal Hemodialysis and Left Ventricular Mass Regression in Patients With End-Stage Renal Disease.
abstract: BACKGROUND
  In-centre nocturnal hemodialysis (INHD, 7-8 hours/session, 3 times/week) is an increasingly utilized form of dialysis intensification, though data on the cardiovascular benefits of this modality are limited.
  
  
  METHODS
  In this prospective cohort study, we enrolled 67 prevalent conventional hemodialysis (CHD, 4 hours/session, 3 times/week) recipients at 2 medical centres in Canada, of whom 37 converted to INHD and 30 remained on CHD. The primary outcome was the change in left ventricular mass (LVM) after 1 year as assessed by cardiac magnetic resonance imaging. Secondary outcomes included changes in serum phosphate concentration, phosphate binder burden, haemoglobin, erythropoiesis stimulating agent usage, and blood pressure.
  
  
  RESULTS
  Conversion to INHD was associated with a 14.2 (95% confidence interval [CI] 1.2-27.2) g reduction in LVM as compared with continuation on CHD. This result was maintained after adjustment for baseline imbalances between the groups and in ancillary analyses. There was a trend toward a larger drop in systolic blood pressure (9.8 [95% CI, -1.4-20.9] mm Hg) among INHD recipients with a significant reduction in the number of prescribed antihypertensive agents (0.7 [95% CI, 0.3-1.1] agents). Serum phosphate declined by 0.40 (95% CI, 0.16-0.63) mmol/L among INHD recipients without any difference in calcium-based phosphate binder requirements, as compared with those who remained on CHD.
  
  
  CONCLUSIONS
  Compared with continuation of CHD, conversion to INHD was associated with significant LVM regression and reduction in serum phosphate concentration at 1 year.
authors.affiliation: Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada. Electronic address: waldr@smh.ca.
authors.forename: Ron
authors.initials: R
authors.lastname: Wald
authors.affiliation: Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Marc B
authors.initials: MB
authors.lastname: Goldstein
authors.affiliation: Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Perl
authors.affiliation: Division of Nephrology, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Mercedeh
authors.initials: M
authors.lastname: Kiaii
authors.affiliation: Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Darren
authors.initials: D
authors.lastname: Yuen
authors.affiliation: Divisions of Cardiology and Medical Imaging, University Health Network, Toronto, Ontario, Canada.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Wald
authors.affiliation: Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Ziv
authors.initials: Z
authors.lastname: Harel
authors.affiliation: Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Jordan J
authors.initials: JJ
authors.lastname: Weinstein
authors.affiliation: Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Baruch
authors.initials: B
authors.lastname: Jakubovic
authors.affiliation: Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada; Division of Cardiology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Howard
authors.initials: H
authors.lastname: Leong-Poi
authors.affiliation: Department of Medical Imaging, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Anish
authors.initials: A
authors.lastname: Kirpalani
authors.affiliation: Department of Radiology and Division of Cardiology, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.affiliation: Division of Nephrology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Niki
authors.initials: N
authors.lastname: Dacouris
authors.affiliation: Division of Nephrology and Center for Translational Metabolism and Health - Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Myles
authors.initials: M
authors.lastname: Wolf
authors.affiliation: Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada; Division of Cardiology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Yan
mesh_terms: D001955:British Columbia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010710:Phosphates / Q000097:blood; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D010710:Phosphates