title: The Effect of Increased Frequency of Hemodialysis on Volume-Related Outcomes: A Secondary Analysis of the Frequent Hemodialysis Network Trials.
abstract: In previous reports of the Frequent Hemodialysis Network trials, frequent hemodialysis (HD) reduced extracellular fluid (ECF) and left ventricular mass (LVM), with more pronounced effects observed among patients with low urine volume (UVol). We analyzed the effect of frequent HD on interdialytic weight gain (IDWG) and a time-integrated estimate of ECF load (TIFL). We also explored whether volume and sodium loading contributed to the change in LVM over the study period. Treatment effects on volume parameters were analyzed for modification by UVol and the dialysate-to-serum sodium gradient. Predictors of change in LVM were determined using linear regression. Frequent HD reduced IDWG and TIFL in the Daily Trial. Among patients with UVol <100 ml/day, reduction in TIFL was associated with LVM reduction. This suggests that achievement of better volume control could attenuate changes in LVM associated with mortality and cardiovascular morbidity. TIFL may prove more useful than IDWG alone in guiding HD practice. Video Journal Club 'Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=441966.
authors.affiliation: Renal Research Institute, New York, N.Y., USA.
authors.forename: Jochen G
authors.initials: JG
authors.lastname: Raimann
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Chan
authors.forename: John T
authors.initials: JT
authors.lastname: Daugirdas
authors.forename: Tom
authors.initials: T
authors.lastname: Depner
authors.forename: Frank A
authors.initials: FA
authors.lastname: Gotch
authors.forename: Tom
authors.initials: T
authors.lastname: Greene
authors.forename: George A
authors.initials: GA
authors.lastname: Kaysen
authors.forename: Alan S
authors.initials: AS
authors.lastname: Kliger
authors.forename: Peter
authors.initials: P
authors.lastname: Kotanko
authors.forename: Brett
authors.initials: B
authors.lastname: Larive
authors.forename: Robert
authors.initials: R
authors.lastname: Lindsay
authors.forename: Michael V
authors.initials: MV
authors.lastname: Rocco
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Chertow
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Levin
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D015312:Hemodialysis Solutions / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012964:Sodium / Q000097:blood*; D014882:Water-Electrolyte Balance / Q000187:drug effects; D015430:Weight Gain / Q000187:drug effects
chemical_list: D015312:Hemodialysis Solutions; D012964:Sodium