Patients with End Stage Renal Disease are dialyzed 3 times per week for about four hours each time. The idea to implement a more frequent dialysis schedule seems appealing where observational studies have associated long dialysis intervals with an excess risk of mortality and cardiovascular disease hospitalizations, while on the other hand a rather new study has suggested that daily dialysis might improve left- ventricular mass and health-related quality of life.
Prof. Carmine Zoccali, NDT Editor-in-Chief took the task o analyse the pros and cons if a more frequent schedule really is efficient, e.g. beneficial and economically justifiable. More on his review on this can be read in the January edition of NDT.
There might be a benefit on mortality but, on the other, a more frequent (e.g. alternate) hemodialysis might increase the risk of arteriovenous fistula problems and, thus, increase the disease burden, Zoccali points out. The impact on the outcome has not yet been proven, he emphasized: “Evidence that these regimes are beneficial mainly derives from observational studies and the possibility that the same regimes are harmful cannot be excluded”. As long as new data is missing, there is no need to change dialysis schedules. “Only in problematic patients we should think about pro-actively applying more frequent HD regimes”.