More Frequent Hemodialysis Improves Outcomes

Yet patients more likely to undergo vascular access interventions

MONDAY, Nov. 22 (HealthDay News) -- More frequent in-center hemodialysis (six days per week instead of three days per week) appears to improve left ventricular mass and improve patient-reported physical health, but may require more frequent interventions related to vascular access, according to a study published online Nov. 20 in the New England Journal of Medicine to coincide with a presentation at the American Society of Nephrology's Renal Week 2010, held from Nov. 16 to 21 in Denver.

Glenn M. Chertow, M.D., of the Stanford School of Medicine in Palo Alto, Calif., and colleagues randomized patients to undergo hemodialysis six times per week (frequent hemodialysis) or three times per week (conventional hemodialysis) for 12 months.

The investigators found that frequent dialysis was associated with significant benefit in both coprimary composite outcomes, with a hazard ratio for death or increase in left ventricular mass of 0.61 and a hazard ratio for death or a decrease in the physical-health composite score of 0.70. More frequent hemodialysis was associated with improved control of hypertension and hyperphosphatemia. However, compared to conventional dialysis, patients who underwent more frequent hemodialysis were more likely to undergo interventions related to vascular access (hazard ratio, 1.71).

"Frequent hemodialysis, as compared with conventional hemodialysis, was associated with favorable results with respect to the composite outcomes of death or change in left ventricular mass and death or change in a physical-health composite score but prompted more frequent interventions related to vascular access," the authors write.

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