More haemodialysis means better survival

File:Plugged into dialysis.jpg

When it comes to dialysis, there’s no clear fixed rules. Yes, there are measures of efficacy including urea clearance and various ratios, but most people end up having somewhere in the range of 2.5-5.5 hours three times per week. What if you increase that though – does that improve the situation?

This article from JASN suggests yes. Using intensive haemodialysis, defined as more than 5.5 hours 3-7x per week, and comparing to a group receiving conventional dialysis (as defined earlier), there was an absolute difference of about 8% when it came to mortality, with a hazard ratio of 0.55.

This is talking about home haemodialysis by the way, which allows for longer, more frequent treatments. There’s a nice article here talking about the return of home haemodialysis from 2010, here.

Although a nice suggestion, this isn’t a randomised trial, nor the same cohort, or highly powered – but this definitely warrants further investigation. Dialysis doesn’t come without risks, but maybe more is better after all.

It’s here.

Oh, and if you’re looking for a nice description of how dialysis works for patients, have a look at this fact sheet from Kidney Health Australia.

source | JASN

image | Dan


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