A systematic review of the effect of nocturnal hemodialysis on blood pressure, left ventricular hypertrophy, anemia, mineral metabolism, and health-related quality of life

Walsh, Michael; Culleton, Bruce F.; Tonelli, Marcello; Manns, Braden

doi:10.1111/j.1523-1755.2005.00228.x

Cited by 182 publications

(161 citation statements)

References 59 publications

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“…Monitoring of a hematocrit-guided ultrafiltration algorithm lowered hospitalization for fluid overload and hypertension among pediatric HD patients (27). Cardiovascular admissions are higher on the day following the longest interdialytic interval in HD patients (28,29); therefore, alternative dialysis schedules deserve further study to determine their impact on hospitalization and readmission (30,31).…”

Section: Discussionmentioning

confidence: 99%

Readmission within 30 days of Hospital Discharge among Children Receiving Chronic Dialysis

Springel

Laskin

Furth

2014

Clinical Journal of the American Society of Nephrology

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Background and objectives The hospital admission rate for children receiving chronic dialysis has been increasing over the last decade. Approximately one third of patients with ESRD age 0-19 years are readmitted to the hospital within 30 days of discharge. The objective of this study was to examine hospital readmissions among a cohort of children receiving chronic dialysis to identify factors associated with higher rates of 30-day readmission.Design, settings, participants, & measurements A retrospective cohort of index admissions was developed among chronic dialysis patients age 3 months to 17 years at free-standing children's hospitals reporting information to the Pediatric Hospital Information System between January 2006 and November 30, 2010, and followed until December 31, 2010. The primary outcome was any-cause 30-day readmission, and the secondary outcome was 30-day readmission for a cause similar to that of the index hospitalization.Results In this cohort, 25% of hospital admissions were followed by a readmission within 30 days. Children older than 2 years of age had a lower odds of readmission (odds ratio [OR], 0.6; 95% confidence interval [95% CI], 0.5 to 0.8). Those receiving hemodialysis had a higher risk of readmission (OR, 1.2; 95% CI, 1.0 to 1.4), and admissions .14 days were also more likely to be followed by a readmission (OR, 1.5; 95% CI, 1.1 to 2.0). Approximately 50% of the readmissions were for a similar diagnosis as the index admission; however, the specific admitting diagnosis was not associated with readmission.Conclusions A significant number of admissions among children receiving long-term dialysis are followed by readmission within 30 days. Further investigation is required to reduce the high rate of readmissions in these children.

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Section: Discussionmentioning

confidence: 99%

Readmission within 30 days of Hospital Discharge among Children Receiving Chronic Dialysis

Springel

Laskin

Furth

2014

Clinical Journal of the American Society of Nephrology

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“…[1][2][3] More frequent hemodialysis has been suggested to approximate continuous glomerular filtration; improvements in BP and phosphorus clearance have frequently been observed. [4][5][6] Whether such mechanisms result in lower mortality risk is unknown, as observational studies that have reported improved survival with more frequent dialysis were relatively small and/or incompletely adjusted for selection bias. [7][8][9][10][11] The popularity of home hemodialysis has recently risen in the United States.…”

mentioning

confidence: 99%

Survival in Daily Home Hemodialysis and Matched Thrice-Weekly In-Center Hemodialysis Patients

Weinhandl

Liu

Gilbertson

et al. 2012

Journal of the American Society of Nephrology

192

171

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Frequent hemodialysis improves cardiovascular surrogates and quality-of-life indicators, but its effect on survival remains unclear. We used a matched-cohort design to assess relative mortality in daily home hemodialysis and thrice-weekly in-center hemodialysis patients between 2005 and 2008. We matched 1873 home hemodialysis patients with 9365 in-center patients (i.e., 1:5 ratio) selected from the prevalent population in the US Renal Data System database. Matching variables included first date of follow-up, demographic characteristics, and measures of disease severity. The cumulative incidence of death was 19.2% and 21.7% in the home hemodialysis and in-center patients, respectively. In the intention-to-treat analysis, home hemodialysis associated with a 13% lower risk for all-cause mortality than in-center hemodialysis (hazard ratio [HR], 0.87; 95% confidence interval [95% CI], 0.78-0.97). Cause-specific mortality HRs were 0.92 (95% CI, 0.78-1.09) for cardiovascular disease, 1.13 (95% CI, 0.84-1.53) for infection, 0.63 (95% CI, 0.41-0.95) for cachexia/dialysis withdrawal, 1.06 (95% CI, 0.81-1.37) for other specified cause, and 0.59 (95% CI, 0.44-0.79) for unknown cause. Findings were similar using as-treated analyses. We did not detect statistically significant evidence of heterogeneity of treatment effects in subgroup analyses. In summary, these data suggest that relative to thrice-weekly in-center hemodialysis, daily home hemodialysis associates with modest improvements in survival. Continued surveillance should strengthen inference about causes of mortality and determine whether treatment effects are homogeneous throughout the dialysis population.

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“…These physiologic restorative properties of NHD have been discussed in detail elsewhere and were the subject of a recent systematic review (6)(7)(8)(9). The majority of NHD research has been conducted by a small group of clinical research teams worldwide with a limited number of NHD patients.…”

Section: Methodologic Limitations Of Existing Researchmentioning

confidence: 99%

Utility and Limitations of a Multicenter Nocturnal Home Hemodialysis Cohort

Copland

Komenda

Levin

et al. 2008

Clinical Journal of the American Society of Nephrology

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Nocturnal home hemodialysis (NHD) is the most intensive dialysis strategy among dialytic renal replacement options and is receiving increased attention as more research reveals its physiologic restorative potential compared with conventional hemodialysis; however, a significant gap in knowledge remains concerning the predictors of program success and the clinical outcomes of NHD. This review aims to highlight the methodologic strengths and pitfalls of various study designs as they pertain to NHD research and lays the foundation for the CANandian Slow Long nightly ExtEnded dialysis Programs (CAN-SLEEP), a multicenter NHD research network aimed to facilitate investigation of NHD.

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A systematic review of the effect of nocturnal hemodialysis on blood pressure, left ventricular hypertrophy, anemia, mineral metabolism, and health-related quality of life

Cited by 182 publications

References 59 publications

Readmission within 30 days of Hospital Discharge among Children Receiving Chronic Dialysis

Readmission within 30 days of Hospital Discharge among Children Receiving Chronic Dialysis

Survival in Daily Home Hemodialysis and Matched Thrice-Weekly In-Center Hemodialysis Patients

Utility and Limitations of a Multicenter Nocturnal Home Hemodialysis Cohort

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