Adequacy of twice weekly hemodialysis in end stage renal disease patients at a tertiary care dialysis centre

Chauhan, Rajeev; Mendonca, Satish

doi:10.4103/0971-4065.151762

Cited by 35 publications

(31 citation statements)

References 17 publications

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“…Almost all our patients paid out of pocket without any inancial aids from the government hence they could not cope with the cost implication of dialysis. Inadequate dialysis and long interval between dialysis has been shown by several observational studies to increase morbidity and mortality risk [17][18][19][20] and lower the quality of life [18].…”

Section: Discussionmentioning

confidence: 99%

Challenges of haemodialysis: A single centre experience in South West Nigeria

SA¹

2019

J Clini Nephrol

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Background: Haemodialysis is the commonest method of Renal Replacement Therapy in Nigeria. Despite an advancement in the technicality and better understanding of haemodialysis, a number of complications are known to be associated with this procedure. Objective: We aimed to highlight our experiences and share some of the uncommon complications encountered during haemodialysis and present the outcome of our patients. Subjects and methods: A retrospective review of 101 patients during the last two years was done. Data extracted include: sociodemographic characteristic, aetiology of kidney disease, type of vascular access, intradialytic complication and outcome of treatment. Results: The total number of dialysis session during the period was 823. Males constituted a higher proportion (64.4%) and were found to be older than female patients 49.8 vs 42.8 years (P=0.001). Majority (89.1%) had chronic kidney disease while chronic glomerulonephritis was the main cause of CKD as seen in about 45% of the patient. Due to the cost implication, only 2(1.98%) were able to undergo 3 sessions of dialysis per week for up to 1 month. Vascular access was femoral (66.3%), internal jugular vein (25.7%), while only 2% used Artero-venous-fi stula and one patient had femoral vessel pseudoaneurysm from frequent cannulation. The commonest complication was hypotension which was present in 15.8%. Twenty-eight deaths were recorded, 44(43%) were either lost to follow up or absconded while 5% were transplanted at a referral centre. Conclusion: Challenges of renal replacement therapy is overwhelming in our country due to poor human and fi nancial resources. Early diagnosis and adequate government support are advocated.

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Section: Discussionmentioning

confidence: 99%

Challenges of haemodialysis: A single centre experience in South West Nigeria

SA¹

2019

J Clini Nephrol

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“…An appropriate target dose of sp Kt / V per session for twice‐weekly HD is unknown. In a study from India (), prolonging treatment time to increase sp Kt / V could improve anemia, blood pressure, albumin, and QOL. In China, treatment duration in twice‐weekly HD is generally longer in duration than that of thrice‐weekly HD (253 ± 28 vs. 240 ± 17 minutes, p < 0.05) and patients on twice‐weekly dialysis have a 6.8 times likelihood of being prescribed a session length of more than 240 minutes.…”

Section: Potential Unfavorable Effect Of Twice‐weekly Dialysismentioning

confidence: 99%

Twice‐Weekly Hemodialysis in China: Can It Be A Better Option for Initiation or Maintenance Dialysis Therapy?

Yan¹,

Ramirez²,

Anand

et al. 2017

Seminars in Dialysis

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Cumulative evidence indicates it may be worthwhile revisiting the twice-weekly hemodialysis (HD) regimen as a valid option for individualized or incremental treatments for selected patients with end-stage renal disease. In this article, we will review the current evidences on the potential pros and cons of twice-weekly HD compared to thrice-weekly HD including China’s experience in the practice of twice-weekly HD. A prudent patient selection and close dialysis adequacy monitoring might be necessary for this medical treatment choice. More randomized prospective controlled studies for the critical evaluation of twice-weekly dialysis are encouraged.

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“…3,20–24 Data from Jordan, Qatar, Iran, and Turkey are drawn from national registries, data from Pakistan, Iraq and Saudi Arabia are drawn from from multi-center studies, and data from India, Thailand, and Sudan are drawn from single-center studies. 3,20–24 …”

Section: Figurementioning

confidence: 99%

“…In contrast, among patients with substantial residual kidney function (i.e., residual urea clearance >3 mL/min/1.73m 2 , matching Adapted from Bieber et al 11 We added data from Saudi Arabia, Turkey, Qatar, Jordan, Iran, Thailand, Sudan, Pakistan, India, and Iraq. 3,[12][13][14][15][16] Data from Jordan, Qatar, Iran, and Turkey are drawn from national registries, data from Pakistan, Iraq and Saudi Arabia are drawn from from multi-center studies, and data from India, Thailand, and Sudan are drawn from single-center studies. 3,[12][13][14][15][16] Reproduced with permission.…”

Section: Survivalmentioning

confidence: 99%

“…3,[12][13][14][15][16] Data from Jordan, Qatar, Iran, and Turkey are drawn from national registries, data from Pakistan, Iraq and Saudi Arabia are drawn from from multi-center studies, and data from India, Thailand, and Sudan are drawn from single-center studies. 3,[12][13][14][15][16] Reproduced with permission. [Color figure can be viewed at wileyonlinelibrary.com] In contrast, a prospective study by Hwang et al found that the cohort on twice weekly hemodialysis had a higher mortality rate compared with the cohort on a thrice weekly schedule when both groups had some residual kidney function (defined as urine output of at least 100 mL/ day).…”

Section: Survivalmentioning

confidence: 99%

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Can twice weekly hemodialysis expand patient access under resource constraints?

Savla

Chertow

Meyer

et al. 2016

Hemodialysis International

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The convention of prescribing hemodialysis on a thrice weekly schedule began empirically when it seemed that this frequency was convenient and likely to treat symptoms for a majority of patients. Later, when urea was identified as the main target and marker of clearance, studies supported the prevailing notion that thrice weekly dialysis provided appropriate clearance of urea. Today, national guidelines on hemodialysis from most countries recommend patients receive at least thrice weekly therapy. However resource constraints in low- and middle-income countries have resulted in a substantial proportion of patients using less frequent hemodialysis in these settings. Observational studies of patients on twice weekly dialysis show that twice weekly therapy has non-inferior survival rates compared with thrice weekly therapy. In fact, models of urea clearance also show that twice weekly therapy can meet urea clearance “targets” if patients have significant residual function or if they follow a protein-restricted diet, as may be common in low- and middle-income countries. Greater reliance on twice weekly therapy, at least at the start of hemodialysis, therefore has potential to reduce health care costs and increase access to renal replacement therapy in low-resource settings; however, randomized control trials are needed to better understand long-term outcomes of twice versus thrice weekly therapy.

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Adequacy of twice weekly hemodialysis in end stage renal disease patients at a tertiary care dialysis centre

Cited by 35 publications

References 17 publications

Challenges of haemodialysis: A single centre experience in South West Nigeria

Challenges of haemodialysis: A single centre experience in South West Nigeria

Twice‐Weekly Hemodialysis in China: Can It Be A Better Option for Initiation or Maintenance Dialysis Therapy?

Can twice weekly hemodialysis expand patient access under resource constraints?

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