Clinical and biochemical correlates of starting “daily” hemodialysis

Woods, J. D.; Port, Friedrich K.; Orzol, Sean; Buoncristiani, U; Young, Eric W.; Wolfe, Robert A.; Held, Philip J.

doi:10.1046/j.1523-1755.1999.00493.x

Cited by 195 publications

(163 citation statements)

References 14 publications

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“…Also, subscales of PCS and MCS, except mental health and social functioning subscales which revealed only a trend, were significantly linked to mortality. Consistent with other reports, we described that serum albumin was one of the strongest independent predictors of patient outcome (5,6,14,15). In this study, we showed that the ideal serum albumin was higher than 4 g/dL, and the risk of death was respectively 3.7, 2.1, and 1.9 folds in patients with the serum albumin ≤ 3.60 g/dL (the lowest quintile), > 3.60 -3.85 g/dL, and > 3.85 -4.00 g/dL compared to patients with serum albumin of more than 4.20 g/dL (the highest quintile).…”

Section: Discussionsupporting

confidence: 91%

SF36 Quality of Life and Mortality across Different Levels of Serum Albumin in Patients with Hemodialysis

et al. 2017

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Background: Patients on hemodialysis (HD) generally display a significant decrease in the quality of life owing to comorbidities, malnutrition, and inflammation. Methods: In this multicenter prospective study, the SF36 (short form with 36 questions scored between 0 and 100) and relevant demographic data and comorbidities (charlson comorbidity index); nutritional factors, and C-reactive protein (CRP) were evaluated in 416 HD patients in September 2012. Hospitalization and mortality were assessed in a median of a 28 month follow-up.

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Section: Discussionsupporting

confidence: 91%

SF36 Quality of Life and Mortality across Different Levels of Serum Albumin in Patients with Hemodialysis

et al. 2017

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“…[5][6][7][8] Two nonrandomized studies suggested that, compared with conventional dialysis, daily dialysis is associated with a five-fold decrease in access complications. 9,10 However, two literature reviews suggested the opposite. 11,12 These reviews highlighted two North American nonrandomized studies that reported a trend to doubling of access interventions in patients receiving daily hemodialysis with arteriovenous fistulae.…”

Section: Discussionmentioning

confidence: 99%

Risk of Vascular Access Complications with Frequent Hemodialysis

Suri

Larive

Sherer

et al. 2013

Journal of the American Society of Nephrology

151

110

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Frequent hemodialysis requires using the vascular access more often than with conventional hemodialysis, but whether this increases the risk for access-related complications is unknown. In two separate trials, we randomly assigned 245 patients to receive in-center daily hemodialysis (6 days per week) or conventional hemodialysis (3 days per week) and 87 patients to receive home nocturnal hemodialysis (6 nights per week) or conventional hemodialysis, for 12 months. The primary vascular access outcome was time to first access event (repair, loss, or access-related hospitalization). Secondary outcomes were time to all repairs and time to all losses. In the Daily Trial, 77 (31%) of 245 patients had a primary outcome event: 33 repairs and 15 losses in the daily group and 17 repairs, 11 losses, and 1 hospitalization in the conventional group. Overall, the risk for a first access event was 76% higher with daily hemodialysis than with conventional hemodialysis (hazard ratio [HR], 1.76; 95% confidence interval [CI], 1.11-2.79; P=0.017); among the 198 patients with an arteriovenous (AV) access at randomization, the risk was 90% higher with daily hemodialysis (HR, 1.90; 95% CI, 1.11-3.25; P=0.02). Daily hemodialysis patients had significantly more total AV access repairs than conventional hemodialysis patients (P=0.011), with 55% of all repairs involving thrombectomy or surgical revision. Losses of AV access did not differ between groups (P=0.58). We observed similar trends in the Nocturnal Trial, although the results were not statistically significant. In conclusion, frequent hemodialysis increases the risk of vascular access complications. The nature of the AV access repairs suggests that this risk likely results from increased hemodialysis frequency rather than heightened surveillance.

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“…Based on a multicenter study of 72 patients who used frequent HD from 1972 to 1996, Woods et al reported that the most common reason given for patients starting frequent HD was lifestyle or employment (24). In the 2004 ESRD Facility Survey, 122 units reported that patients received frequent incenter HD during the day, 19 reported that patients received frequent home HD during the day, 2 reported that patients received in-center nocturnal HD, and 8 reported that patients received home nocturnal HD.…”

Section: Discussionmentioning

confidence: 99%

Dialysis Facility Characteristics and Variation in Employment Rates

Kutner¹,

Bowles²,

Zhang³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background: Investigation of factors associated with variation in dialysis patient employment has focused primarily on patient-level factors. Little is known about facility-level factors that may be associated with patient employment.Design, setting, participants, and measurements: The ESRD Facility Survey (CMS-2744A) began in 2004 to collect counts of employed patients aged 18 to 54, in addition to dialysis unit census, types and timing of treatments offered, and staffing. Using the 2004 ESRD Facility Survey File, we investigated dialysis unit characteristics and facility employment rate of patients aged 18 to 54 in a logistic regression analysis that included hospital-based chronic renal care facilities, nonhospital renal disease treatment centers, independent special purpose renal dialysis facilities, and renal disease treatment centers.Results: Across all facilities, 18.9% of prevalent patients aged 18 to 54 were employed, but facility employment rates ranged from 0 to 100%. Facility employment rate was positively associated independently with availability of a 5 p.m. or later dialysis shift (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.42 to 1.68), availability of peritoneal dialysis or home hemodialysis (HD) training (OR 1.19, 95% CI 1.11 to 1.28), and provision of frequent HD (OR 1.26, 95% CI 1.07 to 1.49), after adjusting for patient/social worker ratio, rurality of unit location, and unit size. In addition, patient receipt of Vocational Rehabilitation (VR) services was more often reported in facilities with higher employment rates.Conclusions: Promoting gainful employment among ESRD patients continues to be a quality improvement need. A dataset that allows adjustment for patient-level variables would facilitate increased understanding of the contribution of dialysis facility variables to patient employment.

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Clinical and biochemical correlates of starting “daily” hemodialysis

Abstract: These results suggest that in certain patients, daily hemodialysis might have advantages over three times per week hemodialysis.

Cited by 195 publications

References 14 publications

SF36 Quality of Life and Mortality across Different Levels of Serum Albumin in Patients with Hemodialysis

SF36 Quality of Life and Mortality across Different Levels of Serum Albumin in Patients with Hemodialysis

Risk of Vascular Access Complications with Frequent Hemodialysis

Dialysis Facility Characteristics and Variation in Employment Rates

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