The “unphysiology” of dialysis: A major cause of dialysis side effects?

Kjellstrand, Carl M.; Evans, Robert; Petersen, Robert J.; Shideman, J. R.; Hartitzsch, B. von; Buselmeier, T. J.

doi:10.1111/j.1492-7535.2004.00083.x

Cited by 66 publications

(82 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Conventional hemodialysis performed 3 times weekly (CHD), though the standard of care throughout the world, is generally regarded as a problematic therapy due to rapid fluxes of fluid, electrolytes, and other factors [1][2][3]. Much concern has been expressed about the high morbidity and mortality as well as impaired quality of life (QOL) in patients maintained on hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

A One-Year Trial of In-Center Daily Hemodialysis with an Emphasis on Quality of Life

Reynolds¹,

Homel²,

Cantey³

et al. 2004

Blood Purif

View full text Add to dashboard Cite

Background/Aims: Hemodialysis is associated with acute changes in several physiologic factors. Previous studies have suggested significant clinical and quality of life (QOL) benefits of daily hemodialysis (DHD) compared with 3 times weekly hemodialysis (CHD). We conducted a prospective trial to evaluate the effects of switching chronic hemodialysis patients to in-center DHD for a 12-month period. Methods: There were no exclusion criteria. Patients received hemodialysis 6 times per week. The study set a standardized weekly Kt/V (stdKt/V) goal of 3.0. A broad array of clinical parameters was determined. QOL was assessed with multiple instruments. Results: Eleven subjects completed 12 months and 12 completed 6 months on DHD. Significant changes relative to baseline at 12 months of DHD included decreased BP and improvements in QOL parameters by multiple techniques. 100% of patients at 12 months wished to continue DHD. Conclusions: DHD offers advantages over CHD with respect to improved QOL and BP control.

show abstract

Section: Introductionmentioning

confidence: 99%

A One-Year Trial of In-Center Daily Hemodialysis with an Emphasis on Quality of Life

Reynolds¹,

Homel²,

Cantey³

et al. 2004

Blood Purif

View full text Add to dashboard Cite

show abstract

“…With HD three times per week, the relatively long interval between dialysis sessions results in a 'peak-andvalley' effect, which is characterized by fluctuations in the levels of toxins and body fluid volume. 20 Several studies have shown that increasing the frequency of dialysis improves outcomes such as anemia, left ventricular hypertrophy, calcium and phosphorus balance and health-related quality of life. Therefore, shorter but more frequent dialysis sessions appear to be a potential solution to this problem.…”

Section: Discussionmentioning

confidence: 99%

Daily dialysis reduces pulse wave velocity in chronic hemodialysis patients

et al. 2012

View full text Add to dashboard Cite

Pulse wave velocity (PWV) is a predictor of morbidity and mortality in patients with end-stage renal disease (ESRD). Dialysis patients show cyclic changes in PWV related to their hydration status and blood pressure. Our aim is to assess the impact of daily dialysis on PWV. We performed a randomized crossover study of 60 patients who underwent standard hemodialysis (HD) three times per week for at least 6 months. Patients were classified into three groups according to their PWV values before (pre-) and after (post-) HD, with a cutoff value of 12 m s À1 , as follows: the low-low (LL) group had normal pre-HD and post-HD PWV; the high-low (HL) group had high pre-HD PWV and normal post-HD PWV; and the high-high (HH) group had high pre-and post-HD PWV. All patients continued standard HD for 2 weeks. A total of 10 patients from each group were randomly assigned to continue standard HD for 1 week and then underwent daily dialysis for 1 week. The remaining 10 patients underwent daily dialysis for 1 week and then underwent standard HD for 1 week. PWV values were measured before and 1 h after each dialysis session. With daily dialysis treatment, 2 of 20 patients (10%) moved from the PWV-HH group to the PWV-HL group, whereas 18 of 20 patients (90%) moved from the PWV-HL group to the PWV-LL group (P¼0.030). Daily dialysis reduces PWV in the ESRD patients. As PWV is a strong predictor of mortality in ESRD and has cyclic variations in patients who are on standard HD, we believe that daily dialysis may be used in patients with high PWV levels to reduce their mortality risk.

show abstract

“…The accumulation and retention of all types and sizes of uremic compounds (and excess water), which have concentration-dependent toxicity, leads to increased morbidity and mortality. Furthermore, the unphysiologic pattern of conventional intermittent HD (three times per week) with rapid change in fluid volume and electrolytes and uremic solutes serum concentrations results in permanent disequilibrium of internal milieu and inter and intra-dialysis complications [10].…”

Section: Introductionmentioning

confidence: 99%

Advances in Hemodialysis Techniques

Karkar¹

2013

Hemodialysis

View full text Add to dashboard Cite

The “unphysiology” of dialysis: A major cause of dialysis side effects?

Cited by 66 publications

References 14 publications

A One-Year Trial of In-Center Daily Hemodialysis with an Emphasis on Quality of Life

A One-Year Trial of In-Center Daily Hemodialysis with an Emphasis on Quality of Life

Daily dialysis reduces pulse wave velocity in chronic hemodialysis patients

Advances in Hemodialysis Techniques

Contact Info

Product

Resources

About