DialysisEthics2_Forum
General Discussion => Main Forum => Topic started by: cschwab on November 23, 2010, 10:32:04 AM
-
Saturday, November 20, 2010
3:30 p.m. EST
Contact:
Bill Polglase
301-795-5230
Daily hemodialysis helps protect kidney patients' hearts
NIH study compared more frequent vs. standard treatment
Frequent hemodialysis improved left ventricular mass (heart size) and self-reported physical health compared to conventional hemodialysis for kidney failure, according to the Frequent Hemodialysis Network (FHN) Daily Trial funded by the National Institutes of Health and the Centers for Medicare & Medicaid Services. Results were published online Nov. 20, 2010, in the New England Journal of Medicine to coincide with a presentation at the American Society of Nephrology meeting in Denver.
Six hemodialysis treatments per week improved left ventricular mass and physical health compared to conventional, three weekly dialysis therapy sessions. Frequent hemodialysis was also associated with improved control of high blood pressure and excessive phosphate levels in the blood, a common problem in patients on hemodialysis. There were no significant effects on cognitive performance, self-reported depression, or the use of drugs to treat anemia.
Previous observational data suggested that the dose of hemodialysis correlates directly with patient survival. However, results from the HEMO Study (http://www.nih.gov/news/pr/dec2002/niddk-18.htm), funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the NIH and published in 2002, showed no added benefit of increasing the per-treatment dose of hemodialysis in the conventional three times per week method. A few small, single-center studies found that the dialysis dose could be greatly increased by adding more dialysis sessions. Those findings led FHN researchers to test the hypothesis that almost daily treatment would improve both objective and subjective, or patient-reported, outcomes, authors said. "We confirmed that by administering dialysis more often, although with a smaller dose each time, we could effectively deliver a higher weekly dose overall," said Griffin P. Rodgers, M.D., NIDDK director. "As a result, patients' hearts remained healthier, they enjoyed better blood pressure control and they enjoyed better physical health than those receiving the standard three treatments per week."
The FHN Daily Trial involved 245 patients at 10 university and 54 community-based hemodialysis facilities in North America between Jan. 2006 and March 2010. Patients were randomly assigned to receive either conventional three weekly dialysis treatments or six treatments a week. The study measured two co-primary outcomes:
* Death, or change in left ventricular mass
-
Thanks for this article! It makes so much sense!