Six Hemodialysis Sessions May Be Better than Three
Doubling the conventional schedule of three hemodialysis (HD) sessions per week improved left ventricular mass and physical health among participants of the Frequent Hemodialysis Network (FHN) Daily Trial.
Among the 245 patients randomized to the three-session or six-session arms of the multicenter study, those undergoing six HD sessions had a 40% reduction in the risk of death or increased left ventricular mass and a 30% reduction in the risk of death or decreased physical-health score compared with subjects receiving thrice-weekly HD.
The six sessions per week also appeared to help improve control of hypertension and hyperphosphatemia. Patients engaging in the extra sessions were more likely to undergo interventions related to vascular access, but the increased frequency had no significant effect on erythropoiesis-stimulating agent use, serum albumin concentration, cognitive performance, or self-reported depression. The FHN Trial Group described their findings online ahead of print in The New England Journal of Medicine (www.nejm.org/doi/pdf/10.1056/NEJMoa1001593) and at November's Renal Week 2010 meeting in Denver.