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10.1097/MD.0000000000002767

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suck abstract from ncbi


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pmid26886622
      Medicine+(Baltimore) 2016 ; 95 (7 ): e2767
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  • Comparison of Clinical Outcome Between Twice-Weekly and Thrice-Weekly Hemodialysis in Patients With Residual Kidney Function #MMPMID26886622
  • Hwang HS ; Hong YA ; Yoon HE ; Chang YK ; Kim SY ; Kim YO ; Jin DC ; Kim SH ; Kim YL ; Kim YS ; Kang SW ; Kim NH ; Yang CW
  • Medicine (Baltimore) 2016[Feb]; 95 (7 ): e2767 PMID26886622 show ga
  • Residual kidney function (RKF) contributes to improved survival in hemodialysis (HD) patients. However, it is not clear whether RKF allows a comparable survival rate in patients undergoing twice-weekly HD compared with thrice-weekly HD.We enrolled 685 patients from a prospective multicenter observational cohort. RKF and HD adequacy was monitored regularly over 3-year follow-up. Patients with RKF were divided into groups undergoing twice-weekly HD (n?=?113) or thrice-weekly HD (n?=?137). Patients without RKF undergoing thrice-weekly HD (n?=?435) were included as controls. Fluid balance and dialysis-associated characteristics were followed and clinical outcomes evaluated using all-cause mortality and cardiovascular events (CVE).In patients with RKF, baseline and follow-up RKF were significantly higher in patients undergoing twice-weekly HD than in those undergoing thrice-weekly HD. Total Kt/V urea (dialysis plus residual renal) in patients with RKF undergoing twice-weekly HD was greater than or equal to those in patients with or without RKF undergoing thrice-weekly HD. Compared with patients with RKF undergoing thrice-weekly HD, patients with RKF undergoing twice-weekly HD had no fluid excess, but their normalized protein catabolic rate became lower since 24-month follow up. In multivariable analyses, patients with RKF undergoing twice-weekly HD had a noninferior risk of mortality (hazard ratio [HR], 0.83; 95% confidence interval [95% CI], 0.34-2.01, P?=?0.68) and of CVE (HR, 0.60; 95% CI, 0.28-1.29, P?=?0.19) compared with patients without RKF undergoing thrice-weekly HD. However, this group showed an independent association with a greater risk of mortality compared with patients with RKF undergoing thrice-weekly HD (HR, 4.20; 95% CI, 1.02-17.32, P?=?0.04).In conclusion, patients with RKF undergoing twice-weekly HD had an increased risk of mortality compared with those undergoing thrice-weekly HD. Decisions about twice-weekly HD should consider not only RKF, but also other risk factors such as normalized protein catabolic rate.
  • |*Registries [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Female [MESH]
  • |Humans [MESH]
  • |Kidney Failure, Chronic/mortality/*therapy [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Proteins/metabolism [MESH]
  • |Renal Dialysis/*statistics & numerical data [MESH]
  • |Republic of Korea/epidemiology [MESH]


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