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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2016 ; 95
(7
): e2767
Nephropedia Template TP
gab.com Text
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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.