Intensive Hemodialysis and Potential Risks with Increasing Treatment

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Intensive Hemodialysis and Potential Risks with Increasing Treatment Kraus MA, Kansal S, Copland M, Komenda P, Weinhandl ED, Bakris GL, Chan CT, Fluck RJ, Burkhart JM. Intensive Hemodialysis and Potential Risks with Increasing Treatment. American Journal of Kidney Diseases, Volume 68, Issue 5, S51 - S58. AdvancingDialysis.org

Infection appears to be more likely with intensive hemodialysis, although the relative importance of frequency versus setting (in-center versus home) merits further investigation.1,2,3,4,5 Chapter 6, Figure 1:6 Relative hazards of cause-specific infection-related hospitalization for short daily hemodialysis versus conventional in-center hemodialysis1 and versus peritoneal dialysis.2 Solid lines represent 95% confidence intervals around estimated hazard ratios (solid dots).Abbreviations: CIHD, in-center hemodialysis; PD, peritoneal dialysis; SDHD, short daily hemodialysis. 1Weinhandl ED, Nieman KM, Gilbertson DT, Collins AJ. Hospitalization in daily home hemodialysis and matched thrice-weekly in-center hemodialysis patients. Am J Kidney Dis Off J Natl Kidney Found. 2015;65(1):98-108. doi:10.1053/j.ajkd.2014.06.015. 2Weinhandl ED, Gilbertson DT, Collins AJ. Mortality, Hospitalization, and Technique Failure in Daily Home Hemodialysis and Matched Peritoneal Dialysis Patients: A Matched Cohort Study. Am J Kidney Dis Off J Natl Kidney Found. 2016;67(1):98-110. doi:10.1053/j.ajkd.2015.07.014. 3FHN Trial Group, Chertow GM, Levin NW, et al. In-center hemodialysis six times per week versus three times per week. N Engl J Med. 2010;363(24):2287-2300. doi:10.1056/NEJMoa1001593. 4Rocco MV, Lockridge RS, Beck GJ, et al. The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial. Kidney Int. 2011;80(10):1080-1091. doi:10.1038/ki.2011.213. 5Spry LA, Burkart JM, Holcroft C, Mortier L, Glickman JD. Survey of home hemodialysis patients and nursing staff regarding vascular access use and care. Hemodial Int Int Symp Home Hemodial. 2015;19(2):225-234. doi:10.1111/hdi.12211. 6Kraus, M.A., Kansal, S., Copland, M. et al, Intensive hemodialysis and potential risks with increasing treatment. Am J Kidney Dis. 2016;68:S51–S58. AdvancingDialysis.org