Authors: Johan M Lorenzen Thomas Thum Georg M Eisenbach Hermann Haller Jan T Kielstein
Publish Date: 2011/02/27
Volume: 44, Issue: 3, Pages: 883-890
Abstract
Under physiological conditions kidneys work continuously 168 h/week In contrast patients with endstage renal disease are usually dialysed only 12 h/week Even if considered adequate by current Kt/Vbased dose estimates this unphysiological dose is associated with an unacceptable annual mortality rate of 10–20 Increasing dialysis dose might ameliorate this mortality rateEleven patients were switched from their conventional haemodialysis cHD 3 × 4 h/week to an intensified short daily home haemodialysis regimen sdhHD 6 × 3 h/week and followed up for 12 months Different parameters were evaluated before treatment conversion and quarterly during followup ie dialysis efficacy mean arterial pressure MAP antihypertensive drug score haemoglobin transferrin saturation ferritin dose of erythropoiesisstimulating agents ESA iron requirement parameters of nutrition body weight albumin protein Creactive protein calcium–phosphate product alkaline phosphatase AP intact parathyroid hormone iPTH and amount of phosphatebinding pharmacotherapyHD efficacy as assessed by cumulative blood volume increased after dialysis intensification P 001 The pre and postdialytic MAP declined during the study period P 00001 while antihypertensive drugs could be reduced P = 002 Haemoglobin levels improved P 00001 Additionally the need for ESAs fell under intensified sdhHD P = 0008 Nutritional status improved albumin P = 003 total serum protein P = 002 ‘dry’ body weight BW and body mass index BMI both P 0001 The calcium–phosphate product declined P 001 without changes in the dose of phosphate binders
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