Daily hemodialysis helps protect kidney patients' hearts

November 22, 2010, National Institutes of Health

Frequent hemodialysis improved left ventricular mass (heart size) and self-reported physical health compared to conventional hemodialysis for kidney failure, according to the Frequent Hemodialysis Network (FHN) Daily Trial funded by the National Institutes of Health and the Centers for Medicare & Medicaid Services. Results were published online Nov. 20, 2010, in the New England Journal of Medicine to coincide with a presentation at the American Society of Nephrology meeting in Denver.

Six hemodialysis treatments per week improved left ventricular mass and physical health compared to conventional, three weekly dialysis therapy sessions. Frequent hemodialysis was also associated with improved control of high blood pressure and excessive phosphate levels in the blood, a common problem in patients on hemodialysis. There were no significant effects on cognitive performance, self-reported depression, or the use of drugs to treat anemia.

Previous observational data suggested that the dose of hemodialysis correlates directly with patient survival. However, results from the HEMO Study (http://www.nih.gov/news/pr/dec2002/niddk-18.htm), funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the NIH and published in 2002, showed no added benefit of increasing the per-treatment dose of hemodialysis in the conventional three times per week method. A few small, single-center studies found that the dialysis dose could be greatly increased by adding more dialysis sessions. Those findings led FHN researchers to test the hypothesis that almost daily treatment would improve both objective and subjective, or patient-reported, outcomes, authors said.

"We confirmed that by administering dialysis more often, although with a smaller dose each time, we could effectively deliver a higher weekly dose overall," said Griffin P. Rodgers, M.D., NIDDK director. "As a result, patients' hearts remained healthier, they enjoyed better blood pressure control and they enjoyed better physical health than those receiving the standard three treatments per week."

The FHN Daily Trial involved 245 patients at 10 university and 54 community-based facilities in North America between Jan. 2006 and March 2010. Patients were randomly assigned to receive either conventional three weekly dialysis treatments or six treatments a week. The study measured two co-primary outcomes:

  • Death, or change in left ventricular mass – the size of the heart's left ventricle – a sign of heart health
  • Death, or change in the component (PHC), compiled from the RAND-36, a patient questionnaire widely used in clinical medicine to determine how well a person feels and functions
Patients randomized to six treatments a week were more likely to undergo treatment for vascular access problems.

The FHN Daily Trial was not designed to detect differences in mortality between treatment groups. However, the study showed promising results that more frequent dialysis could be of benefit to some patients.

Related Stories

Recommended for you

Scientists gain new insight on how antibodies interact with widespread respiratory virus

February 22, 2018
Scientists have found and characterized the activity of four antibodies produced by the human immune system that target an important protein found in respiratory syncytial virus (RSV), according to new research published ...

Study reveals how kidney disease happens

February 22, 2018
Monash researchers have solved a mystery, revealing how certain immune cells work together to instigate autoimmune kidney disease.

Past encounters with the flu shape vaccine response

February 20, 2018
New research on why the influenza vaccine was only modestly effective in recent years shows that immune history with the flu influences a person's response to the vaccine.

Building better tiny kidneys to test drugs and help people avoid dialysis

February 16, 2018
A free online kidney atlas built by USC researchers empowers stem cell scientists everywhere to generate more human-like tiny kidneys for testing new drugs and creating renal replacement therapies.

Study suggests expanded range for emerging tick-borne disease

February 16, 2018
Human cases of Borrelia miyamotoi, a tick-borne infection with some similarities to Lyme disease, were discovered in the eastern United States less than a decade ago. Now new research led by the Yale School of Public Health ...

Expanding Hepatitis C testing to all adults is cost-effective and improves outcomes

February 16, 2018
According to a new study, screening all adults for hepatitis C (HCV) is a cost-effective way to improve clinical outcomes of HCV and identify more infected people compared to current recommendations. Using a simulation model, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.