Effects of hemodialysis dose on anemia, hypertension, and nutrition

There is good evidence that by improving dialysis adequacy, morbidity, and mortality of hemodialysis (HD) patients decrease. Dialysis adequacy has also been related to the better control of arterial blood pressure (BP), anemia and improvement of patients' nutritional status. This is a self-control study of 34 HD patients, (23 males, 11 females), aged 52.6 +/- 15.5 years, HD duration 55.9 +/- 61.2 months, referring to the effect of increasing delivered dialysis dose, over a two-year period, on their clinical and laboratory parameters. Delivered HD dose increased statistically significantly: Urea reduction ratio (URR) increased from 52 +/- 8 to 71 +/- 7% and Kt/V from 0.93 +/- 0.19 to 1.55 +/- 0.29 (p < 0.001). Hb increased statistically significantly from 10.4 +/- 1.7 to 11.0 +/- 1.3 g/dL (p < 0.05) while no difference has been noticed in weekly EPO dose. Both systolic and diastolic BP decreased statistically significantly (from 147 +/- 24 to 133 +/- 25mmHg and from 73 +/- 12 to 66 +/- 13 mmHg respectively, p = 0.001). Serum albumin increased from 4.3 +/- 0.4 to 4.6 +/- 0.3g/dL (p = 0.002) and nPCR from 0.93 +/- 0.16 to 1.20 +/- 0.17 (p < 0.001). We conclude that increasing dialysis dose results in both clinical and laboratory improvement regarding hypertension, nutritional status and control of HD patients' anemia.