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ADEMEX and HEMO trials: where are we going?
1Nephrology Division, Royal Victoria Hospital, McGill University Health Centre, Montreal, Que, Canada. sarah.prichard@muhc.mcgill.ca
Blood Purification
|February 5, 2003
Summary
Dialysis adequacy targets for peritoneal dialysis patients may need reevaluation. Recent trials suggest lower targets might be acceptable, prompting a broader understanding of dialysis effectiveness.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Current K/DOQI guidelines recommend specific targets for dialysis adequacy in peritoneal dialysis patients.
- There is ongoing debate regarding the appropriateness of these established targets.
Purpose of the Study:
- To evaluate the adequacy of current K/DOQI targets for peritoneal dialysis.
- To discuss the implications of recent clinical trials on dialysis adequacy.
Main Methods:
- Review and interpretation of findings from the ADEMEX and HEMO trials.
- Analysis of the impact of these trials on established dialysis adequacy concepts.
Main Results:
- The ADEMEX trial suggests that lower dialysis adequacy targets may be sufficient for peritoneal dialysis patients.
- The HEMO trial raises questions about the benefits of exceeding recommended small solute clearance targets.
Conclusions:
- Recent trial data necessitate a broader definition of dialysis adequacy.
- A risk of complacency exists regarding dialysis adequacy due to these trials, which should be avoided.