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Quotidian dialysis--update 2005.

Andreas Pierratos1, Phil McFarlane, Christopher T Chan

  • 1Humber River Regional Hospital, University of Toronto, 200 Church Street, Weston, Ontario, Canada M9N 1N8. a.pierratos@utoronto.ca

Current Opinion in Nephrology and Hypertension
|February 3, 2005
PubMed
Summary

Quotidian hemodialysis, or daily dialysis, shows growing evidence of improving patient cardiovascular health and quality of life. With industry support and ongoing studies, daily dialysis offers a cost-effective alternative to traditional treatments.

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Area of Science:

  • Nephrology and Dialysis Research
  • Clinical Outcomes and Quality of Life Studies
  • Healthcare Economics and Policy

Background:

  • Increased interest in quotidian hemodialysis following the HEMO study's findings on high-dose, thrice-weekly hemodialysis.
  • A substantial body of new research on daily hemodialysis necessitates a timely review.

Purpose of the Study:

  • To review the latest evidence and global experience with quotidian hemodialysis.
  • To assess the clinical, quality-of-life, and financial implications of daily hemodialysis.

Main Methods:

  • Review of published research and accrued worldwide experience.
  • Analysis of industry advancements in home hemodialysis technology.
  • Consideration of international registry data and funding initiatives.

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Main Results:

  • Evidence confirms cardiovascular and quality-of-life improvements with quotidian hemodialysis.
  • Financial benefits and industry support for patient-friendly home hemodialysis machines are noted.
  • Initiation of prospective randomized controlled studies funded by NIH and CMS, with successful funding secured in British Columbia for daily home hemodialysis.

Conclusions:

  • Quotidian hemodialysis demonstrates increasing evidence of improved clinical outcomes and cost-efficiency.
  • Resolution of reimbursement issues is key to widespread adoption in home and in-center settings.
  • Daily hemodialysis can address declines in peritoneal dialysis utilization and nursing shortages.