High-efficiency short daily haemodialysis--morbidity and mortality rate in a long-term study

Area of Science:

• Nephrology
• Renal Replacement Therapy
• Dialysis Modalities

Background:

• Conventional hemodialysis (CHD) is associated with high morbidity and mortality rates.
• Variations in dialysis session length and frequency are explored to mitigate complications.
• High-efficiency short daily hemodialysis (SDHD) emerges as a potential alternative for patients requiring renal replacement therapy.

Purpose of the Study:

• To evaluate the clinical experience and outcomes of patients treated with SDHD.
• To assess the efficacy and safety of SDHD as a long-term dialysis modality.
• To determine the impact of SDHD on patient survival and vascular access longevity.

Main Methods:

• A cohort of 26 patients (16 males, mean age 35.6 years) underwent SDHD for a mean of 33.6 months.
• Patients previously received conventional hemodialysis (CHD) for a mean of 25.5 months.
• SDHD was administered six times weekly for 1.5-2 hours per session using high flux polysulfone dialyzers (1.8 m²), with native arteriovenous fistulae utilized in 88.5% of cases.

Main Results:

• The study achieved 100% patient survival during the observation period.
• Vascular access survival rates at 12, 24, 36, and 48 months were 100%, 89%, 89%, and 80%, respectively.
• Hospitalization rates were low, with 0.27 hospitalizations per patient-year and 1.24 hospitalization days per patient-year observed in a subgroup of 15 patients.

Conclusions:

• SDHD demonstrates a very low morbidity and mortality rate in long-term patient studies.
• Vascular access failures were not a significant issue in patients undergoing SDHD.
• SDHD is considered a powerful and effective renal replacement therapy for patients on maintenance hemodialysis.