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Published on: May 31, 2022
Daily hemodialysis: a systematic review.
Rita S Suri1, Gihad E Nesrallah, Rahul Mainra
1Division of Nephrology, University of Western Ontario, London, Ontario, Canada. rita.suri@lhsc.on.ca
Clinical Journal of the American Society of Nephrology : CJASN
|August 21, 2007
Summary
Evidence on daily hemodialysis (DHD) shows potential benefits, but current studies are limited. More rigorous randomized trials are needed to confirm the efficacy and safety of DHD for patients with kidney disease.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Clinical Evidence Synthesis
Background:
- Daily hemodialysis (DHD) is increasingly studied for improved patient outcomes.
- The existing evidence base for DHD requires critical evaluation to guide future research.
Purpose of the Study:
- To synthesize and rate the quality of published evidence on daily hemodialysis (DHD).
- To inform sample size and design for a future randomized trial on DHD.
Main Methods:
- Systematic literature search of MEDLINE and EMBASE, supplemented by hand-searches.
- Inclusion of 25 articles reporting original data on DHD in 268 adult patients over >= 3 months.
- Review and quality assessment of studies focusing on outcomes like quality of life, cardiovascular disease, and blood pressure.
Main Results:
- Data from 14 unique cohorts (268 patients) were synthesized; most studies were observational.
- Ten of 11 studies suggested improved blood pressure with DHD, but other outcomes varied.
- High heterogeneity in reporting precluded data pooling; discontinuation rates varied significantly between in-center and home DHD.
Conclusions:
- Current evidence on daily hemodialysis (DHD) is limited by small sample sizes, observational designs, and biases.
- Randomized trials are necessary to establish the definitive efficacy and safety of DHD.
- Further research should address potential risks and optimize DHD protocols.
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