More frequent hemodialysis does not effectively clear protein-bound azotemic solutes derived from gut microbiome...

The 5-year survival rate for hemodialysis patients remains lower than that for some of the more common solid organ cancers. Trials of increasing urea clearance by hemodialysis have failed to demonstrate improved patient survival. Accumulating evidence suggests that protein-bound azotemic solutes derived from gut microbiome metabolism have greater potential for toxicity than urea. The Frequent Hemodialysis Network Trials group now report that increasing dialysis frequency to 6 times a week did not effectively improve clearance of these protein-bound azotemic solutes compared with standard thrice weekly sessions.