Is Twice-weekly Maintenance Hemodialysis Justified?

Area of Science:

• Nephrology
• Renal Replacement Therapy
• Public Health

Background:

• Twice-weekly hemodialysis offers benefits in access longevity, residual renal function preservation, cost-effectiveness, and patient quality of life.
• This regimen is common in developing nations due to resource limitations.
• A 3-year follow-up study evaluated outcomes of patients starting on twice-weekly hemodialysis.

Purpose of the Study:

• To assess the long-term outcomes of patients initiated on a twice-weekly hemodialysis schedule.
• To evaluate the adequacy of dialysis, cost-effectiveness, and impact on hematological and biochemical parameters over 3 years.

Main Methods:

• A 3-year observational follow-up of 88 incident hemodialysis patients.
• Monthly monitoring of dialysis adequacy, hematological, and biochemical parameters.
• Patients were switched to thrice-weekly hemodialysis if complications arose.

Main Results:

• Adequate spKt/V and eKt/V were achieved in 68.54% and 48.34% of patients, respectively.
• Mean hemoglobin was 9.53 g/dl; 74.88% experienced hyperphosphatemia.
• Mortality rate was 27.27% over 3 years, with a mean time to mortality of 503 days.

Conclusions:

• Initiating maintenance hemodialysis twice-weekly is a feasible strategy, especially for patients with preserved residual renal function.
• Biochemical and hematological parameters remained stable and within KDOQI guidelines throughout the study.
• This approach supports access longevity and patient well-being, with flexibility to increase frequency if needed.