Short hemodialysis: long-term mortality and morbidity

Individualized short hemodialysis treatment schedules, approximately three 3-h treatments per week, were introduced in a nephrology unit in 1976. In May 1985, 259 patients had been treated, which corresponds to approximately 60 new patients per million inhabitants per year. Ages at start of therapy ranged between 17 and 78 years. Patient survival was 91% at 1 year, 76% at 5 years, and 60% at 10 years. The analysis of causes of death did not show an increase in cardiovascular or infectious problems. Hospitalization rate (excluding hospitalization at start of therapy and vascular access problems) was 7 +/- 9 days per patient per year (range 2-161). Therefore, it appears that in a largely unselected dialysis population, a schedule of 3-h hemodialysis three times per week may be safely applied for at least 9 years. The claim that short hemodialysis is associated with increased mortality and morbidity appears to be based on other interfering factors.