Physical Activity in Short Daily Home Dialysis versus to In-Center Hemodialysis: Results from the Self-convecTive...

Short daily home hemodialysis preserves physical activity, with ≈30% higher step counts and no dialysis-day decline compared with in-center hemodialysis. Short daily home hemodialysis is associated with a reduced treatment burden despite more frequent sessions. Short daily home hemodialysis delivers effective and more physiological dialysis, achieving better middle-molecule clearance and preserved nutritional status.

Short daily home dialysis (SDHD) has been proposed as a patient-centered alternative to conventional in-center hemodialysis (ICHD).

The multicenter Self-convecTive Evaluation of short daily home dialysis on Physical Activity observational and prospective cohort compared SDHD with ICHD over 12 months in France and Belgium. The primary end point was average daily step count, assessed using wearable activity trackers. Secondary outcomes included sleep, sedentary time, recovery after dialysis, laboratory parameters, quality of life, and treatment burden.

A total of 152 patients were enrolled (82 SDHD, 70 ICHD). At baseline, SDHD patients demonstrated 28% higher activity levels (6673 versus 4768 steps/d), a difference sustained throughout follow-up. Physical activity in ICHD patients was significantly lower on dialysis days, whereas SDHD patients maintained stable patterns. Sleep duration was greater un SDHD (up to 405 minutes/d) and lower in ICHD (to 202 minutes/d). Sedentary time remained consistently lower, and recovery time tended to be shorter in SDHD (60 versus 120 minutes). Laboratory analyses showed lower predialysis β 2-microglobulin and preserved nutritional markers in SDHD, despite similar anemia and metabolic control.

Compared with ICHD, SDHD was associated with sustained preservation of physical activity, better postdialysis recovery, improved sleep, and reduced sedentary burden, supporting its use as a safe and patient-centered modality.