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Twice versus thrice weekly hemodialysis: A systematic review

Twice versus thrice weekly hemodialysis: A systematic review INTRODUCTIONDespite six decades of experience treating patients with end stage kidney disease with hemodialysis (HD), the “optimal” treatment frequency remains unknown. Early HD prescriptions consisted of 24‐h sessions every 5–7 days.1 The first patient who received HD in this manner had an incremental increase in his HD prescription due to the emergence of symptoms of underdialysis including neuropathy and severe hypertension. It was ultimately recognized that development of these symptoms coincided with loss of his residual kidney function (RKF). Another very early HD patient, did not develop these symptoms until much later owing to the fact that he maintained RKF for nearly 18 months after HD initiation.2 Over time, significant technological advances in HD delivery and care allowed for increased HD frequency with the goal of preventing complications of end stage kidney disease.3 Today, the most commonly prescribed HD prescription in high income countries consists of 3–5 h sessions performed thrice weekly.4While the 2006 National Kidney Foundation KDOQI HD practice guidelines did consider a twice weekly schedule acceptable for patients with RKF, the 2015 update does not address twice weekly schedules and focuses more on more frequent prescriptions.4 The 2007 European Renal Association's Best Practice Guideline on Dialysis Strategies recommend HD be http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Hemodialysis International Wiley

Twice versus thrice weekly hemodialysis: A systematic review

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References (52)

Publisher
Wiley
Copyright
© 2022 International Society for Hemodialysis
ISSN
1492-7535
eISSN
1542-4758
DOI
10.1111/hdi.13045
Publisher site
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Abstract

INTRODUCTIONDespite six decades of experience treating patients with end stage kidney disease with hemodialysis (HD), the “optimal” treatment frequency remains unknown. Early HD prescriptions consisted of 24‐h sessions every 5–7 days.1 The first patient who received HD in this manner had an incremental increase in his HD prescription due to the emergence of symptoms of underdialysis including neuropathy and severe hypertension. It was ultimately recognized that development of these symptoms coincided with loss of his residual kidney function (RKF). Another very early HD patient, did not develop these symptoms until much later owing to the fact that he maintained RKF for nearly 18 months after HD initiation.2 Over time, significant technological advances in HD delivery and care allowed for increased HD frequency with the goal of preventing complications of end stage kidney disease.3 Today, the most commonly prescribed HD prescription in high income countries consists of 3–5 h sessions performed thrice weekly.4While the 2006 National Kidney Foundation KDOQI HD practice guidelines did consider a twice weekly schedule acceptable for patients with RKF, the 2015 update does not address twice weekly schedules and focuses more on more frequent prescriptions.4 The 2007 European Renal Association's Best Practice Guideline on Dialysis Strategies recommend HD be

Journal

Hemodialysis International – Wiley

Published: Oct 1, 2022

Keywords: hemodialysis frequency; residual kidney function; survival; systematic review

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