Doubling dialysis frequency helps patients
Kidney failure patients who double the number of weekly dialysis treatments typically prescribed tend to have significantly better heart function, overall health and general quality of life.
Researchers did an analysis that compared the impact of the 40-year-old standard of care - three dialysis treatments per week, for three to four hours per session - with a six-day a week treatment regimen involving sessions of 2.5 to three hours per session. Launched in 2006, the comparison involved 245 dialysis patients in America assigned to either a standard dialysis schedule or the high-frequency option. All participants underwent MRIs to assess heart muscle structure, and all completed quality-of-life surveys. In addition to improved cardiovascular health and overall health, the analysis revealed that two concerns faced by most kidney failure patients - blood pressure and phosphate level control - also fared better under the more frequent treatment programme.
Kidneys work seven days a week, 24 hours a day. Therefore, people feel better if dialysis were to more closely mimic kidney function. But one has to factor in the burden of additional sessions, the travel and the cost. Also, doubling dialysis treatment also increases the number of procedures patients have to undergo to deal with the side effects prompted by more frequent insertion of tubes into the body. Therefore, future treatment plans should be constructed case-by-case. Just the way one size does not fit all, for some patients with kidney failure, no dialysis is the right treatment. For others, it's three times a week in-centre. For others, it's home-based dialysis. For others, perhaps six times a week.
A normal kidney works 168 hours a week filtering our blood and removing fluid. But with dialysis the same work is done intermittently just three times a week, for three to four hours each time. And that's clearly a major problem for dialysis patients, because it's a very harsh form of fluid removal that can stretch and strain the heart and leave patients feeling unwell. So an increased use of dialysis is a more facile approach to controlling blood volume, because it removes fluid in a more sustained and more natural way, which the heart prefers. So ultimately, you have less strain on the heart, less heart failure and patients living longer, the researchers concluded.
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