Skip to main content

Advertisement

SpringerLink
Log in

Frequent hemodialysis: history of the modality and assessment of outcomes

  • Editorial Commentary
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

About 660,000 individuals have end-stage renal disease in the USA, the vast majority of whom are receiving standard, in-center, thrice-weekly hemodialysis (HD). The morbidity and mortality among patients receiving standard HD remain unacceptably high. Studies conducted over the past two decades have provided a substantial amount of information on the advantages and drawbacks of providing more frequent HD treatment, either in-center or at home. In this article I summarize these studies, focusing special attention on the randomized, cross-over study assessing outcomes in children who received either frequent, in-center HD or traditional, thrice-weekly, in-center HD performed by Laskin et al. (Pediatr Nephrol doi:10.1007/s00467-017-3656-x, 2017).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Laskin BL, Huang G, King E, Geary DF, Licht C, Metlay JP, Furth SL, Kimball T, Mitsnefes M (2017) Short, frequent, 5 days per week in-center hemodialysis versus 3 days per week treatment: a randomized cross-over pilot trial through the Midwest Pediatric Nephrology Consortium. Pediatr Nephrol. doi:10.1007/s00467-017-3656-x

  2. US Renal Data System (USRDS) (2015) 2015 USRDS annual data report, volume 2—ESRD in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda. Available at www.usrds.org

  3. Lameire N, Van Biesen W (2010) Epidemiology of peritoneal dialysis: a story of believers and nonbelievers. Nat Rev Nephrol 6:75–82

    Article  PubMed  Google Scholar 

  4. US Renal Data System (USRDS) (2009) 2009 annual data report. Atlas of chronic kidney disease and end-stage renal disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda. Available at www.usrds.org

  5. Scribner BH, Cole JJ, Ahmad S, Blagg CR (2004) Why thrice weekly dialysis? Hemodial Int 8:188–192

    Article  PubMed  Google Scholar 

  6. McLaughlin K, Manns B, Mortis G, Hons R, Taub K (2003) Why patients with ESRD do not select self-care dialysis as a treatment option. Am J Kidney Dis 41:380–385

    Article  PubMed  Google Scholar 

  7. Golper T (2001) Patient education: can it maximize the success of therapy? Nephrol Dial Transplant 16[Suppl 7]:20–24

  8. Hemodialysis Adequacy 2006 Work Group (2006) Clinical practice guidelines for hemodialysis adequacy, update 2006. Am J Kidney Dis 48[Suppl 1]:S2–S90

  9. Baillod R, Comty C, Shaldon S (1965) Over-night unattended haemodialysis in the home. Proc Eur Dial Transpl Assoc 2:99–109

    Google Scholar 

  10. Charra B, Calemard E, Ruffet M, Chazot C, Terrat JC, Vanel T, Laurent G (1992) Survival as an index of adequacy of dialysis. Kidney Int 41:1286–1291

    Article  CAS  PubMed  Google Scholar 

  11. Uldall R, Ouwendyk M, Francoeur R, Wallace L, Sit W, Vas S, Pierratos A (1996) Slow nocturnal home hemodialysis at the Wellesley hospital. Adv Ren Replace Ther 3:133–136

    CAS  PubMed  Google Scholar 

  12. Pierratos A, Ouwendyk M, Francoeur R, Wallace L, Sit W, Vas S, Pierratos A (1998) Nocturnal hemodialysis: three-year experience. J Am Soc Nephrol 9:859–868

    CAS  PubMed  Google Scholar 

  13. Kjellstrand CM, Buoncristiani U, Ting G, Traeger J, Piccoli GB, Sibai-Galland R, Young BA, Blagg CR (2008) Short daily haemodialysis: survival in 415 patients treated for 1006 patient-years. Nephrol Dial Transplant 23:3283–3289

    Article  PubMed  Google Scholar 

  14. Locatelli F, Buoncristiani U, Canaud B, Kohler H, Petitclerc T, Zucchelli P (2005) Dialysis dose and frequency. Nephrol Dial Transplant 20:285–296

    Article  PubMed  Google Scholar 

  15. Lowrie EG, Laird NM, Parker TF, Sargent JA (1981) Effect of the hemodialysis prescription of patient morbidity: report from the National Cooperative Dialysis Study. N Engl J Med 305:1176–1181

    Article  CAS  PubMed  Google Scholar 

  16. Eknoyan G, Beck GJ, Cheung AK, Daugirdas JT, Greene T, Kusek JW, Allon M, Bailey J, Delmez JA, Depner TA, Dwyer JT, Levey AS, Levin NW, Milford E, Ornt DB, Rocco MV, Schulman G, Schwab SJ, Teehan BP, Toto R, Hemodialysis (HEMO) Study Group (2002) Effect of dialysis dose and membrane flux in maintenance hemodialysis. N Engl J Med 347:2010–2019

    Article  PubMed  Google Scholar 

  17. Unruh M, Benz R, Greene T, Yan G, Beddhu S, de Vita M, Dwyer JT, Kimmel PL, Kusek JW, Martin A, Rehm-McGillicuddy J, Teehan BP, Meyer KB, HEMO Study Group (2004) Effects of hemodialysis dose and membrane flux on health-related quality of life in the HEMO study. Kidney Int 66:355–366

    Article  PubMed  Google Scholar 

  18. Rocco MV, Dwyer JT, Larive B, Greene T, Cockram DB, Chumlea WC, Kusek JW, Leung J, Burrowes JD, SL ML, Poole D, Uhlin L, HEMO Study Group (2004) The effect of dialysis dose and membrane flux on nutritional parameters in hemodialysis patients: results of the HEMO study. Kidney Int 65:2321–2334

    Article  CAS  PubMed  Google Scholar 

  19. Walsh M, Culleton B, Tonelli M, Manns B (2005) A systematic review of the effect of nocturnal hemodialysis on blood pressure, left ventricular hypertrophy, anemia, mineral metabolism, and health-related quality of life. Kidney Int 67:1500–1508

    Article  PubMed  Google Scholar 

  20. Chan CT, Floras JS, Miller JA, Richardson RM, Pierratos A (2002) Regression of left ventricular hypertrophy after conversion to nocturnal hemodialysis. Kidney Int 61:2235–2239

    Article  PubMed  Google Scholar 

  21. Chan CT, Jain V, Picton P, Pierratos A, Floras JS (2005) Nocturnal hemodialysis increases arterial baroreflex sensitivity and compliance and normalizes blood pressure of hypertensive patients with end-stage renal disease. Kidney Int 68:338–344

    Article  PubMed  Google Scholar 

  22. Pierratos A (1999) Nocturnal home hemodialysis: an update on a 5-year experience. Nephrol Dial Transplant 14:2835–2840

    Article  CAS  PubMed  Google Scholar 

  23. Lockridge RS Jr, Spencer M, Craft V, Pipkin M, Campbell D, McPhatter L, Albert J, Anderson H, Jennings F, Barger T (2004) Nightly home hemodialysis: five and one-half years of experience in Lynchburg, Virginia. Hemodial Int 8:61–69

    Article  PubMed  Google Scholar 

  24. Culleton BF, Walsh M, Klarenbach SW, Mortis G, Scott-Douglas N, Quinn RR, Tonelli M, Donnelly S, Friedrich MG, Kumar A, Mahallati H, Hemmelgarn BR, Manns BJ (2007) Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and quality of life: a randomized controlled trial. JAMA 298:1291–1299

    Article  CAS  PubMed  Google Scholar 

  25. FHN Trial Group, Chertow GM, Levin NW, Beck GJ, Depner TA, Eggers PW, Gassman JJ, Gorodetskaya I, Greene T, James S, Larive B, Lindsay RM, Mehta RL, Miller B, Ornt DB, Rajagopalan S, Rastogi A, Rocco MV, Schiller B, Sergeyeva O, Schulman G, Ting GO, Unruh ML, Star RA, Kliger AS (2010) In-center hemodialysis six times per week versus three times per week. N Engl J Med 363:2287–2300

    Article  Google Scholar 

  26. Ayus JC, Mizani MR, Achinger SG, Thadhani R, Go AS, Lee S (2005) Effects of short daily versus conventional hemodialysis on left ventricular hypertrophy and inflammatory markers: a prospective, controlled study. J Am Soc Nephrol 16:2778–2788

    Article  CAS  PubMed  Google Scholar 

  27. Weinhandl ED, Nieman KM, Gilbertson DT, Collins AJ (2015) Hospitalization in daily home hemodialysis and matched thrice-weekly in-center hemodialysis patients. Am J Kidney Dis 65:98–108

    Article  PubMed  Google Scholar 

  28. Kotanko P, Garg AX, Depner T, Pierratos A, Chan CT, Levin NW, Greene T, Larive B, Beck GJ, Gassman J, Kliger AS, Stokes JB; FHN Trial Group (2015) Effects of frequent hemodialysis on blood pressure: results from the randomized frequent hemodialysis Network trials. Hemodial Int 19:386–401

    Article  PubMed  PubMed Central  Google Scholar 

  29. Buoncristiani U, Fagugli R, Ciao G, Ciucci A, Carobi C, Quintaliani G, Pasini P (1999) Left ventricular hypertrophy in daily dialysis. Miner Electrolyte Metab 25:90–94

    Article  CAS  PubMed  Google Scholar 

  30. Hall YN, Larive B, Painter P, Kaysen GA, Lindsay RM, Nissenson AR, Unruh ML, Rocco MV, Chertow GM, Frequent Hemodialysis Network Trial Group (2012) Effects of six versus three times per week hemodialysis on physical performance, health, and functioning: Frequent Hemodialysis Network (FHN) randomized trials. Clin J Am Soc Nephrol 7:782–794

    Article  PubMed  PubMed Central  Google Scholar 

  31. Chertow GM, Johansen KL, Lew N, Lazarus JM, Lowrie EG (2001) Vintage, nutritional status, and survival in hemodialysis patients. Kidney Int 57:1176–1181

    Article  Google Scholar 

  32. Kaysen GA, Greene T, Larive B, Mehta RL, Lindsay RM, Depner TA, Hall YN, Daugirdas JT, Chertow GM; FHN Trial Group (2012) The effect of frequent hemodialysis on nutrition and body composition: frequent Hemodialysis Network Trial. Kidney Int 82:90–99

  33. Sikkes ME, Kooistra MP, Weijs PJ (2009) Improved nutrition after conversion to nocturnal home hemodialysis. J Ren Nutr 19:494–499

    Article  CAS  PubMed  Google Scholar 

  34. Rocco MV (2013) Does more frequent hemodialysis provide dietary Freedom? J Renal Nutr 23:259–262

    Article  Google Scholar 

  35. McFarlane P, Komenda P (2011) Economic considerations in frequent home hemodialysis. Semin Dial 24:678–683

    Article  PubMed  Google Scholar 

  36. Lee H, Manns B, Taub K, Ghali WA, Dean S, Johnson D, Donaldson C (2002) Cost analysis of ongoing care of patients with end-stage renal disease: the impact of dialysis modality and dialysis access. Am J Kidney Dis 40:611–622

    Article  PubMed  Google Scholar 

  37. Kroeker A, Clark WF, Heidenheim AP, Kuenzig L, Leitch R, Meyette M, Muirhead N, Ryan H, Welch R, White S, Lindsay RM (2003) An operating cost comparison between conventional and home quotidian hemodialysis. Am J Kidney Dis 42:49–55

    Article  PubMed  Google Scholar 

  38. McFarlane PA, Bayoumi AM, Pierratos A, Redelmeier DA (2003) The quality of life and cost utility of home nocturnal and conventional in-center hemodialysis. Kidney Int 64:1004–1011

    Article  PubMed  Google Scholar 

  39. McFarlane PA, Bayoumi AM, Pierratos A, Redelmeier DA (2006) The impact of home nocturnal hemodialysis on end-stage renal disease therapies: a decision analysis. Kidney Int 69:798–805

    Article  CAS  PubMed  Google Scholar 

  40. Regidor DL, Kovesdy CP, Mehrotra R, Rambod M, Jing J, McAllister CJ, Van Wyck D, Kopple JD, Kalantar-Zadeh K (2008) Serum alkaline phosphatase predicts mortality among maintenance hemodialysis patients. J Am Soc Nephrol 19:2193–2203

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Mucsi I, Hercz G, Uldall R, Ouwendyk M, Francoeur R, Pierratos A (1998) Control of serum phosphate without any phosphate binders in patients treated with nocturnal hemodialysis. Kidney Int 53:1404

    Article  Google Scholar 

  42. Rodriguez-Benot A, Martin-Malo A, Alvarez-Lara MA, Rodriguez M, Aljama P (2005) Mild hyperphosphatemia and mortality in hemodialysis patients. Am J Kidney Dis 46:68–77

    Article  CAS  PubMed  Google Scholar 

  43. Block GA, Hulbert-Shearon TE, Levin NW, Port FK (1998) Association of serum phosphorus and calcium–phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am J Kidney Dis 31:607–617

    Article  CAS  PubMed  Google Scholar 

  44. Young EW, Akiba T, Albert JM, McCarthy JT, Kerr PG, Mendelssohn DC, Jadoul M (2004) Magnitude and impact of abnormal mineral metabolism in hemodialysis patients in the dialysis outcomes and practice patterns study (DOPPS). Am J Kidney Dis 44:34–38

    Article  PubMed  Google Scholar 

  45. Slinin Y, Foley RN, Collins AJ (2005) Calcium, phosphorus, parathyroid hormone, and cardiovascular disease in hemodialysis patients: the USRDS waves 1, 3, and 4 study. J Am Soc Nephrol 16:1788–1793

    Article  CAS  PubMed  Google Scholar 

  46. Jean G, Chazot C, Charra B (2006) Hyperphosphataemia and related mortality. Nephrol Dial Transplant 21:273–280

    Article  PubMed  Google Scholar 

  47. Daugirdas JT, Chertow GM, Larive B, Pierratos A, Greene T, Ayus JC, Kendrick CA, James SH, Miller BW, Schulman G, Salusky IB, Kliger AS, Frequent Hemodialysis Network (FHN) Trial Group (2012) Effects of frequent hemodialysis on measures of CKD mineral and bone disorder. J Am Soc Nephrol 23:727–738

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Ornt DB, Larive B, Rastogi A, Rashid M, Daugirdas JT, Hernandez A, Kurella Tamura M, Suri RS, Levin NW, Kliger AS, Frequent Hemodialysis Network Trial Group (2013) Impact of frequent hemodialysis on anemia management: results from the Frequent Hemodialysis Network (FHN) Trials. Nephrol Dial Transplant 28:1888–1898

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Lo JC, Bewck GJ, Kaysen GA, Chan CT, Kliger AS, Rocco MV, Chertow GM, Study FHN (2016) Hyperprolactinemia in end-stage renal disease and effects of frequent hemodialysis. Hemodial Int. doi:10.1111/hdi.12489

    Google Scholar 

  50. National Kidney Foundation: KDOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Available at http://www.kidney.org/professionals/kdoqi/guidelines_cvd/intradialytic.htm.

  51. Clavo C, Maule S, Mecca F, Quadri R, Martina G, Cavallo Perin P (2002) The influence of autonomic neuropathy on hypotension during hemodialysis. Clin Auton Res 12:84–87

    Article  Google Scholar 

  52. Rocco MV, Lockridge RS, Beck GJ, Eggers PW, Gassman JJ, Greene T, Larive B, Chan CT, Chertow GM, Copland M, Hoy CD, Lindsay RM, Levin NW, Ornt DB, Pierratos A, Pipkin MF, Rajagopalan S, Stokes JB, Unruh ML, Star RA, Kliger AS, Frequent Hemodialysis Network (FHN) Trial Group, Kliger A, Eggers P, Briggs J, Hostetter T, Narva A, Star R, Augustine B, Mohr P, Beck G, Fu Z, Gassman J, Greene T, Daugirdas J, Hunsicker L, Larive B, Li M, Mackrell J, Wiggins K, Sherer S, Weiss B, Rajagopalan S, Sanz J, Dellagrottaglie S, Kariisa M, Tran T, West J, Unruh M, Keene R, Schlarb J, Chan C, McGrath-Chong M, Frome R, Higgins H, Ke S, Mandaci O, Owens C, Snell C, Eknoyan G, Appel L, Cheung A, Derse A, Kramer C, Geller N, Grimm R, Henderson L, Prichard S, Roecker E, Rocco M, Miller B, Riley J, Schuessler R, Lockridge R, Pipkin M, Peterson C, Hoy C, Fensterer A, Steigerwald D, Stokes J, Somers D, Hilkin A, Lilli K, Wallace W, Franzwa B, Waterman E, Chan C, McGrath-Chong M, Copland M, Levin A, Sioson L, Cabezon E, Kwan S, Roger D, Lindsay R, Suri R, Champagne J, Bullas R, Garg A, Mazzorato A, Spanner E, Rocco M, Burkart J, Moossavi S, Mauck V, Kaufman T, Pierratos A, Chan W, Regozo K, Kwok S (2011) The effects of frequent, nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial. Kidney Int 80:1081–1091

    Article  Google Scholar 

  53. Jaber BL, Lee Y, Collins AJ, Hull AR, Kraus MA, McCarthy J, Miller BW, Spry L, Finkelstein FO, FREEDOM Study Group (2010) Effect of daily hemodialysis on depressive symptoms and postdialysis recovery time: interim report from the FREEDOM (Following Rehabilitation, Economics, and Everyday-Dialysis Outcome Measurements) study. Am J Kidney Dis 56:531–539

    Article  PubMed  Google Scholar 

  54. Shoji T, Tsubakihara Y, Fujii M, Imai E (2004) Hemodialysis-associated hypotension as an independent risk factor for two-year mortality in hemodialysis patients. Kidney Int 66:1212–1220

    Article  PubMed  Google Scholar 

  55. Murray AM, Tupper DE, Knopman DS (2006) Cognitive impairment in hemodialysis patients is common. Neurology 25:216–223

    Article  Google Scholar 

  56. Tamura MK, Unruh ML, Nissenson AR, Larive B, Eggers PW, Gassman J, Mehta RL, Kliger AS, Stokes JB, Frequent Hemodialysis Network (FHN) Trial Group (2013) Effect of more frequent hemodialysis on cognitive function in the Frequent Hemodialysis Network trials. Am J Kidney Dis 61:228–237

    Article  Google Scholar 

  57. Suri RS, Larive B, Garg AX, Hall YN, Pierratos A, Chertow GM, Gorodetskeya I, Kliger AS, FHN Study Group (2011) Burden on caregivers as perceived by hemodialysis patients in the Frequent Hemodialysis Network (FHN) Trials. Nephrol Dial Transplant 26:2316–2322

    Article  PubMed  PubMed Central  Google Scholar 

  58. Suri RS, Larive B, Sherer S, Eggers P, Gassman J, James SH, Lindsay RM, Lockridge RS, Ornt DB, Rocco MV, Ting GO, Kliger AS, Frequent Hemodialysis Network Trial Group (2013) Risk of vascular access complications with frequent hemodialysis. J Am Soc Nephrol 24:498–505

    Article  PubMed  PubMed Central  Google Scholar 

  59. Farrington K (2013) Commentary for ‘effect of frequent hemodialysis on residual kidney function: Frequent Hemodialysis Network (FHN) Trials. Kidney Int 83:787–789

    Article  PubMed  Google Scholar 

  60. Daugirdas JT, Greene T, Rocco MV, Kaysen GA, Depner TA, Levin NW, Chertow GM, Ornt DB, Raimann JG, Larive B, Kliger AS, FHN Trial Group (2013) Effect of frequent hemodialysis on residual kidney function. Kidney Int 83:949–958

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Axley B, Speranza-Reid J, Williams H (2012) Venous needle dislodgement in patients on hemodialysis. Nephrol Nurs J 39:435–445

    PubMed  Google Scholar 

  62. Pennsylvania Patient Safety Authority (2010) Hemodialysis administration: strategies to ensure safe patient care. Pennsylvania Patient Safety Authority 7:87–96

    Google Scholar 

  63. U.S. Department of Health and Human Services (DHHS) and Centers for Medicare & Medicaid Services (CMS) (2008) Centers for Medicare & Medicaid Programs; conditions of coverage for end stage renal disease facilities; Final Rule (42 CFR Parts 405, 410, 413 et al.). Federal Register 71:20384. Retrieved from http://www.cms.hhs.gov/CfCsAndCoPs/Downloads/ESRDfinalrule0415.pdf

  64. Renal Physicians Association (2007) Health and safety survey to improve patient safety in end stage renal disease: Report of findings from the ESRD patient survey. Renal Physicians Association, Rockville

  65. Tennankore KK, d’Gama C, Faratro R, Fung S, Wong E, Chan CT (2015) Adverse technical events in home hemodialysis. Am J Kidney Dis 65:116–121

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Devices and Radiological Health, Food and Drug Administration, 10993 New Hampshire Avenue, Building 66-G252, Silver Spring, MD, 20994, USA

    Douglas M. Silverstein

Authors
  1. Douglas M. Silverstein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Douglas M. Silverstein.

Ethics declarations

Conflict of interest

The author declares that there are no conflicts of interest.

Disclaimer

The views and opinions expressed in this publication are those of the author and do not necessarily reflect the official policies of the Department of Health and Human Services, or the United States Government.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Silverstein, D.M. Frequent hemodialysis: history of the modality and assessment of outcomes. Pediatr Nephrol 32, 1293–1300 (2017). https://doi.org/10.1007/s00467-017-3659-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-017-3659-7

Keywords

Search

Navigation