The Effect of Increased Frequency of Hemodialysis on Volume-Related Outcomes: A Secondary Analysis of the Frequent Hemodialysis Network Trials.

Abstract:

:In previous reports of the Frequent Hemodialysis Network trials, frequent hemodialysis (HD) reduced extracellular fluid (ECF) and left ventricular mass (LVM), with more pronounced effects observed among patients with low urine volume (UVol). We analyzed the effect of frequent HD on interdialytic weight gain (IDWG) and a time-integrated estimate of ECF load (TIFL). We also explored whether volume and sodium loading contributed to the change in LVM over the study period. Treatment effects on volume parameters were analyzed for modification by UVol and the dialysate-to-serum sodium gradient. Predictors of change in LVM were determined using linear regression. Frequent HD reduced IDWG and TIFL in the Daily Trial. Among patients with UVol <100 ml/day, reduction in TIFL was associated with LVM reduction. This suggests that achievement of better volume control could attenuate changes in LVM associated with mortality and cardiovascular morbidity. TIFL may prove more useful than IDWG alone in guiding HD practice. Video Journal Club 'Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=441966.

journal_name

Blood Purif

journal_title

Blood purification

authors

Raimann JG,Chan CT,Daugirdas JT,Depner T,Gotch FA,Greene T,Kaysen GA,Kliger AS,Kotanko P,Larive B,Lindsay R,Rocco MV,Chertow GM,Levin NW,Frequent Hemodialysis Network (FHN) Trial Group.

doi

10.1159/000441966

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

277-86

issue

4

eissn

0253-5068

issn

1421-9735

pii

000441966

journal_volume

41

pub_type

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