High-Frequency Hemodialysis

Does daily haemodialysis reduce survival?

“…A power analysis showed that 3,500 patients would need to be randomized to achieve 90% power to detect a 30% reduction in mortality. 10 Since such a recruitment goal would have been impossible, mortality was not a primary outcome of the study. The FHN trial showed other benefits of daily dialysis, including improved physical health as reported by the patient, better blood pressure control and reduced serum phosphorus level.…”

Dialysis time: does it matter? A reappraisal of existing literature

“…Moreover, frequent nocturnal hemodialysis but not short daily dialysis was shown to be associated with a better composite outcome of mortality and major morbidity (acute myocardial infarction or stroke), in a recent observational study [73]. The value of 'short' (2-3 h) daily dialysis as opposed to 'long' (6-8 h) nightly dialysis has been debated [74]. In response to this debate, a large multicenter study is being carried out to compare these two approaches [75].…”

Utility and Limitations of a Multicenter Nocturnal Home Hemodialysis Cohort

“…The primary outcome is a composite of 1-yr mortality (a hard outcome) and change in LVM (a surrogate outcome) or 1-yr mortality and change in health-related quality of life (16). In fact, if mortality alone were the desired outcome, then a prohibitive 5000 patients would have to be randomly assigned to have 90% power to detect a 30% reduction in mortality (17). Although we certainly encourage the conduct of desperately needed trials, given the current gap in knowledge and the limited amount of available resources, randomized trials alone are not a practical means to address many important research questions relating to NHD outcomes.…”