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

Blood Purification
Jochen G RaimannFrequent Hemodialysis Network (FHN) Trial Group

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.

Citations

Apr 21, 2017·Hemodialysis International·Amanda J MillerKarthik K Tennankore
Mar 7, 2017·Seminars in Dialysis·Dana C Miskulin, Daniel E Weiner
Mar 11, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Wesley Hayes, Fabio Paglialonga
Mar 30, 2018·Journal of the American Society of Nephrology : JASN·Charalampos LoutradisCarmine Zoccali
Feb 21, 2019·Hemodialysis International·Michael GirsbergerChristopher T Chan
Mar 13, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Nicholas SangalaAllan Collins
May 12, 2020·Hemodialysis International·Michael GirsbergerChristopher T Chan
Mar 23, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·James TattersallUNKNOWN European Renal Best Practice Guidelines Group and the European Union of Geriatric Medicine Societies (EUGMS) collaborative g
Apr 30, 2021·Néphrologie & thérapeutique·Karthik K TennankoreAmanda J Vinson
Oct 14, 2021·Kidney & Blood Pressure Research·Jochen G RaimannUNKNOWN Frequent Hemodialysis Network (FHN) Trial Group

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