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September 23, 2011

Fifty-year-old dialysis treatment questioned

Daily Briefing

A new study in NEJM challenges traditional dialysis treatment for kidney failure patients, suggesting that administering the treatment only three times weekly may put patients at risk.

According to the AP/Washington Post, about 400,000 U.S. residents undergo dialysis to cleanse their blood, which typically is administered three days per week at dialysis clinics, usually on Mondays, Wednesdays, and Fridays or on Tuesdays, Thursdays, and Saturdays. Patients on both schedules have a two-day break between sessions, which some physicians have suspected can increase patients' risk for complications.

For the new study, researchers from the University of Minnesota and the U.S. Renal Data System analyzed medical records for more than 32,000 patients who underwent dialysis three times weekly between 2005 and 2008. After two years, the findings showed that 41% of participants had died, and 17% of those patients died from heart-related conditions.

The researchers found that patients faced a 22% higher mortality risk on the first day after a long break, compared to other days of the week. Meanwhile, hospital admissions for cardiovascular conditions and stroke more than doubled on Mondays and Tuesdays for the respective schedules.

Commenting on the findings, Eli Friedman, a physician at SUNY Downstate Medical Center, acknowledged that more frequent dialysis could benefit patients, but noted that it would be a "multibillion dollar change." Meanwhile, the AP/Post notes that more frequent treatments would require clinics to hire additional staff, and patients would have to agree to undergo treatment more often (Roan, "Booster Shots," Los Angeles Times, 9/21; AP/Washington Post, 9/21). 

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