Initiating haemodialysis twice-weekly as part of an incremental programme may protect residual kidney function

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2019-06, Vol.34 (6), p.1017-1025
• Main Authors: Kaja Kamal, Raja Mohammed, Farrington, Ken, Busby, Amanda D, Wellsted, David, Chandna, Humza, Mawer, Laura J, Sridharan, Sivakumar, Vilar, Enric
• Format: Article
• Language: English
• Subjects: Aged; Body Weight; Comorbidity; Disease Progression; Female; Humans; Kidney - physiology; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - therapy; Male; Middle Aged; Peripheral Vascular Diseases - mortality; Peripheral Vascular Diseases - therapy; Proportional Hazards Models; Renal Dialysis - methods; Retrospective Studies; Treatment Outcome
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfy321

Abstract Background Initiating twice-weekly haemodialysis (2×HD) in patients who retain significant residual kidney function (RKF) may have benefits. We aimed to determine differences between patients initiated on twice- and thrice-weekly regimes, with respect to loss of kidney function, survival and other safety parameters. Methods We conducted a single-centre retrospective study of patients initiating dialysis with a residual urea clearance (KRU) of ≥3 mL/min, over a 20-year period. Patients who had 2×HD for ≥3 months during the 12 months following initiation of 2×HD were identified for comparison with those dialysed thrice-weekly (3×HD). Results The 2×HD group consisted of 154 patients, and the 3×HD group 411 patients. The 2×HD patients were younger (59 ± 15 versus 62 ± 15 years: P = 0.014) and weighed less (70 ± 16 versus 80 ± 18 kg: P