Comparison of characteristics of centers practicing incremental vs. conventional approaches to hemodialysis delivery – postdialysis recovery time and patient survival

• Published in: Hemodialysis international 2019-07, Vol.23 (3), p.288-296
• Main Authors: Davenport, Andrew, Guirguis, Ayman, Almond, Michael, Day, Clara, Chilcot, Joseph, Wellsted, David, Farrington, Ken
• Format: Article
• Language: English
• Subjects: incremental haemodialysis; postdialysis recovery time; residual kidney function; survival
• ISSN: 1492-7535; 1542-4758
• DOI: 10.1111/hdi.12743

Introduction: Conventional haemodialysis (HD) involves treatment times of around 4 hours thrice weekly, taking no account of residual kidney function (RKF). In incremental HD the frequency and duration of dialysis sessions are individualized according to RKF. There are no studies comparing these approaches. We utilized data from a recent multicenter study to compare patient characteristics and outcomes between a center practicing incremental HD and others using a conventional approach. Methods: Seven hundred and nine patients attending for routine outpatient HD in five UK centers were studied. One center practiced incremental dialysis (n = 254) and four conventional HD (n = 455). Data collected included demographics, comorbidity, dialysis parameters, routine biochemistry and hematology, recovery time postdialysis, and Beck Depression Inventory‐II score (BDI‐II). Patients were followed for a minimum of 12 months. Findings: Pre‐ and postdialysis BP, serum calcium and phosphate were higher in the incremental center, whilst sessional Kt/Vurea was lower (all P