November 30, 2015

The mortality and hospitalization rates associated with the long interdialytic gap in thrice-weekly hemodialysis patients.

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This article aimed to identify factors associated with mortality and hospitalization events in England from 2002-2006 comparing the 2 day vs 3 day intradialytic gap. Higher admission rates were seen after the 2-day gap irrespective of whether thrice-weekly dialysis sequence commenced on a Monday or Tuesday (2.4 per year after the 2-day gap vs. 1.4 for the rest of the week, rate ratio 1.7). Increased mortality following the 2-day gap was similarly independent of session pattern (20.5 vs. 16.7 per 100 patient years, rate ratio 1.22), with these increases being driven by out-of-hospital death (rate ratio 1.59 vs. 1.06 for in-hospital death). Thus, fluid overload may increase the risk of hospital admission after the 2-day gap and that the increased out-of-hospital mortality may relate to a higher incidence of sudden death.  Further subgroup analysis is needed.

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Clinical Nephrology, Clinical Trial Results, Hemodialysis