Frequent dialysis poses risks for kidney disease patients

Frequent treatments improve health but increase risks for certain complications

2013-02-08

(Press-News.org) Highlights Compared with standard dialysis, frequent dialysis can cause complications related to repeated access to the blood. The findings provide valuable information for dialysis patients and their physicians.

Approximately 2 million patients in the world receive dialysis treatments.

Washington, DC (February 7, 2013) — Compared with standard dialysis, frequent dialysis can cause complications related to repeated access to the blood, requiring patients to undergo more repair procedures to the site through which blood is removed and returned, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The study provides important information for physicians and patients as they weigh different dialysis options.

Frequent hemodialysis requires accessing the blood more often than conventional hemodialysis. This is usually done via a long-lasting site through which blood can be removed and returned. While daily or nightly dialysis seems to improve patients' health and quality of life, it's not known whether it increases their risk of experiencing complications. For example, more frequent access use could theoretically cause increased trauma, more inflammation, and greater exposure to bacteria.

To investigate, Rita Suri, MD (Western University and Lawson Health Research Institute, in London, Canada) and her colleagues conducted two separate 12-month clinical trials in which they randomly assigned 245 patients to receive either in-center daily hemodialysis (6 days/week) or conventional hemodialysis (3 days/week) and 87 patients to receive either home nocturnal hemodialysis (6 nights/week) or conventional hemodialysis. Three access events were recorded: repair, loss, and access-related hospitalizations.

Among the major findings:

In the Daily Trial, 77 (31%) of 245 patients experienced one of these events, with the daily group having 33 repairs and 15 losses and the conventional group having 17 repairs, 11 losses, and 1 hospitalization. Overall, the risk for an access event was 76% higher with daily hemodialysis compared with conventional hemodialysis. Similar trends were seen in the Nocturnal Trial, although the results were not statistically significant.

"Our study is the first randomized trial to show that dialyzing more frequently may have potential harmful effects on the hemodialysis vascular access. This has important implications for patients and physicians considering or performing frequent hemodialysis," said Dr. Suri.

### Study co-authors include Brett Larive, Susan Sherer, Paul Eggers, PhD, Jennifer Gassman PhD, Sam James, Robert Lindsay, MD, Robert Lockridge, MD, Daniel Ornt, MD, Michael Rocco, MD, George Ting, MD, Ala Kliger, MD, and the Frequent Hemodialysis Network Trial Group.

Disclosures: Rita Suri and Robert Lindsay have unrestricted research grants from Fresenius Medical Care Canada, and Baxter Inc. Michael Rocco is a consultant for Amgen and DaVita. Robert Lockridge sits on the Machine Medical Advisory Board for Fresenius Medical Care North America.

The article, entitled "Increased Risk of Vascular Access Complications with Frequent Hemodialysis," will appear online at http://jasn.asnjournals.org/ on February 7, 2013, doi: 10.1681/ASN.2012060595.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

ELSE PRESS RELEASES FROM THIS DATE:

Fruits and vegetables may help protect the kidneys

2013-02-08

Highlight Adding fruits and vegetables to the diet is an effective alternative to medication to reduce metabolic acidosis and kidney injury in late-stage chronic kidney disease. Metabolic acidosis is a common complication of kidney disease. Washington, DC (February 7, 2013) — Adding fruits and vegetables to the diet may help protect the kidneys of patients with chronic kidney disease (CKD) with too much acid build-up, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). Western diets that are ...

Placental mammal diversity exploded after age of dinosaurs

2013-02-08

An international team of researchers has reconstructed the common ancestor of placental mammals—an extremely diverse group including animals ranging from rodents to whales to humans—using the world's largest dataset of both genetic and physical traits. In research to be published in the journal Science, the scientists reveal that, contradictory to a commonly held theory, placental mammals did not diversify into their present-day lineages until after the extinction event that eliminated non-avian dinosaurs, and about 70 percent of all species on Earth, some 65 million years ...

New evidence suggests comet or asteroid impact was last straw for dinosaurs

2013-02-08

The demise of the dinosaurs is the world's ultimate whodunit. Was it a comet or asteroid impact? Volcanic eruptions? Climate change? In an attempt to resolve the issue, scientists at the Berkeley Geochronology Center (BGC), the University of California, Berkeley, and universities in the Netherlands and the United Kingdom have now determined the most precise dates yet for the dinosaur extinction 66 million years ago and for the well-known impact that occurred around the same time. The dates are so close, the researchers say, that they now believe the comet or asteroid, ...

Largest-ever study of mammalian ancestry completed by renowned research team

2013-02-08

Pittsburgh, Pennsylvania…A groundbreaking six-year research collaboration has produced the most complete picture yet of the evolution of placental mammals, the group that includes humans. Placental mammals are the largest branch of the mammalian family tree, with more than 5,100 living species. Researchers from Carnegie Museum of Natural History are among the team of 23 that took part in this extensive interdisciplinary effort that utilizes molecular (DNA) and morphological (anatomy) data on an extraordinary scale. By combining these two types of data scientists reconstructed, ...

Scientists team with business innovators to solve 'big data' bottleneck

2013-02-08

In a study that represents a potential cultural shift in how basic science research can be conducted, researchers from Harvard Medical School, Harvard Business School and London Business School have demonstrated that a crowdsourcing platform pioneered in the commercial sector can solve a complex biological problem more quickly than conventional approaches—and at a fraction of the cost. Partnering with TopCoder, a crowdsourcing platform with a global community of 450,000 algorithm specialists and software developers, researchers identified a program that can analyze ...

ORNL scientists solve mercury mystery, Science reports

2013-02-08

By identifying two genes required for transforming inorganic into organic mercury, which is far more toxic, scientists today have taken a significant step toward protecting human health. The question of how methylmercury, an organic form of mercury, is produced by natural processes in the environment has stumped scientists for decades, but a team led by researchers at Oak Ridge National Laboratory has solved the puzzle. Results of the study, published in the journal Science, provide the genetic basis for this process, known as microbial mercury methylation, and have far-reaching ...

HIV exploits a human cytokine in semen to promote its own transmission

2013-02-08

A new report suggests that the concentration of one human cytokine, interleukin 7 (IL-7), in the semen of HIV-1-infected men may be a key determinant of the efficiency of HIV-1 transmission to an uninfected female partner. In their study published February 7 in the Open Access journal PLOS Pathogens, a research group from the Eunice Kennedy-Shriver National Institute of Child Health and Human Development (NICHD) led by Leonid Margolis report that the increased IL-7 concentration in semen facilitates HIV transmission to cervical tissue ex vivo. Semen is a complex biological ...

Canadian researcher helps put humans on the tree of life

2013-02-08

A University of Toronto Scarborough researcher was part of a team that reconstructed the family tree of placental mammals – a diverse group that includes cats, dogs, horses and humans. The research traces placental mammals back to a small, scampering, insect-eating creature that got its start 200,000 years or more after the extinction of the dinosaurs. The work is featured in this week's Science magazine. Mary Silcox, assistant professor of anthropology at UTSC, is a co-author on the paper and the only Canadian member of the team. She was responsible for organizing the ...

Researchers create 'building block' of quanutm networks

2013-02-08

A proof-of-concept device that could pave the way for on-chip optical quantum networks has been created by a group of researchers from the US. Presenting the device today, 8 February, in the Institute of Physics and German Physical Society's New Journal of Physics, it has been described as the "building block of future quantum networks." In an optical quantum network, information is carried between points by photons – the basic unit of light. There is a huge potential for this type of network in the field of quantum computing and could enable computers that are millions ...

New report in Science illuminates stress change during the 2011 Tohoku-Oki earthquake

2013-02-08

The 11 March 2011 Tohoku-Oki earthquake (Mw9.0) produced the largest slip ever recorded in an earthquake, over 50 meters. Such huge fault movement on the shallow portion of the megathrust boundary came as a surprise to seismologists because this portion of the subduction zone was not thought to be accumulating stress prior to the earthquake. In a recently published study, scientists from the Integrated Ocean Drilling Program (IODP) shed light on the stress state on the fault that controls the very large slip. The unexpectedly large fault displacements resulted in the devastating ...

Frequent dialysis poses risks for kidney disease patients

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: