EBPG guideline on dialysis strategies

Extract

1. Time and frequency

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Rationale

Definitions of dialysis schedules

Due to high mortality and morbidity rates and, inter and intradialytic symptoms associated with conventional intermittent HD three times a week, different modalities of HD treatment based on variations in dialysis time and frequency have been developed in the last years:

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Are there specific indications for increasing the duration of HD?

The ideal length of dialysis is still controversial [1–5]. The length of the dialysis should be individualized according to the requirements of each patient [6]. Adequate randomized controlled trials comparing increased dialysis time with conventional HD are lacking, however, some recommendations may be made:

A dialysis session of 8 h three times a week increases both the dialysis dose and time [7]. Uncontrolled study suggests that it results in better blood pressure control with a significant reduction in antihypertensive drugs, fewer intradialytic complications, improvement of nutritional status and an increased survival [1,8]