MINNEAPOLIS—Hemodialysis patients are at a heightened risk in the long, 2-day period in between dialysis treatments, according to a study published online Sept. 22 in the New England Journal of Medicine (NEJM).
For the study, researchers studied 32,065 participants in the End-Stage Renal Disease Clinical Performance Measures Project, a nationally representative sample of U.S. patients receiving hemodialysis three times weekly, at the end of calendar years 2004 through 2007.
Then the compared rates of death and cardiovascular-related hospital admissions on the day after the long (2-day) interdialytic interval with rates on other days. The average age of patients in the study was 62.2 years, and 24.2 percent of patients had been receiving treatment for a year or less.
After a average 2.2. year follow-up, the researchers found a number of event rates were higher the day after a long interval between treatments than on other days. They found the following:
- all-cause mortality (22.1 vs. 18.0 deaths per 100 person-years)
- mortality from cardiac causes (10.2 vs. 7.5)
- infection-related mortality (2.5 vs. 2.1)
- mortality from cardiac arrest (1.3 vs. 1.0)
- mortality from myocardial infarction (6.3 vs. 4.4)
- admissions for myocardial infarction (6.3 vs. 3.9)
- congestive heart failure (29.9 vs. 16.9)
- stroke (4.7 vs. 3.1)
- dysrhythmia (20.9 vs. 11.0)
- any cardiovascular event (44.2 vs. 19.7)
The study was funded by the National Institutes of Health (NIH)