Kamyar Kalantar-Zadeh, Mark Unruh, Philip G Zager, Csaba P Kovesdy, Joanne M Bargman, Jing Chen, Suresh Sankarasubbaiyan, Gaurang Shah, Thomas Golper, Richard A Sherman, David S Goldfarb
Mortality is highest in the first months of maintenance hemodialysis (HD) therapy. In many Western countries, patients who transition to kidney replacement therapy usually begin thrice-weekly HD regardless of their level of residual kidney function (RKF). RKF is a major predictor of survival. RKF may decline more rapidly with thrice-weekly HD treatments, is associated with a reduced need for dialytic solute clearance, and is an important factor in the prescription of peritoneal dialysis. In this article, we review the concept of incremental HD, in which weekly dialysis dose, in particular HD treatment frequency, is based on a variety of clinical factors, such as RKF (including urine output > 0...
August 2014: American Journal of Kidney Diseases