Dialysis 3 Times Weekly May Not Be Enough, New Study Suggests

Dialysis may need to be performed on patients with failing kidneys more than just three times a week, according to a new study published in the New England Journal of Medicine.

The federally-funded study, performed by Dr. Robert Foley of the University of Minnesota and colleagues, found that deaths, heart attacks and hospitalizations were much higher on the day after the two-day interval between treatments each week than at other times, according to the Associated Press.

"We could be doing a better job for our dialysis patients" and that might mean doing it more often, said Dr. Lynda Szczech, a Duke University kidney specialist who had no role in the study, as reported by the Associated Press.

The president of the National Kidney Foundation said she was "very troubled" by the results of the largest dialysis study yet, the Associated Press reports.

Most of the 400,000 Americans with failing kidneys stay alive by getting their blood purified by a machine three days a week at dialysis clinics -usually on Mondays, Wednesdays and Fridays or on Tuesdays, Thursdays and Saturdays, the Associated Press reports. In both cases, there's a two-day break between the last session of the week and the next one.

Medical records of 32,000 people who had in-center dialysis three times a week from 2005 through 2008 were analyzed, the Associated Press reports. The average age was 62 and a quarter had been on dialysis for a year or less. After about two years of follow-up, 41 percent had died, including 17 percent from heart-related causes. Monday was the riskiest day for patients on a Monday-Wednesday-Friday schedule. For those on a Tuesday-Thursday-Saturday schedule, the riskiest day was Tuesday. Researchers found a 22 percent higher risk of death on the day after a long break compared with other days of the week, according to the Associated Press. Doctors have suspected that the two-day break between treatments was risky, and smaller studies have found more heart-related deaths on the day after the gap, the Associated Press reports. "All the fluids and toxins are built up to the highest extent on Monday morning right before dialysis," said Dr. Anthony Bleyer of Wake Forest Baptist Medical Center in North Carolina, who has done similar studies, according to the Associated Press.
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