Hemodialysis Study

The Hemodialysis (HEMO) Study was a multi-center, randomized clinical trial designed to test whether the mortality and morbidity of hemodialysis (HD) patients can be reduced by modifying the dialysis procedure for the removal of toxins from the blood. The study examined two factors, the dose of dialysis delivered and the size of the molecules removed, to determine the effect on the survival or morbidity among hemodialysis patients. A two-by-two factorial design was used to assign 1846 patients randomly to either a standard or high dose of dialysis and to either a dialyzer with a low-flux or high-flux membrane for dialysis three times a week. The primary outcome, death from any cause, was not significantly influenced by the dose or flux assignment. The relative risk of death was not significantly different in the high-dose group compared to the standard-dose group, or the high-flux group as compared with the low-flux group. The main secondary outcomes, including first hospitalization, did not differ significantly for either the dose groups or the flux groups. Patients undergoing hemodialysis three times a week appear to have no major benefit from either a higher dialysis dose than that recommended by current U.S. guidelines or from the use of a high-flux membrane.