PowerPoint Slides for: Prognostic Value of the Delivery Dialysis Dose on Twice-Weekly Hemodialysis Patients

Background: Few studies have evaluated the prognostic
value of dialysis dose in twice-weekly hemodialysis (HD). A single-pool
Kt/V (spKt/V) over 1.70 may benefit patients receiving twice-weekly
maintenance HD. Methods: This is a multicenter randomized
controlled trial performed on 163 patients from 17 dialysis centers in
Shanghai who were allocated to high- (n = 98) and standard-dose groups (n
= 65) and followed through 96 weeks of study period. Therapeutic
approaches were given to increase spKt/V to over 1.70 in the high-dose
group. Data were collected every 12-24 weeks. The primary outcomes were
all-cause mortality and major adverse cardio-cerebrovascular events
(MACEs) occurrence, and secondary outcomes included residual kidney
function (RKF) and health-related quality of life (HR-QOL). Results: The spKt/V in high-dose and standard-dose groups were 1.80 ± 0.23 and 1.55 ± 0.19, respectively, after an 8-week intervention (p
< 0.001). At the end of the study, SF-36 physical function and total
score in high-dose group were 82 (69-90) and 74 (47-84), respectively,
both of which were higher than those in the standard-dose group. Decline
in urine volume was observed in both groups with no significant
difference (p = 0.431). No difference was found in overall survival between the 2 groups (p = 0.580). The 1-year MACE-free survival for high-dose group was 84.49%, better than 76.72% for standard-dose group (p = 0.029). Conclusions:
Higher spKt/V is also associated with MACE-free survival and better
HR-QOL, especially in physical function aspect for twice-weekly dialysis
patients. Increasing spKt/V over 1.70 in twice-weekly HD population
does not cause loss of RKF.