CLINICAL-EXPERIENCE WITH SHORT-TIME HEMODIALYSIS

After at least 6 months on conventional hemodialysis (cellulosic dialyzers, acetate dialysate, and a 3- to 4-hour treatment time), 56 patients were changed to short-time hemodialysis (<180 minutes) using polysulfone dialyzers and bicarbonate-containing dialysate. Treatment time decreased (191 ± 5 v 147 ± 5 min; P = 0.001), while Kt/V (1.22 ± 0.04 v 1.29 ± 0.06; P = NS) and normalized protein catabolic rate (pcr) (1.10 ± 0.05 v 1.10 ± 0.07 g/kg/d; P = NS) remained constant. When compared with the conventional period, 30 months of short-time hemodialysis resulted in no changes in predialysis blood pressure (BP) (151 ± 2/84 ± 1 v 151 ± 2/86 ± 1 mm Hg), postdialysis BP (144 ± 2/81 ± 1 v 143 ± 3/84 ± 1 mm Hg), interdialytic weight gain (2.4 ± 0.1 v 2.7 ± 0.2 kg), or blood urea nitrogen (BUN) (26.1 ± 0.71 v 25.3 ± 1.07 mmol/L [73 ± 2 v 71 ± 3 mg/dL]). Shorter treatment times were not associated with an increase in intradialytic complications. Actually, the frequency (%) of dialysis treatments associated with nausea (5.94 ± 1.33 v 2.21 ± 0.52), vomiting (3.12 ± 0.87 v 0.54 ± 0.14; P < 0.05), headaches (5.60 ± 1.13 v 2.03 ± 0.52; P < 0.05), and back pain (0.91 ± 0.25 v 0.05 ± 0.05; P < 0.05) was decreased. A reduction in serum cholesterol (5.02 ± 0.18 v 4.27 ± 0.41 mmol/L [194 ± 7 v 165 ± 16 mg/dL]; P < 0.05) and triglyceride concentrations (2.34 ± 0.08 v 1.56 ± 0.29 mmol/L [207 ± 7 v 138 ± 26 mg/dL]; P < 0.05) was observed after 6 months on short-time therapy. Short-time hemodialysis did not result in an increase in hospital admissions. In summary, a reduction in hemodialysis treatment time is safe and does not result in increased morbidity provided that high urea clearances are used to maintain an adequate dialysis prescription with a Kt/V in the 1.2 to 1.4 range. © 1992, National Kidney Foundation, Inc.. All rights reserved.