August 23, 2013Clinical Journal of the American Society of Nephrology
Effects of Frequent Hemodialysis on Ventricular Volumes and Left Ventricular Remodeling
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Why the study?
Does frequent hemodialysis reduce ventricular volumes and left ventricular remodeling in patients with ESRD?
Population
332 patients with ESRD (245 in the daily trial, 87 in the nocturnal trial).
Comparison
Frequent hemodialysis for 12 months. vs Conventional hemodialysis for 12 months.
Design
RCT, randomized, All CMRI images were analyzed centrally in a blinded manner.
Follow-up
12 months
Authors
Discussion
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Implication
Supports frequent hemodialysis to limit cardiac remodeling in ESRD; extends randomized evidence on ventricular volume reduction.
Structured PICO
Does frequent hemodialysis reduce ventricular volumes and left ventricular remodeling in patients with ESRD?
P
Population
332 patients with ESRD (245 in the daily trial, 87 in the nocturnal trial).
I
Intervention
Frequent hemodialysis (6 times per week in-center for the daily trial; 6 times per week nocturnal for the nocturnal trial) for 12 months.
C
Comparator
Conventional hemodialysis (3 times per week in-center for the daily trial; 3 times per week predominantly home-based for the nocturnal trial) for 12 months.
O
Outcome
Left and right ventricular end systolic and diastolic volumes, left ventricular mass, and ejection fraction at 12 months ascertained by cardiac magnetic resonance imaging.surrogate
Frequent in-center hemodialysis significantly reduces left and right ventricular volumes and left ventricular mass in ESRD patients, though it does not alter the ratio of LV mass to LV end-diastolic volume.
Limitations
- limited sample size in the nocturnal trial
Cite This Study
Chan et al. (2013) studied this question.
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