Background: Twice-weekly hemodialysis (HD) is prevalent in the developing countries and the clinical outcome of this population remains to be elucidated. Methods: Data were collected from Shanghai Renal Registry. 2,572 patients undergoing regular HD in Shanghai on January 2007 were enrolled into the cohort study with 2 years’ follow-up. Clinical and HD parameters obtained from the network were utilized to compare twice-weekly with thrice-weekly HD. Results: Compared with patients on thrice-weekly HD, the twice-weekly HD patients were significantly younger and had significantly longer HD session time, higher single-pool Kt/V (spKt/V) but shorter HD vintage (p < 0.001). Kaplan-Meier survival analysis indicated that the two groups had similar survival. Multivariate Cox regression analysis showed that age, body mass index, serum albumin and weekly Kt/V were predictors of patient mortality. Conclusions: The similar survival between twice-weekly HD and thrice-weekly HD is likely relating to patient selection; dialysis adequacy of twice-weekly HD remains to be elucidated.

Gotch FA, Sargent JA: A mechanistic analysis of the National Cooperative Dialysis Study (NCDS). Kidney Int 1985;28:526–534.
Keshaviah P: Urea kinetic and middle molecule approaches to assessing the adequacy of hemodialysis and CAPD. Kidney Int 1993;43(suppl 40):S28–S38.
Held PJ, Port FK, Wolfe RA, Stannard DC, Carroll CE, Daugirdas JT, Bloembergen WE, Greer JW, Hakim RM: The dose of hemodialysis and patient mortality. Kidney Int 1996;50:550–556.
Hemodialysis Adequacy 2006 Work Group: Clinical practice guidelines for hemodialysis adequacy. Am J Kidney Dis 2006;48(suppl 1):S13–S97.
European Best Practice Guidelines Expert Group on Hemodialysis, European Renal Association. Section II. Haemodialysis adequacy. Nephrol Dial Transplant 2002;17(suppl 7):S16–S31
The FHN Trial Group: In-center hemodialysis six times per week versus three times per week. N Engl J Med Dec 2010;363:2287–2300.
Fagugli RM, Reboldi G, Quintaliani G, Pasini P, Ciao G, Cicconi B, Pasticci F, Kaufman JM, Buoncristiani U: Short daily hemodialysis: blood pressure control and left ventricular mass reduction in hypertensive hemodialysis patients. Am J Kidney Dis 2001;38:371–376.
Galland R, Traeger J, Arkouche W, Cleaud C, Delawari E,Fouque D: Short daily hemodialysis rapidly improves nutritional status in hemodialysis patients. Kidney Int 2001;60:1555–1560.
Couchoud C, Kooman J, Finne P, Leivestad T, Stojceva-Taneva O, Ponikvar JB, Collart F, Kramar R, de Francisco A, Jager KJ, QUality European STudies Working Group on Dialysis Adequacy: From registry data collection to international comparisons: examples of haemodialysis duration and frequency. Nephrol Dial Transplant 2009;24:217–224.
Hanson JA, Hulbert-Shearon TE, Ojo AO, Port FK, Wolfe RA, Agodoa LY, Daugirdas JT: Prescription of twice-weekly hemodialysis in the USA. Am J Nephrol 1999;19:625–633.
Daugirdas JT: Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. J Am Soc Nephrol 1993;4:1205–1213.
Keshaviah P: Urea kinetic and middle molecule approaches to assessing the adequacy of hemodialysis and CAPD. Kidney Int 1993;43(suppl 40):S28–S38.
Eknoyan G, Beck GJ, Cheung AK: Effect of dialysis dose and membrane flux in maintenance hemodialysis. N Engl J Med 2002;347:2010–2019.
Supasyndh O, Satirapoj B, Seenamngoen S, Yongsiri S, Choovichian P, Vanichakarn S: Nutritional status of twice and thrice-weekly hemodialysis patients with weekly Kt/V > 3.6. J Med Assoc Thai 2009;92:624–631.
Lin YF, Huang JW, Wu MS, Chu TS, Lin SL, Chen YM, Tsai TJ, Wu KD: Comparison of residual renal function in patients undergoing twice-weekly versus three-times-weekly haemodialysis. Nephrology 2009;14:59–64.
Charra B, Calemard E, Ruffet M, Chazot C, Terrat JC, Vanel T, Laurent G: Survival as an index of adequacy of dialysis. Kidney Int 1992;41:1286–1291.
Ateş K, Nergizoğlu G, Keven K, Sen A, Kutlay S, Ertürk S, Duman N, Karatan O, Ertuğ AE: Effect of fluid and sodium removal on mortality in peritoneal dialysis patients. Kidney Int 2001;60:767–776.
Brown EA, Davies SJ, Rutherford P, Meeus F, Borras M, Riegel W, Divino Filho JC, Vonesh E, van Bree M,EAPOS Group: Survival of functionally anuric patients on automated peritoneal dialysis: the European APD Outcome Study. J Am Soc Nephrol 2003;14:2948–2957.
Lin X, Lin A, Ni Z, Yao Q, Zhang W, Yan Y, Fang W, Gu A, Axelsson J, Qian J: Daily peritoneal ultrafiltration predicts patient and technique survival in anuric peritoneal dialysis patients. Nephrol Dial Transplant 2010;25:2322–2327.
Machek P, Jirka T, Moissl U, Chamney P, Wabel P: Guided optimization of fluid status in haemodialysis patients. Nephrol Dial Transplant 2010;25:538–544.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.