Dialysis has both risks and benefits
Of course, frequent dialysis requires accessing the blood more often, which typically is done using a long-lasting puncture site through which blood can be removed and returned. Having the blood cleansed more frequently does typically improve patients’ health and quality of life. It wasn’t known, however, whether these patients also had any higher risk for complications related to repeated use of the blood-access site. In this study, researchers led by Dr. Rita Suri, of Western University and Lawson Health Research Institute in London, Canada, conducted two 12-month clinical trials involving 245 patients. The patients were randomly selected to receive either in-center daily dialysis (six days a week) or standard dialysis (three days per week). Another 87 patients received either frequent home-based dialysis or standard dialysis. In the first hospital-based trial, 31 percent of the 245 patients had to undergo repair of the blood-access site, lost use of the site or were hospitalized due to problems with the site. Complication rates were higher among the frequent-dialysis group: There were 33 repairs and 15 losses in the frequent-dialysis group compared with 17 repairs, 11 losses and one hospitalization in the standard-dialysis group.
Overall, the risk for a problem with the blood-access site was 76 percent higher in the frequent-dialysis group than in the standard-dialysis group, the researchers reported. Similar trends were seen in the home-based trial, but the results were not statistically significant, according to the study results, which were published online Feb. 7 in the Journal of the American Society of Nephrology.
The findings are the first to show that frequent dialysis may have potentially harmful effects on the blood-access site, and provide valuable information for dialysis patients and their doctors, Suri said in a journal news release. “Frequent dialysis has been an area of intense interest since the publication in 2010 of a study from the Frequent Hemodialysis Network (FHN) that found a reduced rate of death and other events.