Phosphorus balance and mineral metabolism with 3h daily hemodialysis

Phosphorus balance and mineral metabolism with 3h daily hemodialysis

Poor control of mineral metabolism is independently associated with mortality in patients receiving hemodialysis. We analyzed data from a 12-month, prospective, non-randomized, controlled study of daily hemodialysis (DHD) (six sessions/week 3h each) (n=26) vs conventional hemodialysis (CHD) (three s...

Full description

Saved in:
Bibliographic Details
Published in:Kidney international Vol. 71; no. 4; pp. 336 - 342
Main Authors: Ayus, J.C., Achinger, S.G., Mizani, M.R., Chertow, G.M., Furmaga, W., Lee, S., Rodriguez, F.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 02-02-2007
Nature Publishing
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
daily dialysis
Emergency and intensive care: renal failure. Dialysis management
hyperphosphatemia
Intensive care medicine
Medical sciences
mineral metabolism
Nephrology. Urinary tract diseases
quotidian dialysis
secondary hyperparathyroidism
short daily hemodialysis
daily dialysis
secondary hyperparathyroidism
mineral metabolism
short daily hemodialysis
quotidian dialysis
hyperphosphatemia
Endocrinopathy
Hydroelectrolytic balance disorder
Secondary
Nephrology
Hemodialysis
Phosphorus
Minerals
Metabolism
Inorganic element
Urology
Extrarenal dialysis
Metabolic disorder
Daily
Parathyroid diseases
Hyperphosphatemia
Dialysis
Balance
Hyperparathyroidism
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Poor control of mineral metabolism is independently associated with mortality in patients receiving hemodialysis. We analyzed data from a 12-month, prospective, non-randomized, controlled study of daily hemodialysis (DHD) (six sessions/week 3h each) (n=26) vs conventional hemodialysis (CHD) (three sessions/week 4h each) (n=51) for achievement of mineral metabolism goals and we performed a substudy of weekly dialytic phosphorus removal in DHD vs CHD. Phosphorus control was superior in the DHD group (% change from baseline to end-of-study -27±30% vs+7%±35% in the CHD group, P=0.0001). Percentage of patients using phosphate binders decreased from 77 to 40% among subjects on DHD, whereas these parameters did not change (76 vs 77%) in the CHD group (P=0.03 by Breslow–Day test for homogeneity of the odds ratios). Weekly mean phosphorus removal was higher in the DHD group (2452±720mg/week vs 1572±366mg/week, P=0.04). Mean normalized protein catabolic rate increased (0.90±0.43–1.22±0.26g/kg/day, P=0.0013). DHD was also associated with an increase in the percent of subjects achieving three or more mineral metabolism goals (for phosphorus, calcium × phosphorus and parathyroid hormone) (15 vs 46%, P=0.046). In conclusion, DHD improves phosphorus control by increasing dialytic phosphorus removal while maintaining nutritional status and reducing the use of phosphate binders. The net effect allows for improved achievement of mineral metabolism goals.
ISSN:0085-2538
1523-1755
DOI:10.1038/sj.ki.5002044