Castro MCM et al. (2006) High-efficiency short daily haemodialysis—morbidity and mortality rate in a long-term study. Nephrol Dial Transplant 21: 2232–2238

Conventional hemodialysis protocols for end-stage renal disease (ESRD) usually comprise thrice-weekly in-center sessions. Evidence is accumulating that more-frequent dialysis might offer advantages in terms of reduced morbidity and mortality.

Researchers at the University of São Paulo carried out a prospective observational study of high-efficiency short daily hemodialysis (SDHD) in 26 patients with a mean age of 35.6 years. Glomerulonephritis was the main cause of ESRD. SDHD using a high-flux polysulfone dialyzer was carried out six times a week in 1.5–2 h sessions.

The mean duration of SDHD treatment was 33.6 months and patient survival was 100%. Complication rates with regard to vascular access (89% of patients were dialyzed via native arteriovenous fistulae) were very low (0.04 failures/patient-year). For the 15 patients remaining on SDHD beyond 36 months, vascular access survival was 89%. Rates of non-vascular-access-related morbidity associated with long-term SDHD were low; 0.27 hospitalizations/patient-year and 1.24 days of hospitalization/patient-year were recorded.

The researchers conclude that SDHD might be a suitable alternative to conventional hemodialysis for patients with ESRD. The investigators highlight the fact that the population studied was relatively young and had few comorbidities; however, as SDHD can be completed in shorter sessions, allowing a higher level of social and professional integration, younger individuals wishing to undertake regular work might prove ideal candidates for this dialysis modality.