Sunday, December 22, 2019


Q: What is the rationale behind "Short daily dialysis (SDD)?

Answer: Studies have shown benefits from SDD both in terms of dialysis efficiency and hemodynamic stability. 

During SDD, shortening the dialysis time while increasing the frequency of dialysis allows more time to be spent dialyzing against higher uremic solute concentration gradients. This enhances the efficiency of solute removal. Ultimately, a new steady-state with lower peak but higher trough solute concentrations are achieved. Also, more frequent dialysis allows for less body fluid accumulation and increased potential for normalizing the extracellular fluid volume. 

 Frequent Hemodialysis Network (FHN) daily trial was a multicenter, randomized trial. It showed that both primary composite outcomes showed benefit with SDD i.e., 

  •  death or one-year change from baseline in left ventricular (LV) mass, and 
  •  death or one-year change in physical health
This rationale is very much applicable to patients with longer length of stay (LOS).



Henderson LW, Leypoldt JK, Lysaght MJ, Cheung AK. Death on dialysis and the time/flux trade-off. Blood Purif 1997; 15:1.

FHN Trial Group, Chertow GM, Levin NW, et al. In-center hemodialysis six times per week versus three times per week. N Engl J Med 2010; 363:2287.

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