Doubling dialysis dosage could mean healthier hearts
New research suggests that kidney failure patients who double the number of their weekly dosage of dialysis often have significantly healthier hearts and a healthier life on the whole.
Researchers say this after analyzing cases of 245 patients who have had three or four sessions of dialysis per week, with three to four hours spent on each session. Each of these patients had to take MRI scans to study their heart muscle structure.
Further, researchers also noted that blood pressure and phosphate levels of such patients were often under control.
Dr. Glenn Chertow, Chief of the nephrology division at Stanford University School of Medicine, says "Kidneys work seven days a week, 24 hours a day". "You could imagine why people might feel better if dialysis were to more closely mimic kidney function. But you have to factor in the burden of additional sessions, the travel and the cost."
However, researchers noted that dialysis treatment is expensive. Medicare only covers the conventional three-day a week dialysis, which amounts to $75,000 to $100,000 a year. Doubling this will definitely tend to be a costly affair.
Twice the number of sessions also meant patients had to deal with more side effects. Researchers noted that in future, such plans should be made case-wise.
"I'm certainly not going to recommend six times a week for all my patients," said Chertow, who is also a Professor of Medicine at Stanford. "One size does not fit all. For some patients with kidney failure, no dialysis is the right treatment. For others, it's three times a week in-center. For others, it's home-based dialysis. For others, perhaps six times a week."
Dr. Matthew Weir, Director of the division of Nephrology at the University of Maryland School of Medicine in Baltimore, said "a normal kidney works 168 hours a week filtering our blood and removing fluid. But with dialysis we try to do the same work intermittently just three times a week, for three to four hours each time. And that's clearly a major problem for dialysis patients, because it's a very harsh form of fluid removal that can stretch and strain the heart and leave patients feeling unwell."
"So I would say that an increased use of dialysis is a more facile approach to controlling blood volume, because it removes fluid in a more sustained and more natural way, which the heart prefers. So ultimately, you have less strain on the heart, less heart failure and patients living longer," Weir said.