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Progressive Hemodialysis: Is It The Future?
Author(s) -
Libetta Carmelo,
Nissani Peni,
Dal Canton Antonio
Publication year - 2015
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12455
Subject(s) - medicine , hemodialysis , regimen , intensive care medicine , dialysis , peritoneal dialysis , surgery
Progressive hemodialysis is based on the simple idea of adjusting its dose according to residual renal function ( RRF ). The progressive, infrequent paradigm is slowly gaining a foothold among nephrologists, despite a lot of skepticism in the scientific world. Given the importance of RRF preservation in conservative therapy, it seems a contradiction to ignore the contribution of RRF when patients initiate hemodialysis ( HD ), especially when it is routinely considered with peritoneal dialysis. While a three‐times‐weekly HD regimen is broadly considered the standard starting regimen for new patients, twice‐weekly HD has been used in selected patients and is currently a common practice in South‐East Asia. Small studies indicate that a once‐weekly HD regimen may be a viable starting option as well. Progressive hemodialysis still requires validation, yet it is promising. We share the belief that a randomized clinical trial to investigate progressive hemodialysis is much needed, but we also strongly recommend including a once‐weekly HD starting dose as part of any such investigation.