The Impact of Hemodialysis Frequency and Duration on Blood Pressure Management and Quality of Life in End-Stage Renal Disease Patients

Cardiovascular complications are the most prominent causes of morbidity and mortality among chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients undergoing standard hemodialysis (HD) therapy. Cardiovascular disease risk is increased significantly through persistent hypertension and blood pressure (BP) fluctuation, which are the most common complications of CKD. It was hypothesized that an extended approach with lengthier and more frequent dialysis sessions, referred to in this paper as “extended hemodialysis” (EHD), can potentially lower and stabilize blood pressure, and consequently reduce the rate of morbidity and mortality. A greater reduction of volume (salt and water) with higher frequency can improve patient quality of life (QOL). Eleven papers, including clinical trials and systematic reviews were chosen and analyzed. The extracted data was used to evaluate the change in blood pressure levels between standard HD and EHD. Overall, the studies showed that EHD resulted in improved blood pressure management; therefore, we concluded that there will be a decrease in cardiovascular disease risk, stroke, and morbidity and mortality rate. There will be also an improvement in patient QOL due to beneficial effects of the EHD.

[1]  F. Hobbs,et al.  Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis , 2016, PloS one.

[2]  K. Dellsperger,et al.  Cardiovascular mortality in dialysis patients. , 2012, Advances in peritoneal dialysis. Conference on Peritoneal Dialysis.

[3]  J. Inrig Antihypertensive Agents in Hemodialysis Patients: A Current Perspective , 2010, Seminars in dialysis.

[4]  C. Blagg Quotidian dialysis: The London, Ontario experience. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[5]  Ethan M Balk,et al.  Effect of frequent or extended hemodialysis on cardiovascular parameters: a meta-analysis. , 2012, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[6]  L. Moist,et al.  Volume control and blood pressure management in patients undergoing quotidian hemodialysis. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[7]  L. Yao,et al.  Effect of Nocturnal Hemodialysis versus Conventional Hemodialysis on End-Stage Renal Disease: A Meta-Analysis and Systematic Review , 2017, PloS one.

[8]  R. Suri,et al.  The impact of quotidian hemodialysis on nutrition. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[9]  Keith C. Norris,et al.  Quality-of-life and mortality in hemodialysis patients: roles of race and nutritional status. , 2011, Clinical journal of the American Society of Nephrology : CJASN.

[10]  K. Kalantar-Zadeh,et al.  Significance of Interdialytic Weight Gain versus Chronic Volume Overload: Consensus Opinion , 2013, American Journal of Nephrology.

[11]  J. Greer End Stage Renal Disease and Medicare , 2003, Health care financing review.

[12]  S. Ha,et al.  Potassium Balances in Maintenance Hemodialysis , 2013, Electrolyte & blood pressure : E & BP.

[13]  Julia Addington-Hall,et al.  The prevalence of symptoms in end-stage renal disease: a systematic review. , 2007, Advances in chronic kidney disease.

[14]  W. Krijnen,et al.  Causes and Consequences of Interdialytic weight gain , 2016, Kidney and Blood Pressure Research.

[15]  R. Agarwal,et al.  On the importance of pedal edema in hemodialysis patients. , 2008, Clinical journal of the American Society of Nephrology : CJASN.

[16]  E. Kusano,et al.  Clinical Implication of the Renin-angiotensin-aldosterone Blockers in Chronic Kidney Disease Undergoing Hemodialysis , 2014, The open cardiovascular medicine journal.

[17]  S. Ramakrishnan,et al.  Survival analysis of patients on maintenance hemodialysis , 2014, Indian journal of nephrology.

[18]  T. Shafi,et al.  Hypertension in Hemodialysis Patients: An Opinion‐Based Update , 2014, Seminars in dialysis.

[19]  G. Murata,et al.  Estimates of Interdialytic Sodium and Water Intake Based on the Balance Principle: Differences Between Nondiabetic and Diabetic Subjects on Hemodialysis , 1998, ASAIO journal.

[20]  M. Edalat-nejad Quality of life and sleep in hemodialysis patients. , 2013, Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia.

[21]  Y. Taniyama Management of hypertension for patients undergoing dialysis therapy , 2016, Renal Replacement Therapy.

[22]  K. Siamopoulos,et al.  THE IMPACT OF SOCIOECONOMIC FACTORS ON QUALITY OF LIFE OF PATIENTS WITH CHRONIC KIDNEY DISEASE IN GREECE. , 2015, Journal of renal care.

[23]  C. Brown,et al.  Hypertension in Chronic Kidney Disease: Navigating the Evidence , 2011, International journal of hypertension.

[24]  Christopher T. Chan,et al.  CHAPTER 5: Frequent and Sustained Hemodialysis , 2006 .

[25]  Mario Prost System , 2019, Concepts for International Law.

[26]  S. Sachdeva,et al.  High blood pressure in dialysis patients: cause, pathophysiology, influence on morbidity, mortality and management. , 2014, Journal of clinical and diagnostic research : JCDR.

[27]  W. Clark,et al.  An operating cost comparison between conventional and home quotidian hemodialysis. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[28]  Joshua M Kaplan,et al.  Nocturnal hemodialysis , 2008, Clinical and Experimental Nephrology.