Older people on frequent dialysis in skilled nursing facilities report rapid recovery

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Source/Disclosures


Disclosures: Kaufman declares that he is a founding member of Dialyze Direct, a current employee of Dialyze Direct and owns stock and/or stock options of Dialyze Direct.


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According to data published in International hemodialysis.

“The cardiovascular and quality of life benefits of more frequent hemodialysis treatment (five or more treatments per week) have been demonstrated for over 10 years. Improved post-dialysis recovery time (DRT) with more frequent hemodialysis is one of the many benefits of this form of therapy for quality of life. So far, these benefits have been demonstrated in a relatively young and robust patient population living at home. Elderly patients residing in a Skilled Nursing (SNF) facility were not studied,” Allen M Kaufman, MD, chief medical officer and senior vice president of clinical and scientific affairs at Dialyze Direct, Healio told. “Despite 15% of the general population on dialysis going through an SNF at some time each year, little has been published about the natural history of end-stage renal disease patients residing in an SNF, and virtually nothing about the effect of more frequent dialysis post-DRT therapy in this group.”



Allen M. Kaufman, MD, Chief Medical Officer and Senior Vice President of Clinical and Scientific Affairs at Dialyze Direct.

Researchers evaluated 2,309 elderly people with ESKD (mean age was 68 years; 53% were male) receiving dialysis from 154 SNFs between November 4, 2019 and June 11, 2021, to determine the time recovery after dialysis.

Patients received more frequent dialysis modeled to provide at least 14 hours of therapy per week. Researchers asked patients to describe their recovery time after each treatment using the following options: 0-0.5 hours, 0.5-1 hour, 1-2 hours, 2-4 hours, 4-8 hours, 8 to 12, the next morning or not even the next morning. The researchers included patients who reported at least 1 week of DRT in a rapid recovery mixed model logistic regression.

Overall, patients received an average of 4.3 weekly dialysis treatments throughout the study period. The analyzes revealed that 92% of patients receiving at least five treatments per week reported a DRT of less than or equal to 2 hours, despite advanced age, “frailty” and comorbidities.

“Compared to the 8-21 hour post-DRT baseline for conventional dialysis, 92% of patients with more frequent dialysis recovered within 2 hours and 80% recovered within 1 hour. So even elderly and frail SNF residents with multiple complex medical conditions benefit from more frequent dialysis,” Kaufman told Healio. “The results are very promising in that they potentially improve the ability of these patients to participate in rehabilitation and restorative services while living in NFS. This will be the subject of our next series of studies.

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