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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Alkaline Phosphatase, Antihypertensive Agents, Blood Pressure, Blood Proteins, Body Mass Index, Body Weight, C-Reactive Protein, Calcium, Chelating Agents, Female, Ferritins, Hematinics, Hemodialysis, Home, Hemoglobins, Humans, Longitudinal Studies, Male, Middle Aged, Parathyroid Hormone, Phosphates, Renal Insufficiency, Chronic, Retrospective Studies, Serum Albumin, Transferrin, Uremia.
user
Does conversion from conventional in-centre thrice-weekly haemodialysis to short daily home haemodialysis ameliorate uremia-associated clinical parameters? Context: Under physiological conditions, kidneys work continuously, 168 h/week. In contrast, patients with end-stage renal disease are usually dialysed only 12 h/week. Even if considered adequate by current Kt/V-based dose estimates, this unphysiological dose is associated with an unacceptable annual mortality rate of 10-20%. Increasing dialysis dose might ameliorate this mortality rate. Eleven patients were switched from their conventional haemodialysis (cHD, 3 × 4 h/week) to an intensified short daily home haemodialysis regimen (sdhHD, 6 × 3 h/week) and followed up for 12 months. Different parameters were evaluated before treatment conversion and quarterly during follow-up [i.e. dialysis efficacy, mean arterial pressure (MAP), antihypertensive drug score, haemoglobin, transferrin saturation, ferritin, dose of erythropoiesis-stimulating agents (ESA), iron requirement, parameters of nutrition (body weight, albumin, protein), C-reactive protein, calcium-phosphate product, alkaline phosphatase (AP), intact parathyroid hormone (iPTH) and amount of phosphate-binding pharmacotherapy]. HD efficacy as assessed by cumulative blood volume increased after dialysis intensification (P < 0.01). The pre- and post-dialytic MAP declined during the study period (P < 0.0001), while antihypertensive drugs could be reduced (P = 0.02). Haemoglobin levels improved (P < 0.0001). Additionally, the need for ESAs fell under intensified sdhHD (P = 0.008). Nutritional status improved [albumin, P = 0.03; total serum protein, P = 0.02; 'dry' body weight (BW) and body mass index (BMI) (both P < 0.001)]. The calcium-phosphate product declined (P < 0.01), without changes in the dose of phosphate binders.
assistant
Conversion from conventional in-centre to short daily home HD leads to an improvement in numerous dialysis-associated metabolic variables and thus represents an attractive treatment modality for selected patients. Final Decision: yes