Published in:
01-12-2013 | Nephrology - Original Paper
The role of short daily hemodialysis in the control of hyperphosphatemia, secondary hyperparathyroidism and anemia
Published in: International Urology and Nephrology | Issue 6/2013
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Background
Hyperphosphatemia, secondary hyperparathyroidism (SHPT) and anemia are common secondary complications in hemodialysis patients with end-stage renal disease (ESRD). Compared with conventional hemodialysis (CHD), short daily hemodialysis (sDHD) has been found to be more effective in patients with ESRD. The objective of this study was to determine whether sDHD could improve hyperphosphatemia, SHPT and anemia in patients with ESRD.
Methods
Twenty-seven patients (11 women and 16 men, 46.8 ± 13.4 years old) were switched from CHD to sDHD. All hematologic parameters were measured prior to the switch (baseline), at 3 months after the switch (sDHD1) and at 6 months after the switch (sDHD2).
Results
The serum phosphate decreased from 2.54 ± 0.32 mmol/L at baseline to 2.15 ± 0.36 mmol/L (p < 0.001) at sDHD1 and 1.97 ± 0.33 mmol/L (p < 0.001) at sDHD2. Calcium-phosphate product decreased from 5.18 ± 1.24 mmol2/L2 at baseline to 4.20 ± 0.71 mmol2/L2 (p < 0.001) at sDHD1 and 4.02 ± 0.83 mmol2/L2 (p < 0.001) at sDHD2. The serum PTH levels decreased from 223.9 ± 124.7 pmol/L at baseline to 196.3 ± 101.3 pmol/L (p < 0.05) at sDHD2. The hemoglobin concentration increased significantly from CHD to sDHD. However, the requirement for erythropoietin (EPO) dose decreased from 6847.8 ± 1057.3 u/week at baseline to 5869.6 ± 1094.6 u/week (p < 0.05) at sDHD2.
Conclusions
sDHD may decrease serum phosphate, calcium-phosphate product and PTH, increase hemoglobin levels and decrease exogenous EPO dose requirements compared with CHD in hemodialysis patients.