From adequate to optimal dialysis long 3 x 8 hr dialysis: a reasonable compromise
Charra, B.
Nefrologia Publicacion Oficial de la Sociedad Espanola Nefrologia 25(Suppl 2): 19-24
2005
ISSN/ISBN: 0211-6995 PMID: 16050397 Document Number: 585013
Long dialysis (3 x 8 hours/week) has been used in Tassin for three decades now, without method modifications. Results have been excellent considering both morbidity and mortality. Best survival compared to short dialysis is mainly due to low cardiovascular mortality. It is probably due to a good control of arterial hypertension, without antihypertensive medication, and the low rate of intradialytic hypotension. Slow ultrafiltration, allowed by the extended dialysis session, associated with a low-salt diet and a moderate interdialysis weight gain, tend to normalize extracellular volume and ensure normotension. Long hemodialysis assure a good dialysis dose in terms of small and even middle molecules, with good nutrition, anemia correction, phosphate and potassium control with few drugs. Optimal dialysis needs several conditions, each of them necessary. Time seems a central factor, providing a high treatment safety margin. While it is quite difficult to achieve excellent dialysis results with short sessions, long-dialysis is easy to perform with high reliability.