The following is a summary of “Impact of hemodialysis hours on outcomes in older patients”, published in the February 2023 issue of Nephrology by Yeung, et al.
Longer hemodialysis treatments were linked to better survival, according to prior research. There is a global trend toward older individuals who frequently receive hemodialysis. For a study, researchers sought to ascertain if becoming older reduced the mortality advantage of longer hemodialysis sessions.
It was a retrospective cohort analysis of individuals who started thrice-weekly hemodialysis ≥65 years ago and were reported to the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry between 2005 and 2015. Participants were included 90 days following the commencement of dialysis. All-cause mortality was the main result. A Cox regression analysis used hemodialysis session length as the exposure of interest.
About 4,727 of the 8,224 patients who began hemodialysis as their initial course of therapy for renal failure when they were≥ 65 years old or older throughout the time period perished. In unadjusted analyses, longer dialysis sessions were linked to a lower risk of mortality [hazard ratio, HR, for ≥5 h versus 4 to <4.5 h: 0.81 (0.75–0.88, p < .001)]. Although younger, patients with lengthier dialysis sessions had more co-morbid conditions. Longer hours still had a survival advantage in an adjusted model that took into account age and other factors (HR for prior comparison: 0.75 (0.69-0.82, P< .001)), and there was no evidence of an interaction between age and hours (P =.89).
In patients 65 years of age and older, the apparent survival benefit of prolonged hemodialysis sessions seemed to be maintained. In actuality, it was important to carefully balance the advantages of extended dialysis sessions in the patient population against other aspects.