Dialysis patients and Monday roulette

Published Wednesday, 6 June 2012 1:52AM CDT by filed under ESRD

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Dialysis patients and Monday roulette

A new study published in Nature‘s Kidney International finds that dialysis schedules may affect the day of the week dialysis patients are most likely to die. For in-center hemodialysis patients, that would be the day after the longest interval without dialysis. For patients on a Monday, Wednesday, Friday schedule that would be Monday; for patients on a Tuesday, Thursday, Saturday schedule that would be Tuesday.

The study attributes the mortality day of the week difference to the usual suspects: “During the intervals between dialysis sessions, electrolytes, fluid, and various uremic toxins accumulate and, as a result, contribute to an increased risk of mortality.”

What’s especially interesting about this study is that mortality is stronger for cardiovascular events than noncardiovascular in the US but Japanese patients had a higher risk of dying from a noncardiovascular event on the day before the longest interval without dialysis. In Europe, patients had a higher risk of dying from a cardiovascular event on the day before the longest interval without dialysis.

The study also reinforced previous findings that dialysis patients in the US fair far worse than their Japanese and European counterparts. Hemodialysis patients have relatively high mortality rates: ~23 percent in the US, 15 percent in Europe, and 9 percent in Japan.

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