AI Article Synopsis
- There are fewer randomized controlled trials on hemodialysis compared to other internal medicine fields, leading to no significant progress in outcomes.
- The National Cooperative Dialysis Study and the HEMO trial focused on important health metrics like morbidity and mortality but didn't include newer techniques like on-line hemodiafiltration, which may offer benefits.
- There's an urgent need for well-structured long-term trials to explore how current HD methods can effectively enhance the health of patients with uremia.
Article Abstract
There are considerably fewer randomized controlled trials investigating hemodialysis (HD) than other fields of internal medicine, and no significant improvements have been observed over time. Only the National Cooperative Dialysis Study and the HEMO trial were based on hard endpoints such as morbidity and mortality, but neither considered on-line hemodiafiltration or super-flux membranes, which are thought to provide a number of advantages in terms of the cardiovascular condition of uremic patients. However, results of well-designed clinical trials showing that increasing convection may improve the clinical outcome of HD patients are still lacking. The need for maximizing removal of uremic toxins calls for more frequent HD sessions, but this may be affected by many organizational problems. Therefore, well-designed, long-term clinical trials are urgently needed to investigate which currently available therapeutic instruments can improve the clinical outcome of uremic patients.
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| http://dx.doi.org/10.1159/000089441 | DOI Listing |
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