AI Article Synopsis
- The study aims to compare daily hemodialysis (DHD) and traditional thrice-weekly hemodialysis (HD) to assess improvements in patient quality of life, health outcomes, and hospital usage.
- Up to 500 DHD participants will be recruited from 70 clinical sites for a three-year study, with a control group of 5,000 patients undergoing standard thrice-weekly HD.
- Outcomes will include hospitalization rates, medical costs, quality-of-life changes, and various health metrics, providing insights into the clinical and economic advantages of DHD.
Article Abstract
Background: Conventional thrice-weekly hemodialysis (HD) has limited the ability to generate further improvements in patient quality of life, morbidity, and mortality. Daily HD (DHD) offers the promise of providing clinical and economic benefits. The objectives of the Following Rehabilitation, Economics and Everyday-Dialysis Outcome Measurements Study are to evaluate outcomes of DHD (6 times/wk) with the NxStage System One (NxStage Medical Inc, Lawrence, MA) device.
Design: Cohort study with matched control group.
Setting & Participants: The DHD group will include up to 500 participants at 70 clinical sites, enrolling for 3 years with a minimum of 1-year follow-up. Study candidates include adult patients (age >or= 18 years) with end-stage renal disease who are considered suitable candidates for DHD with the NxStage System One device by the treating physician and who have Medicare as their primary insurance payer. The control group will consist of a matched thrice-weekly in-center HD cohort derived from the US Renal Data System database using a 10:1 ratio, totaling 5,000 patients.
Predictor: Treatment with DHD and "standard of care" thrice-weekly HD.
Outcomes & Measurements: The primary intent-to-treat analysis compares hospitalization days/patient-year between the DHD and thrice-weekly HD groups. Other outcomes recorded in both groups include non-treatment-related medical expenditures. In addition, in the DHD cohort, changes in quality-of-life measures (baseline, 4 and 12 months, and every 6 months thereafter); urea kinetics; parameters related to anemia, bone and mineral metabolism, and nutrition; vascular access interventions; and use of medications will be examined.
Conclusions: This study has the potential to elucidate the health and economic benefits of DHD and complement results of current clinical trials.
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| http://dx.doi.org/10.1053/j.ajkd.2008.07.013 | DOI Listing |
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