Up to 75 percent of patients with chronic kidney disease suffer from a heart complication called left ventricular hypertrophy (LVH). This common heart problem occurs when the muscle of the main pumping chamber grows too thick. In some cases, this can lead to heart failure – even sudden death. In fact, heart attacks are the leading cause of death in people with kidney failure.
One of the main causes of LVH is fluid build-up. In the two or three days between standard in-center dialysis treatments, patients can put on as much as five liters (more than a gallon) of extra fluid. Having fluid levels "yo-yo" up and down with three-times-weekly treatments is tough on the heart.
Here's how more frequent home hemodialysis is different:
For more frequent home hemodialysis patients, dialysis is performed five or six times a week instead of the standard three-times-weekly schedule for in-center dialysis. That means less time for fluid to build up between treatments, so less fluid needs to be taken off at each treatment. More frequent treatments mean fewer ups and downs in fluid levels, which studies have shown may reduce stress on the heart.
Despite the health benefits that more frequent home hemodialysis may provide to those with chronic kidney disease, this form of therapy is not for everyone. The reported benefits of more frequent home hemodialysis may not be experienced by all patients. The risks associated with hemodialysis treatments in any environment include, but are not limited to, high blood pressure, fluid overload, low blood pressure, heart-related issues, and vascular access complications. The medical devices used in hemodialysis therapies may add additional risks including air entering the bloodstream, and blood loss due to clotting or accidental disconnection of the blood tubing set. Certain risks are unique to the home. Treatments at home are done without the presence of medical personnel and on-site technical support. Patients and their care partners must be trained on what to do and how to get medical or technical help if needed.
- Ayus J, et al. Effects of SDHD vs CHD on LVH and Inflammatory markers. J Am Soc Nephrol. 2005; 16:2778-2788.
- Fagugli R, et al. SDHD: Blood pressure control and LVM reduction in hypertensive HD patients. Am J Kidney Dis. Vol 38, No. 2 2001;371-376.