Item #7
Morning
and Evening Dialysis Sessions Linked to Improved Survival
Patients
who undergo hemodialysis in the morning or evening have better
survival rates than those who undergo dialysis in the afternoon.
That,
according to a report published in the April issue of the American
Journal of Kidney Diseases.
"Because
of our large sample size, we were also able to look at the effect of
evening shift dialysis on survival," he said. Similar to the
morning shift findings, survival was improved for patients dialyzed in
the evening versus the afternoon.
The
findings are based on a study of nearly 7000 patients with renal
failure who began hemodialysis between 1990 and 1993 and were entered
into a national registry. Survival data were analyzed based on the
time of day dialysis was performed: morning shift (5 am to 12 pm),
afternoon shift (12 pm to 6 pm), or evening shift (6 pm to 12 am).
The
4-year survival rates for patients who underwent morning, afternoon,
and evening shift dialysis were 28.8%, 24.1%, and 38.7%, respectively.
On multivariate analysis, morning and evening sessions were associated
with significantly lower mortality rates than afternoon sessions.
The
researchers found that the effect of dialysis time on survival was
limited to patients who were 60 years of age or older.
"In
terms of a real mechanism for why morning shift dialysis may be
beneficial, the authors of the previous study speculated that it may
be due to better sleep during morning sessions," Dr. Abbott said.
"My own bias, however, is that if there is a true benefit it is
more related to effects on cardiovascular function than on sleep
patterns." Am
J Kidney Dis 2003;41:796-806.
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