1 / 8

The INHD Study

The INHD Study. The INHD Study. Source Lacson E Jr., Wang W, Lester K, et al. Outcomes associated with in-center nocturnal hemodialysis from a large multicenter program. Clin J Am Soc Nephrol. 2010;5(2):220–226. Background

ojal
Download Presentation

The INHD Study

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The INHD Study

  2. The INHD Study Source Lacson E Jr., Wang W, Lester K, et al. Outcomes associated with in-center nocturnal hemodialysis from a large multicenter program. Clin J Am Soc Nephrol. 2010;5(2):220–226.

  3. Background It has been observed that though there is a gradual improvement in survival in the past decade, overall death rates of long-term hemodialysis (HD) patients remain high. Various approaches have been tried to overcome this, and includes increasing dialysis dosage and long-duration overnight HD. The first free-standing In-center Nocturnal HemoDialysis (INHD) program was started in the United States in April 1999. Recent publications have demonstrated an improvement in laboratory and patient outcomes upon conversion from conventional HD (CHD) to INHD in small, single-center experiences.

  4. Aim To evaluate the epidemiology and outcomes of prevalent INHD patients from the largest multicenter outpatient INHD program in the world.

  5. Methods

  6. Key results • Patients who were on INHD were younger, and they had less diabetes compared to 15,334 control subjects. • Unadjusted hazard ratio was 0.59 for mortality and 0.76 for hospitalization. After adjustment for case mix and access type, only hospitalization remained significant. Fewer INHD patients were hospitalized (48% vs 59%) with a normalized rate of 9.6 vs 13.5 hospital days per patient-year (Fig. 1). • As compared to controls, INHD patients exhibited favorable quality-of-care. • Indicators such as higher albumin and lower phosphorus. • INHD patients had greater inter-dialytic weight gains but lower BP. • Mean equilibrated Kt/V was higher in INHD patients related to longer treatment time, despite lower blood and dialysate flow rates.

  7. Conclusion This study is the first to evaluate mortality and hospitalization outcomes in INHD patients relative to patients on CHD and is the largest study of INHD patients reported to date. Patients who were on INHD exhibited 41% lower HR for mortality and 24% lower HR for hospitalization compared to CHD control subjects. Patients who were on INHD exhibited excellent quality indicators, with better survival and lower hospitalization rates.

More Related