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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
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Impact of hemodialysis dose and frequency on survival of patients on chronic hemodialysis in Lithuania during 1998–2005

Department of Nephrology, Kaunas University of Medicine, Lithuania
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Medicina 2010, 46(8), 516; https://doi.org/10.3390/medicina46080074
Received: 15 June 2010 / Accepted: 6 August 2010 / Published: 11 August 2010
Introduction. The question of the targets of dialysis dosing remains controversial since the beginning of the long-term dialysis treatment era. It is still uncertain if higher dialysis dose is better. The aim of our study was to investigate issues of dialysis dose in Lithuania during the period of 1998–2005 and to determine associations between hemodialysis dose and survival of patients on chronic hemodialysis.
Material and methods.
We analyzed data of all patients who started hemodialysis due to endstage renal disease in Lithuania between January 1, 1998, and December 31, 2005. The information about hemodialysis frequency, duration, and adequacy (according to Kt/V) was obtained from medical documentation. The overall survival rate was estimated using the Kaplan- Meier method. Survival comparisons were made using the log-rank or Breslow tests. Univariate Cox proportional hazards analysis was used to select variables significantly associated with the risk of death; then these variables were included in multivariate Cox proportional hazards models.
Results. During the study period, from 2428 patients who started chronic hemodialysis, 58.5% of patients started hemodialysis three times a week. More than one-third (36.2%) of patients were dialyzed twice weekly, and 5.3% of patients started hemodialysis once weekly. Survival analysis revealed that patients dialyzed less than three times per week survived shorter than patients receiving a higher dialysis dose. Duration of HD session of ≤8 hours per week was an independent risk factor for mortality. A higher mean Kt/V was associated with better survival of patients on chronic hemodialysis.
Conclusions. Dialysis frequency and weekly duration of HD sessions were dependent on HD accessibility in Lithuania during the period of 1998–2005. Better survival of patients on chronic hemodialysis was associated with a higher hemodialysis dose.
Keywords: hemodialysis; Kt/V; survival hemodialysis; Kt/V; survival
MDPI and ACS Style

Stankuvienė, A.; Žiginskienė, E.; Kuzminskis, V.; Bumblytė, I.A. Impact of hemodialysis dose and frequency on survival of patients on chronic hemodialysis in Lithuania during 1998–2005. Medicina 2010, 46, 516.

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