Risk Up for Patients During Long Interdialytic Interval

Higher mortality, adverse cardiovascular events risk on day after long interdialytic interval

WEDNESDAY, Sept. 21 (HealthDay News) -- For patients receiving hemodialysis, mortality and adverse cardiovascular-related events occur mainly on the day after the long interdialytic interval, rather than on other days, according to a study published in the Sept. 22 issue of the New England Journal of Medicine.

Robert N. Foley, M.B., B.S., from the United States Renal Data System in Minneapolis, and colleagues investigated whether the long interdialytic interval (two days) is correlated with adverse events in patients receiving hemodialysis. The rates of death and cardiovascular-related hospital admissions were compared on the day after the long interdialytic interval and on the other days. Data from 32,065 participants (mean age, 62.2 years) receiving hemodialysis three times per week at the end of the calendar year 2004 through 2007 were analyzed. A total of 24.2 percent of the patients had been receiving dialysis for one year or less. All participants were followed up for an average of 2.2 years.

The investigators found that on the day after the long interdialytic interval, the rates were higher for all-cause mortality (22.1 versus 18.0 deaths per 100 person-years), mortality from cardiac causes (10.2 versus 7.5), mortality from cardiac arrest (1.3 versus 1.0), mortality from myocardial infarction (6.3 versus 4.4), infection-related mortality (2.5 versus 2.1), and admissions for stroke (4.7 versus 3.1), dysrhythmia (20.9 versus 11.0), myocardial infarction (6.3 versus 3.9), congestive heart failure (29.9 versus 16.9), and any cardiovascular event (44.2 versus 19.7).

"The long (two-day) interdialytic interval is a time of heightened risk among patients receiving hemodialysis," the authors write.

Several authors disclosed financial relationships with pharmaceutical and biotechnology companies.

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