Abstract
Five hours of hemodialysis three times a week was tentatively shortened to 4 hours. This trial was done with the following conditions in order to maintain the same dialysis dose (Kt/V): 1) Dialysate volume was maintained at the same level. 2) Blood flow and the dialyzer surface were increased. 3) Diet content was reevaluated. 4) Patients were notified that dialysis-time might be extended if interdialytic weight-gain exceeded the limit of asymptomatic ultrafiltration volume in each patient. The results of an approximately 1-year trial were as follows: 1) All patients accepted the shortening of dialysis time though some worried about worsening of subjective well-being and laboratory data. 2) BUN, serum creatinine, phosphate, HS-PTH and β2-MG were essentially unchanged. 3) In most cases, Kt/V, PCR, TACBUN showed no significant decrease after the shortening. 4) 4 hours of hemodialysis was associated with difficulty in obtaining the proposed ultrafiltration volume in a few cases who were in cardiac failure or had poorly managed salt and water intake. One case experienced worsening of his restless leg syndrome. 5) Most cases necessitated no additional antihypertensive medications. 6) No undesirable effects were observed over the one year trial period in most cases though higher efficiency hemodialysis was inevitable. Longer observation is mandatory because we can not conclude that Kt/V results or patient survival will be the same with a different dialysis-time.
