Dialysis Recovery Time May Predict Higher Death Risk In Chronic Kidney Disease Patients

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Recovery time after a Chronic Kidney Disease (CKD) patient's Hemodialysis (HD) treatment has a significant impact on their quality of life and expected mortality risk. Published in the American Journal of Kidney Diseases, the Birmingham Heartlands Hospital found that 32% of patients reported a recovery time shorter than 2 hours; 41%, 2-6 hours; 17%, 7-12 hours; and 10% longer than 12 hours.

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Compared with patients who had 2-6 hour recovery times, those with a reported recovery time of more than 12 hours had a 16% increased risk of hospitalization, and 30% increased risk of death, according to the study. After adjusting for demographic and comorbid (illness existing simultaneously with another medical condition) factors, it was found that each additional hour of recovery time was associated with a 3% increased risk of hospitalization and a 5% increased risk of death from any cause.

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Longer recovery time was directly associated with greater intradialytic (dry) weight loss, longer dialysis session length, and lower dialysate sodium concentration. More specifically, each 1% increase in intradialytic weight loss was associated with a 4% increased risk of longer recovery times. Also, each 30-minute increase in a person's dialysis session length was associated with a 5% increase in recovery. What's more, dialystat sodium concentrations of less than 140 mEq/L were associated with a 34% increase in post dialysis recovery.

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Based on this study, dialysis patients can directly improve their survival outcomes by following their recommended diet plan to maintain their dry weight. If you have lost weight, you may begin feeling nauseous because you are pulling off too much fluid during your treatment. Be sure to talk to your Healthcare Team about adjusting your goals which may be too high. Also, you can improve how you feel after dialysis by closely abiding by your fluid restrictions. 

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Weight gain is a common challenge in those on dialysis. If you have gained "real" weight (body mass and not fluid) your estimated dry weight will need to be raised. Gaining too much weight could lead to increased time on the machine to get a proper cleaning. Thus you should try to avoid significant weight gain between your treatments.  Researchers mentioned that, “Recovery time has a significant impact on patients and may be affected by modifiable aspects of the treatment regimen.” Hence, you should work with your Dialysis Care Team to limit your recovery time as much as possible so that you can experience a long and quality life. Visit KidneyBuzz.com everyday for the most Breaking News & Information, tailored to those with Kidney Failure and/or Diabetes.

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References: 

"Longer Dialysis Recovery Time Predicts Higher Death Risk." Renalandurologynews.com. Renal and Urology News.

Manfred Hecking*,†, Angelo Karaboyas*, Rajiv Saran‡, Ananda Sen§, Masaaki Inaba‖, Hugh Rayner¶, Walter H. Hörl†, Ronald L. Pisoni*, Bruce M. Robinson*, Gere Sunder-Plassmann†, Friedrich K. Port*⇓. "Dialysate Sodium Concentration and the Association with Interdialytic Weight Gain, Hospitalization, and Mortality." Http://cjasn.asnjournals.org/. American Society of Nephrology.

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