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Time of day of hemodialysis delivery affects survival

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – Undergoing hemodialysis in the morning rather than in the afternoon appears to confer a significant survival advantage, according to investigators at Emory University in Atlanta.

In the December 5th issue of The Journal of the American Medical Association, Dr. Donald L. Bliwise and colleagues report on a cohort randomly derived from the population of all Georgia patients with end-stage renal disease who were 60 years of age or older at baseline. The investigators interviewed the subjects twice, in 1988 and 1991, and tracked mortality through July 1999.

The median survival among the 167 patients who had dialysis in the morning was 941 days, compared with 470 days for the 75 treated in the afternoon (p < 0.001), the researchers found. The protective effect of treatment time was sustained in multivariable Cox analysis. The researchers could discern no significant differences between the two groups for any cause of death.

Dr. Bliwise and his associates postulate that biochemical clearance may be better in the morning than in the afternoon, or the "salutary effects of sleep" during morning hemodialysis may contribute to survival.

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