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Hemodialysis frequency: It is time to change the prescription (pp. 117-124) $100.00
Authors:  (Nathalia P. Paschoalin Carvalho, Túlio Coelho Carvalho, and Raphael P. Paschoalin)
Cardiovascular complications are the most prominent cause of morbidity and mortality
among patients with chronic kidney disease (CKD) and end-stage renal disease under
hemodialysis therapy. The risk of cardiovascular disease is significantly increased by
persistent hypertension and fluctuating blood pressure, both of which are common
complications of CKD. Conventional hemodialysis treatment, performed three times a
week for 4 hours, is controversial in the clinical practice of nephrology. This program,
established in 1965, continues today, although recent studies have shown a shift toward
more frequent sessions. Hemodialysis regimens with a frequency greater than three times
per week have been gaining interest worldwide. The hypothesis behind this approach is
that more frequent dialysis sessions could potentially decrease and stabilize blood pressure,
consequently reducing the rates of morbidity and mortality. Some of the demonstrated
benefits of this approach include: better extracellular volume control associated with
improved control of blood pressure, reduced frequency of intradialytic hypotension,
improved cardiac function and structure, improved nutritional state, better control of
mineral and bone diseases related to CKD (reduced phosphorus and parathyroid hormone)
leading to a possible reduction in vascular calcification, reduced use of erythropoiesisstimulating
agents, better quality of life, and reduced hospitalization. The frequency of
hemodialysis has been shown to be an interesting factor related to hemodialysis treatment,
and its benefits should be individually evaluated for each patient. 

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Hemodialysis frequency: It is time to change the prescription (pp. 117-124)