The
vast majority of hemodialysis patients in the United States
undergo dialysis three times per week for 31/2
to 4 hours per session. This regimen has been the most common
type of hemodialysis ever since ESRD was added to the Medicare
program. Medicare payment policy, also known as the composite
rate, is premised on thrice weekly dialysis. In the past few
years, hemodialysis on a daily basis has been tested at a few
centers. Two forms of daily dialysis are currently in use: long
nocturnal dialysis and short day-time dialysis. Preliminary
information from these recent experiences has generally been
positive. Consequently, daily dialysis is considered by many
in the renal community to be a potential complement to current
thrice weekly dialysis. However, the evidence for this is based
on very few patients and sites. Daily dialysis presents the
possibility of a greatly increased weekly dose of dialysis over
current prescriptions. A clinical trial, including examination
of cost and payment issues, has the possibility of determining
the clinical value of this therapy.
The
goals of this workshop are:
1.
To
review the current knowledge base concerning daily hemodialysis
2.
To
examine the scientific basis for more frequent hemodialysis
3.
To
discuss the practical aspects of implementing daily hemodialysis
4.
To
identify the essential features of a randomized clinical trial
of daily hemodialysis
The workshop will serve as a basis for
the potential development of an RFA for a clinical trial(s).
S P O N S O R S
National Institute of Diabetes & Digetive & Kidney Diseases
