Effects of Extended Haemodialysis Treatment Duration in Patients With End-stage Renal Disease

Feasibility and Physiological and Nutritional Effects of Extended Treatment Duration in Patients With End-stage Renal Disease on Haemodialysis

Design: Prospective randomised cross-over study. Fifty-two eligible patients will be randomised to a treatment time of either 6 hours or 4 hours for a period of 24 weeks and following a washout period of 4 weeks, switch to the alternative treatment time for an additional 24 weeks. Aims: To examine the feasibility and effect of extended dialysis treatment time, 6 hours thrice weekly, versus the standard, 4 hours thrice weekly, comparing the differences from baseline in outcome measures over a total 12-month period. Primary outcome measure 1]Serum albumin Secondary outcome measures Nutritional status Malnutrition-inflammation score Dietary intake Hand-Grip strength Energy expenditure Quality of life Patient reported quality of life and time to recovery from dialysis Serum biomarkers BNP Troponin MCP-1 Others 24- hour Ambulatory blood pressure 24-hour accelerometer Population: Local haemodialysis population of 1200 patients Eligibility: Minimum 90days on haemodialysis treatment Duration: Fifty-six weeks

Inclusion Criteria: Dialysis dependant for over 90 days Exclusion Criteria: Haemodialysis for less than 90 days Patients with anticipated life expectancy less than 6 months secondary to significant morbidity e.g. metastatic malignancy, advanced human immunodeficiency virus Patients with acute liver disease; History of underlying haematological condition; Elective planned change of renal replacement modality within the 12 months.