2011 Top Game Changers in Nephrology

George Bakris, MD; Jeffrey S. Berns, MD; Lynda A. Szczech, MD; Carol Peckham

Disclosures

November 16, 2011

In This Article

4. Never on Sunday -- Except for Dialysis?

A recent study in The New England Journal of Medicine by Robert Foley and colleagues[9]suggests that weekends may be bad for dialysis patients. Jeffrey Berns commented, "In this interesting study of more than 36,000 patients who had participated in the End-Stage Renal Disease (ESRD) Clinical Performance Measures Project, these investigators found that on the day after the long weekend, interdialytic interval, all-cause mortality, cardiac mortality, vascular mortality, admissions for cardiovascular disease, as well as infection-related mortality were significantly increased. There has already been discussion of whether dialysis schedules should be changed to be every other day or more frequently, or whether an extra dialysis treatment should be inserted somewhere up along the way. Whether patients need an extra treatment, whether they need a longer treatment on Friday and Monday or Tuesday and Saturday, or whether they need an adjustment in the ultrafiltration rate or even in the dialysate composition all remain unknown. Before we jump in and make changes in our dialysis therapies on the basis of this study (which was fascinating and elegant but, nonetheless, still retrospective) we need to think about prospective studies that might be done to answer some of the questions and hypotheses that are raised by this study."

Watch the complete commentary from Jeffrey Berns, MD.

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