The investigators hypothesize that an increase in the duration of dialysis session in thrice weekly center hemodialysis may provide better outcome, less morbidity, higher quality of life, lesser requirement of medications, and lower total cost.
The proposed prospective and controlled clinical trial aims to compare 4-hour and 8-hour dialysis sessions in thrice weekly center HD regarding mortality, hospitalization rate, several clinical and laboratory parameters, and total cost. Four hundred and ten HD patients will be taken into the study. The study will last for 12 months. The patients will be placed in two groups: 1. Four-hour dialysis session, blood flow rate 300-400 ml/min 2. Eight-hours dialysis session, blood flow rate 200-250 ml/min Sample size is estimated with following hypotheses: twelve months duration of follow-up; twelve months survival of the control group 85%; a bilateral alpha risk equal to 5%; an expectation that 12-months survival to be 95% by 8-hours dialysis; a 85% power to detect the decrease in annual mortality by 8-hours dialysis comparing to 4-hours dialysis; a 10% of dropout rate. The required sample is total 410 patients.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
410
conventional hemodialysis
long dialysis
FMC Turkey Clinics
Adana, Turkey (Türkiye)
Ege University School of Medicine Nephrology Department
Izmir, Turkey (Türkiye)
total mortality
Time frame: one year
cardiovascular mortality
Time frame: one year
changes in health-related quality of life, depression burden, cognitive function
Time frame: one year
required medications
Time frame: one year
total cost
Time frame: one year
changes in blood pressure, left ventricular geometry, coronary artery calcification, arterial stiffness,upper mid-arm circumference,hematocrit and related rHu-EPO doses, the levels of phosphorus, albumin, lipid parameters, hsCRP, and β-2 microglobulin
Time frame: one year
hospitalization rate
Time frame: one year
Vascular access patency
Time frame: one year
post-dialysis body weight and total body water
Time frame: one year
arrythmia episodes determined by Holter-ECG
Time frame: one year
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