Effect of the Hemodialysis Prescription on Patient Morbidity

TLDR

The study evaluated how different dialysis prescriptions affect morbidity in 151 patients enrolled in a cooperative trial. Patients were assigned to four groups varying dialysis duration (long vs short) and target blood urea nitrogen (high vs low), with no restriction on dietary protein. High‑BUN prescriptions led to greater withdrawals, hospitalizations, and overall morbidity, while mortality and dialysis time had no significant impact, suggesting that efficient urea removal with adequate protein intake may reduce morbidity.

Abstract

This report summarizes morbidity in 151 patients in a cooperative trial designed to evaluate the clinical effects of different dialysis prescriptions. Four treatment groups were divided along two dimensions: dialysis treatment time (long or short), and blood urea nitrogen (BUN) concentration averaged with respect to time (TACurea) (high or low). Dietary protein was not restricted. There was no difference in mortality between the groups. Withdrawal of patients from the high-BUN groups for medical reasons was significantly greater than withdrawal from the low-BUN groups. Hospitalization was also greater in the high-BUN groups, but dialysis treatment time had no significant effects. The data indicate that the occurrence of morbid events is affected by the dialysis prescription. Increased morbidity appears to accompany prescriptions associated with a relatively high BUN. Conversely, morbidity may be decreased by prescriptions associated with more efficient removal of urea if the dietary intake of protein and other nutrients is adequate.