Evidence map›Paper›PMID 25560227›Full record

Trial reportHemodialysis international. International Symposium on Home Hemodialysis2015

Effects of frequent hemodialysis on blood pressure: Results from the randomized frequent hemodialysis network trials.

Peter Kotanko, Amit X Garg, Tom Depner, Andreas Pierratos, Christopher T Chan, Nathan W Levin, Tom Greene, Brett Larive, Gerald J Beck, Jennifer Gassman and 3 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Hemodialysis international. International Symposium on Home Hemodialysis, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Low dialysate sodium levels for chronic haemodialysis.The Cochrane database of systematic reviews · 2024
    Pooled it
  4. Interventions for fatigue in people with kidney failure requiring dialysis.The Cochrane database of systematic reviews · 2023
    Pooled it
  5. Low dialysate sodium levels for chronic haemodialysis.The Cochrane database of systematic reviews · 2019
    Pooled it
  6. Pooled it
  7. Guideline
  8. Trial
  9. BP in Dialysis: Results of a Pilot Study.Journal of the American Society of Nephrology : JASN · 2018
    Trial
  10. Article
  11. Observational
  12. The cardiovascular unphysiology of thrice weekly hemodialysis.Current opinion in nephrology and hypertension · 2025
    Review
  13. The Burden of Home Dialysis: An Overlooked Challenge.Clinical journal of the American Society of Nephrology : CJASN · 2024
    Review
  14. Article
  15. Article
  16. Five Things to Know About Intradialytic Hypertension.Canadian journal of kidney health and disease · 2022
    Article
  17. Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Peter KotankoRenal Research Institute, New York City, New York, USA.
Amit X GargDepartment of Medicine, London Health Sciences Centre, London, Ontario, Canada.
Tom DepnerDavis Medical Center, University of California Davis, Sacramento, California, USA.
Andreas PierratosHumber River Regional Hospital, University of Toronto, Toronto, Ontario, Canada.
Christopher T ChanDivision of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Nathan W LevinRenal Research Institute, New York City, New York, USA.
Tom GreeneDivision of Epidemiology, University of Utah, Salt Lake City, Utah, USA.
Brett LariveDepartment of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Gerald J BeckDepartment of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Jennifer GassmanDepartment of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Alan S KligerDepartment of Medicine, Hospital of Saint Raphael, Yale University School of Medicine, New Haven, Connecticut, USA.
John B StokesUniversity of Iowa, Iowa City, Iowa, USA.
FHN Trial Group

Funding

The Short-Daily Hemodialysis Pilot StudyU01DK066579 · NIDDK · RENAL RESEARCH INSTITUTE, LLC · PI LEVIN, NATHAN W · 2003 to 2010
$5.0M
NIDDK NIH HHS U01 DK066579
6 · The paper itself

Abstract

Hypertension is a common complication of chronic kidney disease and persists among most patients with end-stage renal disease despite the provision of conventional thrice weekly hemodialysis (HD). We analyzed the effects of frequent HD on blood pressure in the randomized controlled Frequent Hemodialysis Network trials. The daily trial randomized 245 patients to 12 months of 6× ("frequent") vs. 3× ("conventional") weekly in-center hemodialysis; the nocturnal trial randomized 87 patients to 12 months of 6× weekly nocturnal HD vs. 3× weekly predominantly home-based hemodialysis. In the daily trial, compared with 3× weekly HD, 2 months of frequent HD lowered predialysis systolic blood pressure by -7.7 mmHg [95% confidence interval (CI): -11.9 to -3.5] and diastolic blood pressure by -3.9 mmHg [95% CI: -6.5 to -1.3]. In the nocturnal trial, compared with 3× weekly HD, 2 months of frequent HD lowered systolic blood pressure by -7.3 mmHg [95% CI: -14.2 to -0.3] and diastolic blood pressure by -4.2 mmHg [95% CI: -8.3 to -0.1]. In both trials, blood pressure treatment effects were sustained until month 12. Frequent HD resulted in significantly fewer antihypertensive medications (daily: -0.36 medications [95% CI: -0.65 to -0.08]; nocturnal: -0.44 mediations [95% CI: -0.89 to -0.03]). In the daily trial, the relative risk per dialysis session for intradialytic hypotension was lower with 6×/week HD but given the higher number of sessions per week, there was a higher relative risk for intradialytic hypotensive requiring saline administration. In summary, frequent HD reduces blood pressure and the number of prescribed antihypertensive medications.

Indexed as

Blood PressureFemaleHumansKidney Failure, ChronicMaleMiddle AgedRenal DialysisBlood pressurefrequent hemodialysishemodialysishypertensionnocturnal hemodialysis

Identifiers

PMID25560227
PMCPMC4490029

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.