Evidence map›Paper›PMID 41767695›Full record

ArticleKidney medicine2026

Incremental Hemodialysis Practices and Impact on Survival: Systematic Review and Meta-Analysis.

Adil M Hazara, Abdullah Abdullah, Victoria Allgar, Maureen Twiddy, Sunil Bhandari

Abstract read
In one paragraph

Article in Kidney medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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

5 authors.

Adil M HazaraDepartment of Renal Medicine, York and Scarborough Teaching Hospitals NHS Foundation Trust, United Kingdom.
Abdullah AbdullahBlackpool Teaching Hospitals NHS Foundation Trust, United Kingdom.
Victoria AllgarFaculty of Health, Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom.
Maureen TwiddyInstitute of Clinical and Applied Health Research, University of Hull, Hull, United Kingdom.
Sunil BhandariHull York Medical School/Department of Health Sciences, University of York, Heslington, York, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Starting hemodialysis (HD) incrementally may help reduce the burden of treatment in patients with established kidney failure. A systematic review has been conducted to describe variations in the practice of incremental HD worldwide and to study its impact on mortality. Study Design: Systematic review. Setting & Population: Patients with established kidney failure starting HD. Selection Criteria for Studies: Medline and Academic Search Premier were searched from inception to July 20, 2020, for observational and interventional studies comparing incremental or twice weekly treatments with conventional treatment, with mortality as one of the outcome measures. Predictor: Incremental (or twice-weekly) HD therapy versus thrice-weekly treatments. Outcomes: Mortality. Results: Fourteen studies were included (combined 91,928 participants; 5,075 [5.5%] in the intervention, 86,853 [94.5%] in standard treatment groups). Large variations in the practice of incremental HD were noted with treatments differing in HD frequency, treatment goals, monitoring schedules, duration of the incremental program, and cointerventions. Larger studies with lowest risk of bias demonstrated equivalent survival between incremental and conventional treatment groups. Meta-analysis of mortality hazards showed an overall hazard ratio of 0.97 (95% CI 0.76-1.19). Centers which screened patients for adequacy of residual kidney function at baseline and pursued prespecified treatment goals have demonstrated better outcomes in incremental HD recipients compared with conventional treatment. There is evidence of publication bias in the literature. Limitations: Studies from diverse settings, searches limited to English language. Conclusions: There is wide variation in the interpretation of incremental HD treatments and therefore primary studies of incremental HD must be examined in the context of their settings, population, and available resources. Optimal method of implementing incremental HD remains controversial; available data indicate that incremental HD is at least noninferior to conventional HD.

Indexed as

Early mortalityend-stage renal diseaseincremental hemodialysismortalitytwice-weekly hemodialysis

Identifiers

PMID41767695
PMCPMC12937166

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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.