Increased Frequency of In-Center Hemodialysis as Rescue Therapy: Impact on Hospitalization for Acute Cardiovascular Events

Abstract

Background: The intermittency of conventional hemodialysis (HD) leads to an increase in cardiovascular events. Objective: We aimed to evaluate the effect of in-center frequent HD (FHD, 4–6 times a week) as a rescue option for cardiovascular events. Method: Patients who failed to achieve fluid volume control with conventional HD (thrice a week) were administered FHD. A total of 52 patients were divided into 2 groups by left ventricular ejection fraction (LVEF): low ejection fraction (LEF [n = 26], LVEF < 55%) and normal ejection fraction (NEF [n = 26], LVEF ≥55%). Mortality and hospitalization rates were evaluated. Results: All-cause mortality tended to be higher in the LEF than in the NEF group (p = 0.09). The 1-year hospitalization rate for acute cardiovascular events decreased in both LEF (1.24–0.89; p = 0.049) and NEF (0.36–0.16; p = 0.01) groups. In Cox regression models, LVEF < 55% (hazard ratio 3.81; 95% CI 1.15–12.66; p = 0.03) was identified as the risk factor for hospitalization for acute cardiovascular events. Conclusion: In-center FHD may decrease acute cardiovascular events.