JULES TRAEGER

Professor Jules Traeger, MD, Association Utilisation Rein Artificiel, Lyon, France, presented a paper reviewing the excellent results obtained with daily hemodialysis after 1 year. Moreover, it was shown that the improvements of cardiovascular problems, hypertension, and left ventricular hypertrophy appear during the first 3 months after the initiation of daily dialysis, and plateau after 6 months. At the same time, improvement in nutrition with a higher normalized protein catabolic rate (nPCR), improvement in well-being, and better tolerance of hemodialysis were observed.

It appears that daily hemodialysis (2 hours, 6/week) can be considered as a “rescue therapy” for patients who experience persisting complications despite adequate standard hemodialysis (4 hr x 3/wk with a Kt/V > 1.2).

The question remains whether these patients will be able to return to standard hemodialysis after 3–6 months of daily hemodialysis therapy. Preliminary results show that 2 patients with volume-dependent hypertension cured by daily hemodialysis had recurrence of hypertension. Another patient with resolved malnutrition remains stable after a few months of standard hemodialysis. All 3 patients complained of the reappearance of postdialysis asthenia.