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Night dialysis patients' survival rates comparable to some kidney transplant patients.

Patients who receive night home hemodialysis live just as long as those who receive kidney transplants from deceased donors, according to a new study by Canadian researchers. The work followed 1,239 patients for up to 12 years, comparing night home hemodialysis patients to patients who received either a deceased donor or living donor kidney transplant.

The survival between night home dialysis patients and those who received kidney transplants from deceased donors was found to be comparable, while the survival of the patients who received a transplant from a living kidney donor was better than the other groups. These results, published in the international September issue of the journal Nephrology Dialysis Transplantation, suggest that night home hemodialysis, an intensive dialysis of six- to eight-hour sessions for up to seven times a week, may be a "bridge to transplant" or a "suitable alternative" to transplant should a patient be too high risk for a transplant or not be able to get a living or deceased donor as the organ shortage continues.

Night home hemodialysis patients were from the Toronto General and Humber River Regional Hospitals, together representing the largest and longest established group of such patients worldwide. "This study allows me to actually answer what my patients have been asking me for over a decade: 'What does night home hemodialysis mean for my life span?'," Dr. Christopher Chan, medical director of Home Hemodialysis at Toronto General Hospital, University Health Network, the R. Fraser Elliott Chair in Home Dialysis and an associate professor at the University of Toronto, said in a prepared statement. "I can now tell them that this specific dialysis option is as good as getting a transplant from a deceased donor."

Mortality rates were 14.7 percent for night home hemodialysis patients; 14.3 percent for patients with transplants from deceased donors; and 8.5 percent for patients with transplants from living donors. The results diverge from previous evidence that dialysis is inferior to transplantation, Dr. Chan said, adding that there is much benefit to be gained by long, frequent dialysis.
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Publication:Transplant News
Date:Sep 1, 2009
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