HMN 2026: How Longer dialysis times are associated with better survival

For adults undergoing maintenance in-center hemodialysis, longer dialysis times are associated with better survival, according to a study published in the June issue of Kidney International Reports.

Rachel Lasky, M.P.H., from the Renal Research Institute in Waltham, Massachusetts, and colleagues obtained data from a retrospective cohort of 146,127 maintenance in-center hemodialysis patients, aged 18 to 89 years. Participants were stratified into treatment-time groups based on their mean delivered treatment time during the exposure period: 180 to 194, 195 to 209, 210 to 224, 225 to 239, 240 to 254, and 255 to 269 minutes.

The mean dialysis vintage was more than four years, and few patients likely had residual kidney function. The researchers found that patients in the groups receiving 195 to 209, 210 to 224, 225 to 239, and 240 to 254 minutes of treatment time had reduced relative mortality rates of 15%, 19%, 19%, and 27%, respectively, compared with those receiving 180 to 194 minutes of treatment time. In patient subgroups across a wide range of ultrafiltration volumes, as well as with a single-pool Kt/V (spKt/V) >1.4, but not with spKt/V longer treatment times (up to 240 to 254 minutes) with reduced hospitalization rates and shorter hospital stays in secondary analyses.

“Our findings provide additional observational data supporting an association between longer treatment time and better outcomes,” the authors write. “These findings suggest that it may be advantageous to extend treatment time for most patients, preferably to a minimum of 240 minutes, but even to just >210 minutes for individuals with prescribed treatment times

Several authors disclosed ties to the biopharmaceutical and medical device industries.

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