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Time gap in dialysis found dangerous

LOS ANGELES -- A major study challenges the way failing kidneys have been treated for half a century, finding that three-times-a-week dialysis to cleanse the blood of toxins may not be enough.

Deaths, heart attacks and hospitalizations were much higher on the day after the two-day interval between treatments each week than at other times, the federally funded study found.

The president of the National Kidney Foundation said she was "very troubled" by the results, published in today's New England Journal of Medicine.

"We could be doing a better job for our dialysis patients," said Dr. Lynda Szczech, a Duke University kidney specialist who had no role in the study.

Kidneys rid the body of waste and fluids. Most of the 400,000 Americans with failing kidneys stay alive by getting their blood purified by a machine three days a week at dialysis clinics -- usually on Mondays, Wednesdays and Fridays or on Tuesdays, Thursdays and Saturdays. There's a two-day break between the last session of the week and the next one.

The weekly schedule, around since the mid-1960s, gives patients a weekend break from the hours of being hooked up to a machine. But doctors have suspected that the two-day hiatus was risky.

"All the fluids and toxins are built up to the highest extent on Monday morning right before dialysis," said Dr. Anthony Bleyer of Wake Forest Baptist Medical Center in North Carolina, who has done similar studies.

The latest research, funded by the National Institutes of Health, is the largest yet. It was done by Dr. Robert Foley of the University of Minnesota and colleagues. All reported receiving fees from dialysis clinics and suppliers. -- AP

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