Results of Daily Hemodialysis in Catanzaro: 12-Year Experience With 22 Patients Treated For More Than One Year

Since 1985, we have been treating patients with daily hemodialysis (D-HD). We report our results with 22 patients treated on D-HD and daily home hemodialysis (DHHD) for a long-term period. Patients had very good survival of native forearm arteriovenous fistula access, and upper arm access with superficialized basilic vein. One access survived 18 years: 8 years on standard hemodialysis (STND-HD) and 10 years on D-HD. Only two fistulas failed. Blood pressure control in 12 hypertensive patients was obtained without antihypertensive drugs in 8 and with fewer medications in 4. Hematocrit and hemoglobin improved in all patients. Cardiothoratic index decreased in all patients, and we noticed a reduction in the most important echocardiographic indices in 12 patients with cardiac hypertrophy: intraventricular septum thickness, left ventricle posterior wall thickness, left ventricle internal diastolic diameter, and left atrium diameter. Data also showed improvement in nutritional status. For the most part, the levels of hormones normalized, with regular menstrual cycles in women and good sexual function in men. In our experience both elderly and young patients with severe cardiovascular diseases, severe hypertension or hypotension, anemia, and nutritional problems can, with D-HD, achieve good quality of life and start work again. D-HD, in our opinion, is the treatment of choice for patients without comorbid conditions, because good metabolic control, good nutrition, and a more normal hormonal status allow them to feel well and to have an almost normal lifestyle.