Kidney failure patients who double the number of weekly dialysis treatments typically prescribed had significantly better heart function, overall health and general quality of life, new research indicates.

The comparison involved 245 dialysis patients assigned to either a standard dialysis schedule or the high-frequency option. All participants underwent MRIs to assess heart muscle structure, and all completed quality-of-life surveys. In addition to improved cardiovascular health and overall health, the analysis further revealed that two concerns faced by most kidney failure patients - blood pressure and phosphate level control - also fared better under the more frequent treatment program.

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After three months, Hb, hematocrit, and TSAT increased significantly in groups two and three, but remained unchanged in group one. EPO dose decreased significantly in groups two and three, but not in group one. The researchers concluded IV and oral vitamin C therapy can improve anemia, hyperferritemia and EPO resistance in HD patients, and the effect of IV and oral vitamin C are similar.

Approximately 500,000 Americans require dialysis to treat kidney disease; of that population nearly half of the deaths that occur are caused by cardiovascular disease. Dialysis patients have extraordinarily high mortality rates with cardiac disease accounting for 43 percent of deaths in this population and approximately 27 percent of the mortalities are due to sudden cardiac death. Patients on dialysis are excluded from clinical trials examining sudden cardiac death because of their kidney disease. The lack of research complicates doctors' ability to understand the connection between renal disease and cardiovascular disease. The risk of cardiac arrest in dialysis patients is related to age and dialysis duration. Longer dialysis duration is associated with higher mortality.

By analyzing USRDS data, researchers are beginning to better understand how cardiovascular disease affects renal patients and to develop plans for preventing sudden cardiac death. The best methods for prevention are medicinal options, including beta-blockers, ACE inhibitors and angiotensin type II receptor blockers (ARB), or both external and implantable defibrillators. The research also indicates a connection between potassium levels in a patient's dialysate prescription and sudden cardiac death. Patients who suffered a cardiac arrest during dialysis were twice as likely to be on low-potassium dialysate versus higher levels of potassium, which were associated with the best survival rates.

Compared with a reference value of 5.0-6.0 mg/dL, a phosphorus level greater than 7.0 was associated with increased six-year mortality risk after adjusting for demographics and co-morbid conditions. Patients with a phosphorus level of 7.0-8.0 had a 30 percent increased death risk. Patients with levels of 8.0-9.0 and 9.0 or higher had a 60 percent increased risk. Lower baseline phosphorus levels (below 5.0) appeared protective. Patients with serum phosphorus levels of 4.0-5.0, 3.0-4.0, and below 3.0 were at 21, 22, and 19 percent decreased risk of death, respectively.