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Short daily hemodialysis

Gihad E Nesrallah, MD, MSc, FRCPC, FACP
Robert M Lindsay, MD, FRCPC, FRCPE
Andreas Pierratos, MD, FRCPC
Section Editor
Steve J Schwab, MD
Deputy Editor
Alice M Sheridan, MD


The first successful use of short daily or "quotidian" hemodialysis was first reported by DePalma in 1969 [1,2]. This approach was based upon the premise that improved patient outcomes, compared with conventional three times per week hemodialysis, would occur with a dialysis schedule that consisted of the same number of hours of dialysis per week but delivered over twice as many sessions. More specifically, this schedule consists of daily hemodialysis (five to seven days per week) provided for a duration of 1.5 to 3 or more hours per session.

Initial attempts to popularize daily dialysis in the United States were thwarted by financial and logistical issues. This led to a decline in its use both in the home and in-center settings.

Over the last decade, however, there has been a resurgence in the use of daily dialysis, with several studies emerging from the United States and Europe showing improvements in various intermediate outcomes. In the wake of the Hemodialysis (HEMO) study, attention has turned from increasing the per-session dialytic dose to altering variables such as treatment frequency or duration to improve outcomes [3,4]. Daily dialysis has also been proposed as a rescue therapy and in the intensive care unit (ICU) setting [5,6] (see "Sustained low efficiency or extended daily dialysis"). Short daily hemofiltration and hemodiafiltration have also been introduced, being used both in center and at home [7,8]. The 2015 Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines suggest offering in-center short daily hemodialysis as an alternative to conventional hemodialysis [9].

This topic review will discuss short daily hemodialysis. A review of long daily or nocturnal hemodialysis is presented separately. (See "Technical aspects of nocturnal hemodialysis".)


The rationale for short daily hemodialysis is based upon a strategy that is proposed to enhance both dialysis efficiency and hemodynamic stability.


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Literature review current through: Sep 2016. | This topic last updated: Aug 26, 2016.
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