Contact:

Dr. Paul Eggers
Telephone 301-594-8305
e-mail: pe39h@nih.gov

Description:

Over the last year a strong interest has developed throughout the renal community in the potential of intensified dialysis regimens, either slow nocturnal or short daily dialysis, to improve patient outcomes. Increasing dialysis frequency has a number of theoretical advantages as a strategy to improve dialysis dose, since clearance of accumulated toxins is greatest early in a dialysis run. In a small number of sites, with highly selected patient groups, markedly improved patient rehabilitation, better control of plasma phosphate and reduced Epogen requirements have been reported with more frequent dialysis.

In collaboration with HCFA, the NIDDK organized an intensive two-day planning meeting of dialysis experts to explore the feasibility of a randomized trial or observational studies of these new treatment strategies. Experts at the meeting were in general strongly supportive of the need for careful evaluation of these new therapeutic approaches. The feasibility of a randomized trial was discussed extensively; most meeting participants were strongly supportive of the need for the kind of rigorous evaluation only possible with randomized participants.

The proposed RFA will solicit applications to support the implementation of a carefully designed randomized trial of frequent dialysis. The overall goal is to assess the impact of more frequent dialysis on patient morbidity and mortality. It is envisioned that a planning group will be established in 2002, with the expectation that the trial will move into full implementation by 2003.