The initial attitudes of patients toward longer maintenance hemodialysis

Longer hemodialysis (HD) as practiced in parts of Europe and Japan may impr ove both blood pressure control and patient survival. Nevertheless, in the USA, the trend has been to shorten dialysis time using larger dialyzers and increased blood flows. Many patients find the notion of shorter dialysis e nticing. Most are unaware of the potential benefits of longer dialysis. We surveyed stable chronic HD patients in an urban area, the vast majority of whom received conventional 4-hour treatments, regarding their attitude towa rd extending their dialysis time to 5 hours. They were informed that longer dialysis has been associated with better blood pressure control and improv ed survival. One hundred and sixteen patients completed questionnaires duri ng a single dialysis session. Forty-six (40%) agreed to extended dialysis w hile 70 (60%) did not. There was no difference between the groups with resp ect to the following variables: age, race, etiology of ESRD, time on dialys is, marital status, number of children at home, number residing, in the hou sehold, education, or employment status. Male gender was associated with a positive response (p = 0.03). Various suggested and spontaneous reasons wer e given for a negative response. Conclusion: With minimally detailed inform ation, 4 in 10 patients were willing to extend their treatment time to 5 ho urs in the hope of improving morbidity and survival. No sociodemographic va riable except gender was associated with a positive response.