{
    "abstract": "Since 2001, twice-weekly hemodialysis has been the standard method for starting hemodialysis at the Alba Hospital (Piedmont, Italy).\nIncident patients who started in-center hemodialysis from January 2001 to December 2016, had sufficient\u00a0residual kidney function (urine output\u2009>\u2009500\u00a0ml/day), and survived on hemodialysis\u2009>\u20091\u00a0year were selected and\u00a0followed until death or censoring on December 31, 2019. The endpoints for the whole cohort are survival, duration of twice-weekly hemodialysis, preservation of residual kidney function, and cost savings. Analysis was performed on subgroups with long-term (L:\u2009>\u2009\u2009=\u2009365\u00a0days) or short-term (S:\u2009<\u2009365\u00a0days) twice-weekly hemodialysis duration, matched for age, sex, year of hemodialysis start, type of vascular access and diabetes.\nThe study included 146 patients with a total follow-up of 251,328 patient-days, of which 80,635 on twice-weekly hemodialysis. The median survival was 1793\u00a0days, median twice-weekly hemodialysis duration was 417\u00a0days, and median residual kidney function duration was 820\u00a0days. In the matched comparison, the long-term duration twice-weekly hemodialysis group had lower admissions (18.2 vs 27.7/1000 patient-days) and unscheduled hemodialysis session rates (0.26 vs 0.75/1000 patient-days) and greater median residual kidney function duration (1353 vs 445\u00a0days), but similar median survival (1809 vs 1744\u00a0days). During twice-weekly hemodialysis, 12,291 hemodialysis sessions were spared, resulting in a cost saving of 1,986,226 Euros, based on current local reimbursement fees.\nTwice-weekly hemodialysis, under strict clinical surveillance appears to be a safe, feasible, and cost-saving method for initiating hemodialysis in patients with residual kidney function.",
    "authors": [
        {
            "affiliation": "SC Nefrologia e Dialisi, Osp S. Lazzaro, Alba, CN, Italy. andrea_campo@hotmail.com.",
            "firstname": "Andrea",
            "initials": "A",
            "lastname": "Campo"
        },
        {
            "affiliation": "SC Nefrologia e Dialisi, Osp S. Lazzaro, Alba, CN, Italy.",
            "firstname": "Franco",
            "initials": "F",
            "lastname": "Goia"
        },
        {
            "affiliation": "SC Nefrologia e Dialisi, Osp S. Lazzaro, Alba, CN, Italy.",
            "firstname": "Roberto",
            "initials": "R",
            "lastname": "Cottino"
        },
        {
            "affiliation": "SC Nefrologia e Dialisi, Osp S. Lazzaro, Alba, CN, Italy.",
            "firstname": "Carmen",
            "initials": "C",
            "lastname": "Gandolfo"
        },
        {
            "affiliation": "SC Nefrologia e Dialisi, Osp S. Lazzaro, Alba, CN, Italy.",
            "firstname": "Giusto",
            "initials": "G",
            "lastname": "Viglino"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s) under exclusive licence to Italian Society of Nephrology.",
    "doi": "10.1007/s40620-025-02271-z\n10.1053/j.ajkd.2016.12.004\n10.1093/ndt/gfz035\n10.1053/j.ajkd.2015.07.015\n10.1111/sdi.12701\n10.1097/MD.0000000000002767\n10.1056/NEJMoa021583\n10.1038/ki202.457\n10.1007/s40620-022-01507-6\n10.1186/s12882-018-1189-6\n10.23876/j.krcp.23.177",
    "journal": "Journal of nephrology",
    "keywords": [
        "Cost saving",
        "Hospitalisation",
        "Incremental Haemodialysis",
        "Residual kidney function"
    ],
    "methods": null,
    "publication_date": "2025-04-23",
    "pubmed_id": "40266462\n12490682\n23344474\n36396845\n35819039\n30626347",
    "results": "The study included 146 patients with a total follow-up of 251,328 patient-days, of which 80,635 on twice-weekly hemodialysis. The median survival was 1793\u00a0days, median twice-weekly hemodialysis duration was 417\u00a0days, and median residual kidney function duration was 820\u00a0days. In the matched comparison, the long-term duration twice-weekly hemodialysis group had lower admissions (18.2 vs 27.7/1000 patient-days) and unscheduled hemodialysis session rates (0.26 vs 0.75/1000 patient-days) and greater median residual kidney function duration (1353 vs 445\u00a0days), but similar median survival (1809 vs 1744\u00a0days). During twice-weekly hemodialysis, 12,291 hemodialysis sessions were spared, resulting in a cost saving of 1,986,226 Euros, based on current local reimbursement fees.",
    "title": "Reduced intensity incremental\u00a0hemodialysis start\u00a0does\u00a0not decrease life expectancy and saves money: results of the RIDDLE study.",
    "xml": "<Element 'PubmedArticle' at 0x7885062284a0>"
}