Implications of the Long Inter-Dialytic Gap: A Problem of Excess Accumulation vs. Excess Removal?

Evidence suggests that patients receiving intermittent maintenance hemodialysis treatments experience higher mortality the day after the long 2-day interdialytic gap. A new study confirms higher mortality and reports increased hospitalization immediately after the long interdialytic interval among incident hemodialysis patients in the United Kingdom. Larger fluid accumulation followed by excessive ultrafiltration and abrupt fluctuations in serum potassium concentrations may be among potential factors contributing to the morbidity and mortality of this precarious period.