International differences in hemodialysis delivery and their influence on outcomes

Am J Kidney Dis. 2011 Sep;58(3):461-70. doi: 10.1053/j.ajkd.2011.04.021. Epub 2011 Jul 23.


There are many variations in the delivery of hemodialysis. These variations include components of conventional dialysis, such as membrane type, dialysis dose, and session duration. In addition, alternative approaches to dialysis, such as hemodiafiltration, nocturnal hemodialysis, and short daily hemodialysis, also may be considered. For some of these practice variations, data exist to support one approach over another (eg, fistulas rather than grafts and catheters), but for many, no such data exist. Very few practice variations have been examined in randomized trials, and we are reliant predominantly on observational data. This review examines some practice variations in hemodialysis delivery, attempting to highlight which of these may be appropriate to consider when optimizing dialysis delivery in the clinic.

Publication types

  • Review

MeSH terms

  • Arteriovenous Shunt, Surgical
  • Europe
  • Global Health
  • Hemodiafiltration
  • Hemodialysis Solutions
  • Humans
  • Outcome Assessment, Health Care*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Renal Dialysis / instrumentation
  • Renal Dialysis / methods*
  • Renal Dialysis / mortality
  • United States


  • Hemodialysis Solutions