ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: SA-PO682

Seven Days a Week Dialysis Service to Achieve an Effective In-Center Short Daily Hemodialysis Program

Session Information

Category: Dialysis

  • 604 Home and Frequent Dialysis


  • Pascoal, Pedro, Centro Brasiliense de Nefrologia & Dialise, Brasilia, Brazil
  • Simon, Adolfo, Centro Brasiliense de Nefrologia & Dialise, Brasilia, Brazil
  • Xavier, Kelia, Centro Brasiliense de Nefrologia & Dialise, Brasilia, Brazil
  • Bello, Vilber, Centro Brasiliense de Nefrologia & Dialise, Brasilia, Brazil
  • Lauar, Juliane, Centro Brasiliense de Nefrologia & Dialise, Brasilia, Brazil
  • Pascoal, Istenio, Centro Brasiliense de Nefrologia & Dialise, Brasilia, Brazil

In-center hemodialysis programs usually operate Monday through Saturday, encompassing two conventional thrice-weekly schedules: Mon-Wed-Fri or Tue-Thu-Sat. On Sundays, in the midst of the long 72-hour Fri-Mon or Sat-Tue interval, dialysis centers are regularly closed and patient care relies on emergency rooms. After setting up a 6 days a week in-center short daily hemodialysis program, we started to provide dialysis treatments also on Sundays. We have now examined the 10-year impact of the seven-day availability on patient schedule and compliance as well as on hospitalization and survival rates.


We assessed the conversion rate from 6 to 7 times a week, the prevalence of absences from hemodialysis treatments (no shows), the hospitalization rate and the actuarial survival curve of 160 private-insured patients (98M/62F; mean age at dialysis initiation 57.3±8.2 yrs, range 8-92) receiving in-center short daily hemodialysis treatments (6-7 times/week; lasting 118±18.7 min, range 90-180; ultrapure dialysate and single-use highflux dialyzer). To accommodate all patient needs, our hemodialysis schedule encircles five 2-hour duration shifts on weekdays, 3 shifts on Saturdays and 2 shifts on Sundays.


From June 2007 to May 2017, 24 out 160 (15%) of our cumulative short daily hemodialysis patients extended their schedule from 6 to 7 treatments per week, 9 (6%) chose Saturdays as their regular day-off, and the remained 127 (79%) have ocasionally dialysed on Sundays to replace most of the missed treatment occurring in their original track. Over the 10-year study period, the average missed treatment rate was 1.47% or 4.5 days per patient-year and the hospitalization rate was 0.4 admissions per patient-year. In parallel, the 5-year cumulative patient survival rates were 98%, 92%, 82%, 69% and 60% at 12, 24, 36, 48 and 60 mo, respectively. Sunday dialysis additional costs have been offset by favoring low missed treatment rate and very low hospitalization rate.


Historically all but a few dialysis centers have provided treatments and care for patients Monday to Saturday, leading to concerns of higher mortality over weekends. To sustain a short daily hemodialysis program and to overcome its compliance and economic challenges, our dialysis center has successfully established a regular seven days a week schedule.