Hemodialysis Regimens/Prescriptions

The proliferation of HD regimens during the past few decades has generated much confusion and alphabet soup of terms without a firm structure or consistency.  The terminology used in the literature to describe the various HD regimens is confusing, inconsistent and at times simply incorrect (i.e. “daily-nightly HHD”).  In an attempt to improve communication, let us first define a few selected terms frequently used to describe HD regimens:

Quotidian – Daily, recurring every 24 hours, includes nightly.  Generally applied to therapies practiced 5 to 7 days per week.

Hemeral – Refers to therapy provided at home.

Enhanced – As applied to dialytic therapy, the term generally denotes a frequency of every other day or elimination of the two day hiatus without dialysis (3.5 to 4 times per week).  The term “second-daily” is often used in Australia and New Zealand interchangeably with enhanced.  We propose the term HD3.5 to denote every other day.

Nocturnal – Performed at night.

Nightly – Performed every night or 5 to 7 nights per week.

Daily – Performed every day or 5 to 7 days per week.

Conventional – As applied to hemodialysis, denotes center, hospital or satellite therapy 3 times per week.

We propose the following nomenclature and structure to describe the various regimens and prescriptions of HD, regardless of the location where dialysis is administered (center, home, satellite):

  1. Time or duration of dialytic session (qualitative) denoted in lower case
  2. Modality (HD, home HD, hemodiafiltration [HDF]) denoted in upper case
  3. Frequency of dialysis (sessions per week) denoted numerically in subscript

For example, short daily HD, 5 x/week would be shown as:

Description of typical HD prescriptions

Prescription Abbreviation Frequency Duration Total time

QB

QD

(Sessions/wk) (hrs/wk) (hrs/wk) (ml/min) (ml/min)
Conventional HD

cHD3

3

3-6

9-18

200-450 300-800
Long  thrice-weekly HD

lHD3

3

7-12

21-36

200-300 250-500
Conventional HD, QOD

cHD3.5

3.5

3-6

10.5-21

300-450 500-800
Long HD, QOD

lHD3.5

3.5

7-12

24.5-42

200-300 250-500
Short daily HD

sHD5-7

5-7

2-2.5

10-17.5

300-450 500-800
Long nightly (or daily) HD

lHD 5-7

5-7

7-12

35-84

200-300 250-500