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):
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Time or duration of dialytic session (qualitative) denoted in lower case
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Modality (HD, home HD, hemodiafiltration [HDF]) denoted in upper case
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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 |