Three contentious issues in dialysis


The following section is primarily aimed at those who work in the dialysis field – nephrologists, specialist trainees, nurses, and technicians. It deals with three areas that I feel are important and about which there remains undoubted contention.

The three sub-sections introduce and discuss some rather more complex concepts – particularly in the first section on ‘optimal’ dialysis.

The opinions expressed are my own and, although consistent with the views of many others, may not concur with the views of all. Nevertheless, it is my belief that these issues are all important and central to the argument regarding NHHD and the search for more flexible and outcome driven regimes.

Free and active discussion is necessary before dialysis can emerge from the apathy that I believe has shackled it for 3 decades, setting it on a new path to a more outcome-driven, flexible and affordable treatment in the future.

The three sections are …


What is ‘Optimal’ haemodialysis


Is ‘adequate’ still good enough?


Towards ‘Flexible’ haemodialysis


Is conventional HD doing enough?


How much ‘bang for each buck’


Can more be done better, but for less?





Authored by Prof John Agar. Copyright © 2012
Nocturnal Haemodialysis Program, Barwon Health.
All rights reserved. Revised: July 1st 2012