Progressive Hemodialysis: Is It The Future?

Carmelo Libetta, Peni Nissani, Antonio Dal Canton

Research output: Contribution to journalArticlepeer-review


Progressive hemodialysis is based on the simple idea of adjusting its dose according to residual renal function (RRF). The progressive, infrequent paradigm is slowly gaining a foothold among nephrologists, despite a lot of skepticism in the scientific world. Given the importance of RRF preservation in conservative therapy, it seems a contradiction to ignore the contribution of RRF when patients initiate hemodialysis (HD), especially when it is routinely considered with peritoneal dialysis. While a three-times-weekly HD regimen is broadly considered the standard starting regimen for new patients, twice-weekly HD has been used in selected patients and is currently a common practice in South-East Asia. Small studies indicate that a once-weekly HD regimen may be a viable starting option as well. Progressive hemodialysis still requires validation, yet it is promising. We share the belief that a randomized clinical trial to investigate progressive hemodialysis is much needed, but we also strongly recommend including a once-weekly HD starting dose as part of any such investigation.

Original languageEnglish
Pages (from-to)179-83
Number of pages5
JournalSeminars in Dialysis
Issue number3
Publication statusPublished - May 2016


  • Editorial


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