TATH trial: Twice-weekly haemodialysis can be an alternative to thrice weekly regimen

The TATH trial revealed, that a reduction to a twice-weekly haemodialysis schedule did not increase mortality or hospitalisation rates compared with 3 times weekly dialysis, suggesting twice-weekly intervention as a potentially simpler regimen.

A twice-weekly haemodialysis schedule may be a preferred option for patients, considering e.g., cost, travel time, or preference. The prospective, multicentre, non-randomised TATH trial (NCT03415776) compared twice-weekly versus 3 times weekly dialysis, with cross-over permitted to limit attrition for participants who had started haemodialysis between January 2018 and August 2021. Participants who were terminally ill were excluded. The primary endpoint was all-cause mortality at 2 years. Due to the COVID-19 pandemic, recruitment rates were low, and the trial was terminated early: Of the total 806 planned participants, 132 were included in the 3 times weekly and 71 in the twice-weekly group [1].

Baseline characteristics were balanced between groups, but more patients in the twice-weekly group (41%) versus the thrice-weekly group (25%) had employment and worked at the time of dialysis. “Survival rates did not differ between twice weekly and thrice weekly dialysis groups after 2 years follow-up (HR 0.84; 95% CI 0.37–1.90)”, said Dr Mabel Aoun (Saint Joseph University of Beirut, Lebanon), who presented the results.

The number of deaths numerically decreased from 31 deaths with the 3 times weekly regimen and 15 deaths with the twice-weekly regimen. However, sudden cardiac deaths were more common in the twice-weekly (53.3%) compared with the thrice-weekly regimen (12.7%). With the trial taking place during the COVID-19 pandemic, the rate of infection-related deaths was high (26.7% vs 38.7% in the twice vs thrice weekly groups). The groups did not differ regarding rates of uncontrolled hypertension, cumulative erythropoietin dose or cumulative number of hospital admissions at the 2-year cut-off point.

“Participants receiving twice-weekly haemodialysis had similar survival and hospitalisation rates at 2 years compared with participants on a thrice-weekly schedule”, summarised Dr Aoun.

1. Aoun M, et al. Twice Against Thrice-weekly Hemodialysis: the TATH trial. Abstract #1809, ERA 2024, 23–26 May, Stockholm, Sweden.

Medical writing support was provided by Mihai Surducan, PhD.

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Posted on 20 June 202424 June 2024