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Aim: Extended hours haemodialysis is associated with superior survival to standard hours. However, residual confounding limits the interpretation of this observation. We aimed to determine the effect of a period of extended hours dialysis on long‐term survival among participants in the ACTIVE Dialysis trial. Methods: Two‐hundred maintenance haemodialysis recipients were randomized to extended hours dialysis (median 24 h/wk) or standard hours dialysis (median 12 h/wk) for 12 months. Further pre‐specified observational follow up occurred at 24, 36 and 60 months. Vital status and modality of renal replacement therapy were ascertained. Results: Over the 5 years, 38 participants died, 30 received a renal transplant, and 6 were lost to follow up. Total weekly dialysis hours did not differ between standard and extended groups during the follow‐up period (14.1 hours [95%CI 13.4‐14.8] vs 14.8 hours [95%CI 14.1‐15.6]; P =.16). There was no difference in all‐cause mortality (hazard ratio for extended hours 0.91 [95%CI 0.48‐1.72]; P =.77). Similar results were obtained after censoring participants at transplantation, and after adjusting for potential confounding variables. Subgroup analysis did not reveal differences in treatment effect by region, dialysis setting or vintage (P‐interaction.51,.54,.12, respectively). Conclusion: Twelve months of extended hours dialysis did not improve long‐term survival nor affect dialysis hours after the intervention period. An urgent need remains to further define the optimal dialysis intensity across the broad range of dialysis recipients. SUMMARY AT A GLANCE: Twelve months of extended‐hour dialysis did not improve long‐term survival or affect dialysis hours after the intervention period among 200 patients. These results suggest that the optimal dialysis intensity across a broad range of dialysis recipients remains to be defined. [ABSTRACT FROM AUTHOR]

Aim: Several studies have verified that unfractionated heparin (UFH) and low molecular heparin (LWMH) can induce bone loss, and bone mineral density has been inversely associated with vascular calcification in some clinical researches. But few have focused on the relationship between types and dosages of heparin and the progression of vascular calcification. We observed the progression of coronary artery calcification (CAC) in maintenance haemodialysis (MHD) patients who were treated with UFH and LMWH. Methods: This was a prospective prevalent cohort study of MHD patients. Computed tomography was performed at enrolment and 2 years after enrolment, and CAC score was obtained. Demographic and clinical data, baseline and time‐average laboratory indices were collected. Multiple linear regression and logistic regression were used to estimate the influencing factors of progression of CAC. Results: In this study, (i) we initially enrolled 69 HD patients, and then 56 patients finished the follow‐up. (ii) Among the total 56 patients, 27 patients (48.2%) were treated with UFH, 14 (25.0%) with LMWH and 15 (26.8%) with both. The median baseline CAC scores of three groups (UFH, LMWH and both users) were 91.0 (1.0, 1052.0), 134.0 (0, 1292.0) and 250.5 (27.0, 1139.0), respectively, with no significant difference (P = 0.663); the median CAC progression scores were 42.0 (0, 364.0), 172.0 (7.0, 653.0) and 118.5 (0, 434.0), respectively, with no significant difference (P = 0.660). (iii) Pearson and spearman correlation analysis shown that the progression of CAC was not associated with cumulative dosage of heparin used. (iv) After adjusted for diabetes mellitus, time‐averaged intact parathyroid hormone, phosphate and alkaline phosphatase, logistic regression analysis showed using different types of heparin was not an independent risk factor for CAC progression; and multiple linear regression analysis showed that the type of heparin used was not associated with CAC progression. Conclusion: There were no significant differences in the effects of the types and dosages of heparin on CAC progression in patients on haemodialysis. SUMMARY AT A GLANCE: This study shows no significant effects of different types and dosages of heparin on baseline and progression of coronary artery calcification in hemodialysis patients. [ABSTRACT FROM AUTHOR]