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March 13, 2002

Does Time of Day of Hemodialysis Affect Survival?

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(10):1262-1264. doi:10.1001/jama.287.10.1261

To the Editor: Dr Bliwise and colleagues1 speculate on the beneficial and protective effects of sleep on the risk of mortality among patients receiving hemodialysis, but temporal changes in renal function also may have played a key role in their findings.

On the one hand, the renal system is organized according to a specific temporal order that is oscillatory in nature. Most, if not all, renal functions exhibit temporal changes; for example, glomerular filtration rate, urine production, and renal excretion of solutes all significantly increase during daytime and reach their minimum at night.2

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