Hemp Dialysis: Not a Recognized Treatment for Renal Impairment
Hemp dialysis is not a recognized or evidence-based treatment option for patients with impaired renal function, and there is no scientific evidence supporting its safety or efficacy for this purpose.
Current Evidence on Hemp/Cannabis in Kidney Disease
While there has been some interest in cannabinoids in nephrology, there is no evidence supporting "hemp dialysis" as a legitimate treatment modality. The available evidence on cannabis/hemp in kidney disease indicates:
A 2020 review noted that cannabis may have potential medicinal benefits for treating symptoms in advanced CKD and ESRD patients, particularly as a pain adjuvant that might reduce opioid requirements, but it does not replace standard dialysis treatment 1.
A 2021 survey of Canadian nephrologists found that while many supported researching cannabinoids for symptom management in kidney disease patients (particularly for refractory symptoms), this was for symptom control rather than as a renal replacement therapy 2.
A 2001 review highlighted significant safety concerns regarding herbal remedies in dialysis patients, noting unpredictable pharmacokinetics, potential drug interactions, and possible nephrotoxicity 3.
Standard Renal Replacement Therapies
For patients with end-stage renal disease (ESRD), evidence-based treatment options include:
Conventional Hemodialysis
- KDOQI guidelines recommend a target single pool Kt/V of 1.4 per hemodialysis session for patients treated thrice weekly, with a minimum delivered spKt/V of 1.2 4.
- For patients with low residual kidney function (<2 mL/min), a minimum of 3 hours per session is recommended 4.
Alternative Hemodialysis Schedules
- In-center short frequent hemodialysis may be offered as an alternative to conventional thrice-weekly hemodialysis after considering individual patient preferences 4.
- Home long hemodialysis (6-8 hours, 3-6 nights per week) may be considered for lifestyle considerations 4.
Special Considerations
- During pregnancy, women with ESRD should receive long frequent hemodialysis either in-center or at home 4.
- For patients with large weight gains, high ultrafiltration rates, poorly controlled blood pressure, or poor metabolic control, additional hemodialysis sessions or longer treatment times should be considered 4.
Stroke Prevention in Dialysis Patients
Dialysis patients have a higher risk of stroke, and management should focus on:
- Targeting systolic BP <120 mmHg for dialysis patients who have suffered a stroke 5.
- Using antiplatelet therapy for secondary stroke prevention, with aspirin as the preferred agent 5.
- Careful attention to volume control and avoiding aggressive ultrafiltration immediately after stroke 5.
- Considering hemodiafiltration as an alternative to conventional hemodialysis, which has shown a 61% risk reduction in stroke compared to conventional hemodialysis 5.
Cardiovascular Complications in CKD
Cardiovascular complications are the most common causes of death in patients with kidney failure on dialysis treatment 6. Management should include:
- Addressing traditional risk factors in early CKD stages
- Managing non-traditional risk factors in intermediate and late stages, including:
- Sodium retention
- Volume expansion
- Anemia
- Inflammation
- Mineral bone disorders
- Uremic toxins
Conclusion
There is no scientific evidence supporting "hemp dialysis" as a legitimate treatment for renal impairment. Patients with impaired renal function should receive standard, evidence-based renal replacement therapies as recommended by established guidelines. While there may be a role for cannabinoids in symptom management for some CKD patients, this is entirely separate from renal replacement therapy, which remains the cornerstone of treatment for ESRD.