In-Center Nocturnal Hemodialysis Versus Conventional Hemodialysis: A Systematic Review of the Evidence

Wong, Ben; Collister, David; Muneer, Maliha; Storie, Dale; Courtney, Mark; Lloyd, Anita; Campbell, Sandy; Pauly, Robert P.

doi:10.1053/j.ajkd.2017.01.047

Cited by 30 publications

(28 citation statements)

References 41 publications

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“…Our finding that the psychosocial factors employment status and ambulatory assistance are important predictors of INHD receipt is important in the context of the many studies comparing health and health care use outcomes for INHD and HD patients. While these studies have generally found that INHD patients have better outcomes, as shown in Wong and colleagues’ recent systematic review of this comparative literature, our work suggests that some of these differences may be attributable to confounding by indication: a healthier mix of patients on INHD than on HD as of treatment selection. In future studies, researchers will need to account for these differences between INHD users and comparison patients to avoid overestimating any benefits of INHD relative to HD.…”

Section: Discussionmentioning

confidence: 49%

“…One of the most significant ways in which nephrologists are innovating in the treatment of patients with end stage renal disease (ESRD) concerns the timing and intradialytic duration of hemodialysis treatment sessions. Compared to traditional in‐center hemodialysis (HD) administered during daytime hours, in‐center nocturnal hemodialysis (INHD) is typically characterized by nighttime administration, slower ultrafiltration, and longer sessions (5 to 8 hours vs. 3 to 5 hours), though the treatment frequency often remains thrice weekly for both INHD and HD …”

Section: Introductionmentioning

confidence: 99%

“…(Notably, these benefits have often been shown to be small or null in some studies . Thus it is a potential concern that the literature's findings may be confounded by unmeasured differences between INHD and HD patients that influence both treatment selection and outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…Compared to traditional in-center hemodialysis (HD) administered during daytime hours, in-center nocturnal hemodialysis (INHD) is typically characterized by nighttime administration, slower ultrafiltration, and longer sessions (5 to 8 hours vs. 3 to 5 hours), though the treatment frequency often remains thrice weekly for both INHD and HD. 1 The use of INHD is not widespread in the United States-national estimates of its prevalent use are not yet available-and so the evidence comparing the outcomes of INHD patients and patients undergoing other treatments is in its early stages. To date, this early evidence suggests that INHD patients may have better health outcomes than HD patients, 1 including significant reductions in mortality and hospitalizations, elevated hemoglobin concentrations and improved anemia control, improved phosphorus control, higher urea clearance, lower blood pressure, and improvements in dimensions of quality of life, including sleep, appetite, and energy level.…”

Section: Introductionmentioning

confidence: 99%

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Association between patient psychosocial characteristics and receipt of in‐center nocturnal hemodialysis among prevalent dialysis patients

Wilk

Tang

Hoge

et al. 2019

Hemodialysis International

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Introduction: Compared to traditional in‐center hemodialysis (HD), in‐center nocturnal dialysis (INHD) is characterized by longer sessions and nighttime administration, which may lead to better outcomes for some patients. Given the importance of patient choice in the decision to initiate INHD, we explored associations between patients’ psychosocial characteristics and their receipt of INHD. Methods: Among hemodialysis patients at a medium‐sized dialysis organization, we identified INHD patients as those for whom ≥80% of dialysis sessions were INHD sessions—starting at 6:30 pm or later and lasting ≥5 hours—over the 3 months (≥20 sessions total) after their first INHD session. We extracted dialysis session data from electronic medical records and psychosocial data from social worker assessments. We tested associations of patients’ psychosocial characteristics—as well as demographic and clinical characteristics—with INHD receipt among all hemodialysis patients (INHD and HD) in bivariate analyses and multivariable logistic regression models. Findings: Among 759 patients with complete data, we identified 47 (6.2%) as INHD patients. On average, these patients were more likely than HD patients to be employed (full‐time 10.6% vs. 5.2%; part‐time 17.0% vs. 4.2%; P < 0.001), and they were significantly less likely to require ambulatory assistance (14.9% vs. 39.6%, P < 0.001). In multivariable regressions, we found that part‐time employment (versus being unemployed) was associated with a 7.1 percentage‐point higher likelihood of being an INHD patient (P = 0.01), and the negative association with ambulatory assistance needs approached statistical significance (P = 0.056). No other psychosocial factors included in this main regression analysis were statistically significantly associated with INHD patient status. Discussion: Researchers comparing the outcomes of patients undergoing INHD versus other treatment modalities will need to account for differences in employment status—and other factors like requiring ambulatory assistance and age which may predict the ability to work—between INHD users and comparison patients to avoid bias in estimates.

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Section: Discussionmentioning

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between patient psychosocial characteristics and receipt of in‐center nocturnal hemodialysis among prevalent dialysis patients

Wilk

Tang

Hoge

et al. 2019

Hemodialysis International

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“…Nevertheless, serum levels in these treatments do not reach the normal range . Although a recent meta‐analysis showed lower systolic blood pressure, increased hemoglobin levels and lower serum phosphate level in patients undergoing nocturnal HD compared with those undergoing conventional HD, there have been no RCTs examining the effect of intensive therapy on DRA outcomes.…”

Section: Extracorporeal β2m Removal In Hemodialysis Patientsmentioning

confidence: 99%

Hemodialysis‐related amyloidosis: Is it still relevant?

Kaneko

Yamagata

2018

Seminars in Dialysis

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Accumulation of amyloid fibrils from β2-microglobulin (β2M) was first recognized as a characteristic osteoarticular complication in long-term hemodialysis (HD) patients and called "HD-related amyloidosis" (HRA). However, this syndrome can also be observed in end-stage renal diseases (ESRD) patients undergoing peritoneal dialysis, and even in patients with chronic renal failure before the initiation of dialytic therapy, suggesting that HD is not a direct cause but that accumulation of β2M or some β2M-associated molecules in the body is a common pathogenesis. Currently the term "dialysis-related amyloidosis" (DRA) is widely used for β2M-amyloid (Aβ2M) amyloidosis associated with ESRD, although DRA patients consist mostly of those undergoing long-term HD. Factors other than β2M accumulation also play a role in the formation/local deposition of Aβ2M and disruption of tissue architecture. Conformational changes of β2M by misfolding/unfolding, and promoting/inhibitory effects induced by other coexisting molecules, advanced glycation and oxidation, and direct cell toxicity have also been documented. Two technological improvements of HD have been the keys to prevent the development and progression of DRA: the efficient removal of β2M by using high-flux membranes, high-volume convection and adsorptive column/membrane, as well as the use of biocompatible membranes and dialysates (eg, ultrapure and acetate-free dialysates) have minimized both inflammation and β2M production. Epidemiologically, a decrease in the incidence of DRA has recently been reported; however, longer survival of HD patients may contribute to the development of more DRA, though with a delayed onset. In this article, we describe the pathogenesis of DRA, the strategies developed for its prevention and minimization, and the favorable epidemiological data achieved by these efforts.

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Nutritional status in short daily hemodialysis versus conventional hemodialysis patients in China

Jiang

Ren

et al. 2018

Int Urol Nephrol

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In-Center Nocturnal Hemodialysis Versus Conventional Hemodialysis: A Systematic Review of the Evidence

Cited by 30 publications

References 41 publications

Association between patient psychosocial characteristics and receipt of in‐center nocturnal hemodialysis among prevalent dialysis patients

Association between patient psychosocial characteristics and receipt of in‐center nocturnal hemodialysis among prevalent dialysis patients

Hemodialysis‐related amyloidosis: Is it still relevant?

Nutritional status in short daily hemodialysis versus conventional hemodialysis patients in China

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