Nocturnal intermittent hemodialysis

Abstract

Preemptive renal transplantation is the method of choice for end stage renal disease in childhood and adolescence. However, without preemptive transplantation, waiting time for kidney transplantation might exceed several years. The poor quality of life and the extremely high morbidity and mortality rates of dialysis patients have led to the development of intensified hemodialysis programs in which the modes of dialysis (short daily, nocturnal intermittent or daily nocturnal) are different. Such programs have been shown to significantly improve several uremia-associated parameters, such as blood pressure, phosphate control, anemia and growth retardation, in both adult and pediatric (children and adolescents) patients and lead to a reduction in medications, including phosphate binders, erythropoietin and antihypertensive agents. Fluid limitations and dietary restrictions can also be lifted. With respect to psychosocial rehabilitation and quality of life, nocturnal intermittent dialysis programs provide a reasonable compromise of all forms of intensified programs. Experiences and practical approaches of our own in-center nocturnal intermittent hemodialysis program in the light of the recent publications are described in this review.

Effect of nocturnal hemodialysis on sleep parameters in patients with end-stage renal disease: a systematic review and meta-analysis

“…For ESRD patients, the most common therapy is conventional hemodialysis (CHD), also known as intermittent hemodialysis, which conducts dialysis 3 days per week with each session lasting 4–5 hours. Nocturnal hemodialysis (NHD) is a novel and intensive form of renal replacement therapy, which occurs 4–7 nights per week with each session lasting 5–8 hours at home or in a center [ 10 ]. In the past ten years, a small but growing number of studies have shown NHD is superior to CHD in reversing many of the physiologic perturbations of uremia [ 11 – 15 ].…”