Nocturnal Hemodialysis

The options available to patients with end stage renal disease have increased over the last few years

Although In-center hemodialysis remains the predominant choice of most patients, there is now an increasing percentage of patients who are interested in the home modalities.   As a result the percentage of patients on peritoneal dialysis (chronic ambulatory peritoneal dialysis, cycler assisted peritoneal dialysis or combination of both) and home hemodialysis have increased.  However a number of patients are unable to benefit from this treatment modalities due to some limitations at home.

Thus in-center nocturnal hemodialysis becomes a viable option for those patients that could benefit from prolonged  and gentle hemodialysis under the supervision of the dialysis team. In this scenario the patient shows up for dialysis at between 8.00 p.m. and 9.00 p.m. and is on the machine for between six to eight hours depending on the prescription.  During the treatment period, privacy is maintained by proper spacing and a universal lights out policy is in effect at about 10.30.p.m.

The benefits of this variant of hemodialysis include better fluid management, better blood pressure control, better energy level and better phosphate control.

My experience so far with this modality has been interesting and I always offer it to patients that I think will benefit from longer, and gentler form of hemodialysis.