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Nocturnal hemodialysis

Michael V Rocco
BACKGROUND: Chronic hemodialysis (HD) in the 1960s encompassed a wide variety of prescriptions from twice weekly to five times per week HD. Over time, HD prescriptions in the West became standardized at three times per week, 2.5-4 h per session, with occasional additional treatments for volume overload. SUMMARY: When clinical trials of dialysis dose failed to show significant benefit of extending time compared with the traditional dialysis prescription, interest in more frequent HD was renewed...
December 2015: Kidney Diseases
Rosemary Masterson, Susan Blair, Kevan R Polkinghorne, Kenneth K Lau, Michael Lian, Boyd J Strauss, John G Morgan, Peter Kerr, Nigel D Toussaint
Introduction Higher calcium dialysate is recommended for quotidian nocturnal hemodialysis (NHD) (≥6 nights/week) to maintain bone health. It is unclear what the optimal calcium dialysate concentration should be for alternate night NHD. We aimed to determine the effect of low calcium (LC) versus high calcium (HC) dialysate on cardiovascular and bone parameters in this population. Methods A randomized controlled trial where participants were randomized to LC (1.3 mmol/L, n = 24) or HC dialysate (1.6 or 1...
June 30, 2016: Hemodialysis International
Jeffrey Perl, Sahir Kalim, Ron Wald, Marc B Goldstein, Andrew T Yan, Nazanin Noori, Mercedeh Kiaii, Julia Wenger, Christopher Chan, Ravi I Thadhani, S Ananth Karumanchi, Anders H Berg
Introduction Among conventional hemodialysis (CHD) patients, carbamylated serum albumin (C-Alb) correlates with urea and amino acid deficiencies and is associated with mortality. We postulated that reduction of C-Alb by intensive HD may correlate with improvements in protein metabolism and cardiac function. Methods One-year observational study of in-center nocturnal extended hemodialysis (EHD) patients and CHD control subjects. Thirty-three patients receiving 4-hour CHD who converted to 8-hour EHD were enrolled, along with 20 controls on CHD...
June 21, 2016: Hemodialysis International
Karin J R Ipema, Simone Struijk, Annet van der Velden, Ralf Westerhuis, Cees P van der Schans, Carlo A J M Gaillard, Wim P Krijnen, Casper F M Franssen
BACKGROUND: Hemodialysis patients experience an elevated risk of malnutrition associated with increased morbidity and mortality. Nocturnal hemodialysis (NHD) results in more effective removal of waste products and fluids. Therefore, diet and fluid restrictions are less restricted in NHD patients. However, it is ambiguous whether transition from conventional hemodialysis (CHD) to NHD leads to improved intake and nutritional status. We studied the effect of NHD on protein intake, laboratory indices of nutritional status, and body composition...
2016: PloS One
Tina Zupančič, Rafael Ponikvar, Jakob Gubenšek, Jadranka Buturović-Ponikvar
The aim of our prospective study was to quantify phosphate removal during long nocturnal high-flux hemodialysis or hemodiafiltration (HD) with total dialysate collection. Eight patients (two women) were studied for the first-in-the-week HD session that lasted 7-8 h. Total dialysate was collected. Serum and collected dialysate phosphate concentrations were measured every hour. Phosphate removal as assessed from the serum concentration was most important during the first 2 h of HD, and then a plateau was reached...
June 2016: Therapeutic Apheresis and Dialysis
Bourne L Auguste, Darren Yuen, Christopher T Chan
BACKGROUND: Compared with the general population, end-stage renal disease patients are at increased risk for bone loss and fractures. Nocturnal hemodialysis offers superior calcium-phosphate control and improved uremic clearance compared with conventional hemodialysis. Rates of bone loss by type of hemodialysis are unknown. OBJECTIVES: This study aims to determine whether there are differences in bone loss between frequent nocturnal hemodialysis and conventional hemodialysis...
2016: Canadian Journal of Kidney Health and Disease
Mark L Unruh, Brett Larive, Paul W Eggers, Amit X Garg, Jennifer J Gassman, Fredric O Finkelstein, Paul L Kimmel, Glenn M Chertow
BACKGROUND: Many patients who receive maintenance hemodialysis experience poor sleep. Uncontrolled studies suggest frequent hemodialysis improves sleep quality, which is a strong motivation for some patients to undertake the treatment. We studied the effects of frequent in-center ('daily') and nocturnal home hemodialysis on self-reported sleep quality in two randomized trials. METHODS: Participants were randomly assigned to frequent (six times per week) or conventional (three times per week) hemodialysis in the Frequent Hemodialysis Network Daily (n = 245) and Nocturnal (n = 87) Trials...
June 2016: Nephrology, Dialysis, Transplantation
Orlando Camacho, Maria Carmela Rosales, Tariq Shafi, Jonathan Fullman, Natalie S Plummer, Timothy W Meyer, Tammy L Sirich
BACKGROUND: The protein-bound solutes p-cresol sulfate (PCS) and indoxyl sulfate (IS) accumulate to high plasma levels in renal failure and have been associated with adverse events. The clearance of these bound solutes can be altered independently of the urea clearance by changing the dialysate flow and dialyzer size. This study tested whether a sustained difference in clearance would change the plasma levels of PCS and IS. METHODS: Fourteen patients on thrice-weekly nocturnal hemodialysis completed a crossover study of two periods designed to achieve widely different bound solute clearances...
August 2016: Nephrology, Dialysis, Transplantation
Timothy Jee Kam Koh, Christopher T Chan
Adrenal insufficiency is a complication of chronic corticosteroid therapy. Unexplained hypotension may be a manifestation of an adrenal insufficient state in patients with a history of corticosteroid therapy on hemodialysis. We present a series of five cases of patients on nocturnal home hemodialysis with hypotension as the main manifestation of adrenal insufficiency. Unexplained hypotension in patients with a history of corticosteroid therapy should prompt the managing clinician to consider adrenal insufficiency as a possible cause...
July 2016: Hemodialysis International
Michael Joseph Lavery, Carolyn Stull, Michael Owen Kinney, Gil Yosipovitch
Chronic pruritus is a debilitating condition with numerous etiologies. Many patients suffer from nocturnal pruritus, which can decrease quality of life and affect mortality in hemodialysis patients. Nocturnal pruritus may occur in all sleep stages but is most prevalent in stages N1 and N2. Further research is needed to elucidate the pathophysiology of nocturnal itch, which will aid in the development of tailored management strategies.
2016: International Journal of Molecular Sciences
Yasmin Brahmbhatt, Arinze Ikeme, Navjyot Bhogal, Vincenzo Berghella
Pregnancy in the setting of the uremic milieu of renal disease has a lower success rate than in the normal population and is a rare event. While intensified renal replacement therapy (RRT) during pregnancy can lead to improved outcomes, most studies have focused on nocturnal hemodialysis as the main RRT in pregnancy. Although thousands of patients use the home NxStage System One short daily hemodialysis (SDHD) machine in the United States, pregnancy outcomes with this therapy are unknown. The NxStage System One uses low-volume dialysate and hence small and middle molecule clearance may differ compared to conventional therapies and affect pregnancy outcomes...
2016: Case Reports in Nephrology
Chong-Ting Lin, Xi-Ning Liu, Hong-Lei Xu, Hui-Yan Sui
OBJECTIVE: To evaluate menstrual disturbances and sex hormonal status in premenopausal women with end-stage renal disease (ESRD). SUBJECTS AND METHODS: The study consisted of 184 patients with ESRD treated with one of four treatment modalities (46/modality): conventional hemodialysis (CHD), continuous ambulatory peritoneal dialysis (CAPD), nocturnal hemodialysis (NHD) and renal transplantation (RT). Blood samples were collected to determine sex hormone levels. Sociodemographic and clinical data were collected from medical records...
2016: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Maria-Eleni Roumelioti, Christos Argyropoulos, Vernon Shane Pankratz, Manisha Jhamb, Filitsa H Bender, Daniel J Buysse, Patrick Strollo, Mark L Unruh
BACKGROUND: Automated peritoneal dialysis (APD) is one of the fastest growing dialysis modalities. It is unknown whether sleep and mood are disturbed while performing repeated overnight exchanges. OBJECTIVES: In this report, we aim to describe and compare the prevalence of sleep-disordered breathing (SDB), periodic limb movements (PLMS), poor sleep quality (SQ), and depression among APD patients compared with stages 3b-5 (estimated glomerular filtration rate ≤44 ml/min/1...
2016: Canadian Journal of Kidney Health and Disease
K Mnif, F Jarraya, H Chaker, H Mahfoudh, S Feki, S Charfeddine, L Abid, S Kammoun, K Kammoun, J Hachicha
OBJECTIFS: La pression artérielle (PA) présente une variation continue durant le jour et la nuit. Les patients traités par hémodialyse (HD) subissent un rythme particulier imposé par les séances d'HD un jour sur deux. La relation entre le niveau de la PA et la morbi-mortalité cardiovasculaire ne simule pas celle observée chez les sujets à fonction rénale préservée. Le dilemme d'épidémiologie inverse a même été introduit. Les données issues des mesures ambulatoires de la PA (MAPA) permettent une meilleure caractérisation de la PA durant les activités quotidiennes et le sommeil, et, surtout, une meilleure corrélation avec l'atteinte des organes cibles que la mesure clinique de la PA...
December 2015: Annales de Cardiologie et D'angéiologie
Bradley S Dixon, John M VanBuren, James R Rodrigue, Robert S Lockridge, Robert Lindsay, Christopher Chan, Michael V Rocco, Jacob J Oleson, Leigh Beglinger, Kevin Duff, Jane S Paulsen, John B Stokes
BACKGROUND: It is uncertain whether switching to frequent nocturnal hemodialysis improves cognitive function in well-dialyzed patients and how this compares to patients who receive a kidney transplant. METHODS: We conducted a multicenter observational study with longitudinal follow-up of the effect on cognitive performance of switching dialysis treatment modality from conventional thrice-weekly hemodialysis to frequent nocturnal hemodialysis, a functioning renal transplant or remaining on thrice-weekly conventional hemodialysis...
2016: BMC Nephrology
Edward Buitenwerf, Arne J Risselada, Eric N van Roon, Nic J G M Veeger, Marc H Hemmelder
BACKGROUND: Nadroparin is used during hemodialysis to prevent clotting of the extra corporeal system. During nocturnal hemodialysis patients receive an increased dosage of nadroparin compared to conventional hemodialysis. We tested whether the prescribed dosage regimen of nadroparin, according to Dutch guidelines, causes accumulation of nadroparin. METHODS: Anti-Xa levels were used as an indicator of nadroparin accumulation. Anti-Xa was measured photometrically in 13 patients undergoing nocturnal hemodialysis for 4 nights a week...
June 2015: BBA Clinical
Sisse H Laursen, Amanda Buus, Morten H Jensen, Peter Vestergaard, Ole K Hejlesen
PURPOSE: Hyperphosphatemia constitutes a major problem in end-stage renal disease patients. At this stage, dialysis efficacy usually plays an important role in obtaining phosphate levels within the normal range. Currently, no practical tool capable of making individualized predictions about phosphate changes during and after hemodialysis (HD) have gained clinical acceptance. As a result, optimal dialysis prescriptions seem to be difficult to achieve. The objective of the present study was to develop and test a quantitative tool to predict intradialytic and postdialytic (2 hours) phosphate kinetics in HD therapy...
November 2015: International Journal of Artificial Organs
Ayman Karkar, Jörgen Hegbrant, Giovanni F M Strippoli
Home hemodialysis (HD) is a modality of renal replacement therapy that can be safely and independently performed at home by end-stage renal disease (ESRD) patients. Home HD can be performed at the convenience of the patients on a daily basis, every other day and overnight (nocturnal). Despite the great and many perceived benefits of home HD, including the significant improvements in health outcomes and resource utilization, the adoption of home HD has been limited; lack or inadequate pre-dialysis education and training constitute a major barrier...
November 2015: Saudi Journal of Kidney Diseases and Transplantation
Amy Bennett Bridge, Karyn E Holt
Compared to conventional hemodialysis dialysis, nocturnal hemodialysis represents a more effective modality for receiving hemodialysis and has been associated with a 25% reduction in risk of death and improved quality of life. This article identifies the evidence about the mortality and morbidity risk for patients undergoing conventional hemodialysis vs. nocturnal hemodialysis.
July 2015: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Ron Wald, Marc B Goldstein, Jeffrey Perl, Mercedeh Kiaii, Darren Yuen, Rachel M Wald, Ziv Harel, Jordan J Weinstein, Baruch Jakubovic, Howard Leong-Poi, Anish Kirpalani, Jonathon Leipsic, Niki Dacouris, Myles Wolf, Andrew T Yan
BACKGROUND: In-centre nocturnal hemodialysis (INHD, 7-8 hours/session, 3 times/week) is an increasingly utilized form of dialysis intensification, though data on the cardiovascular benefits of this modality are limited. METHODS: In this prospective cohort study, we enrolled 67 prevalent conventional hemodialysis (CHD, 4 hours/session, 3 times/week) recipients at 2 medical centres in Canada, of whom 37 converted to INHD and 30 remained on CHD. The primary outcome was the change in left ventricular mass (LVM) after 1 year as assessed by cardiac magnetic resonance imaging...
March 2016: Canadian Journal of Cardiology
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