Nocturnal hemodialysis: Three-year experience

Andreas Pierratos, Michaelene Ouwendyk, Robert Francoeur, S. Vas, Dominic S C Raj, Anne Marie Ecclestone, Veronica Langos, Robert Uldall

Research output: Contribution to journalArticle

311 Citations (Scopus)

Abstract

There is evidence that high frequency, as well as long duration, hemodialysis provides better clinical outcomes. We developed nocturnal hemodialysis, a new innovative form of renal replacement therapy, which is performed six to seven nights per week for 8 to 10 h during sleep at home. Blood flow was set at 300 ml/min and dialysate flow at 100 ml/min. An internal jugular catheter was used as the vascular access. Special precautions were taken to prevent accidental disconnection during sleep, as well as air embolization. Dialysis functions from the patient's home were monitored continuously via a modem at the nocturnal hemodialysis center. Twelve patients have completed training and have been successfully performing nocturnal hemodialysis for up to 34 mo. This study represents 170 patient months of experience accumulated over 3 yr. There was hemodynamic stability and significant subjective improvement in patient well being. Nightly Kt/V was 0.99. Weekly removal of phosphate was twice as high and β2 microglobulin 4 times as high as conventional hemodialysis. All patients have discontinued their phosphate binders and have increased dietary phosphate and protein intake. BP control was achieved with fewer medications. Dialyzer reuse has decreased the operating costs to the level of the other form of home dialysis. Complications were infrequent and were related primarily to the dialysis access. Nocturnal hemodialysis represents the most efficient form of dialysis at low cost and should be considered as an option for patients who can be trained for home hemodialysis.

Original languageEnglish
Pages (from-to)859-868
Number of pages10
JournalJournal of the American Society of Nephrology
Volume9
Issue number5
Publication statusPublished - May 1998

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Renal Dialysis
Dialysis
Phosphates
Sleep
Home Hemodialysis
Modems
Costs and Cost Analysis
Renal Replacement Therapy
Dietary Proteins
Dialysis Solutions
Blood Vessels
Neck
Catheters
Hemodynamics
Air

ASJC Scopus subject areas

  • Nephrology

Cite this

Pierratos, A., Ouwendyk, M., Francoeur, R., Vas, S., Raj, D. S. C., Ecclestone, A. M., ... Uldall, R. (1998). Nocturnal hemodialysis: Three-year experience. Journal of the American Society of Nephrology, 9(5), 859-868.

Nocturnal hemodialysis : Three-year experience. / Pierratos, Andreas; Ouwendyk, Michaelene; Francoeur, Robert; Vas, S.; Raj, Dominic S C; Ecclestone, Anne Marie; Langos, Veronica; Uldall, Robert.

In: Journal of the American Society of Nephrology, Vol. 9, No. 5, 05.1998, p. 859-868.

Research output: Contribution to journalArticle

Pierratos, A, Ouwendyk, M, Francoeur, R, Vas, S, Raj, DSC, Ecclestone, AM, Langos, V & Uldall, R 1998, 'Nocturnal hemodialysis: Three-year experience', Journal of the American Society of Nephrology, vol. 9, no. 5, pp. 859-868.
Pierratos A, Ouwendyk M, Francoeur R, Vas S, Raj DSC, Ecclestone AM et al. Nocturnal hemodialysis: Three-year experience. Journal of the American Society of Nephrology. 1998 May;9(5):859-868.
Pierratos, Andreas ; Ouwendyk, Michaelene ; Francoeur, Robert ; Vas, S. ; Raj, Dominic S C ; Ecclestone, Anne Marie ; Langos, Veronica ; Uldall, Robert. / Nocturnal hemodialysis : Three-year experience. In: Journal of the American Society of Nephrology. 1998 ; Vol. 9, No. 5. pp. 859-868.
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