In response to the rising costs of providing renal replacement therapy to an increasingly large dialysis population, our group has been developing a new modality-slow nocturnal home hemodialysis (SNHHD)-whereby patients dialyze 5 to 7 nights a week for 8 to 10 hours while sleeping. Vascular access is established by means of a Cook silastic jugular catheter, and special precautions are taken to prevent accidental disconnection. A trained staff remotely monitors dialysis functions on a computer via a modem. Five patients to date have completed training with the modality and have been successfully performing SNHHD for between 4-14 months. All patients have discontinued their phosphate binders and have increased their dietary phosphate intake. Average predialysis urea and creatinine levels have been significantly reduced to 9.6 mmol/L (26.8 mg/dl) and 486 μmol/L (5.5 mg/dl), respectively. Four out of the 5 patients have reported that they sleep soundly and have experienced greatly increased energy and stamina. Repeated in situ reuse of the dialyzer and blood lines will reduce the patient's work and make SNHHD a very inexpensive modality.
|Journal||Dialysis and Transplantation|
|Publication status||Published - Jan 1 1995|
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