Navigation Links
For Some Kidney Patients, Home Dialysis Is Better

Evidence suggests nighttime treatment yields better results

SATURDAY, July 25 (HealthDay News) -- More than 340,000 Americans are on dialysis to treat kidney failure, but only a tiny fraction are taking advantage of a treatment option that may improve their quality of life.

Studies suggest that home hemodialysis administered overnight, otherwise known as "nocturnal dialysis," may be a better way to go for some patients. The key advantage is it allows for many more hours of blood-cleansing therapy than a kidney patient would typically receive in a conventional, three-times-a-week dialysis center-based program.

"If I had kidney failure, and I think this applies to at least a number of physicians who know what all this is about, what we would do is we would do overnight dialysis six nights a week," said Dr. Christopher R. Blagg, professor emeritus of medicine at the University of Washington and executive director emeritus of Northwest Kidney Centers in Seattle.

Hemodialysis is one of two main types of dialysis treatment administered when a person's kidneys are no longer functioning. It uses a machine to remove wastes and excess fluid from the blood. (Peritoneal dialysis, by contrast, uses the lining of the patient's own abdomen as a filtering device.)

When home hemodialysis is performed overnight, the patient sleeps while the machine does its work. Treatment usually takes place six days a week or every other night over a six- to eight-hour stretch, says the National Kidney Foundation.

Experts say it's not for everyone, particularly people with other serious medical problems, such as cardiovascular disease. But science is beginning to show that nocturnal dialysis has significant advantages.

In a study published in the Journal of the American Medical Association, researchers randomly assigned 52 patients to receive either frequent nocturnal hemodialysis, meaning five or six days a week for a minimum of six hours, or conventional hemodialysis treatments three times weekly. Patients in the nighttime portion of the study were trained to perform hemodialysis at home.

After six months, those receiving nighttime treatments had better heart health, blood pressure and some measures of quality of life than those in conventional treatment.

And Turkish researchers found that eight-hour nighttime treatments performed three times a week cut the death risk of patients by 80 percent compared with conventional four-hour treatments done three times a week. The findings were presented at last year's annual meeting of the American Society of Nephrology.

Dr. Michael V. Rocco, a professor of internal medicine-nephrology at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., says doctors may know more about the effects of more frequent dialysis in the next few years as a result of two National Institutes of Health-sponsored clinical trials.

In one study, patients will receive treatment at a dialysis center on a conventional, three-times-a-week basis or on a frequent, six-times-a-week schedule. The other study will compare nocturnal hemodialysis administered six times a week for at least six hours with conventional, three-times-a-week home hemodialysis.

"These studies on daily and nocturnal [hemodialysis] will provide us with far more dependable information than we now have with observational studies alone," Rocco said.

At present, fewer than 1 percent of all U.S. dialysis patients -- roughly 3,000 people -- do home hemodialysis, Blagg noted.

Several factors are contributing to the lack of growth in nocturnal hemodialysis in the United States, Rocco noted. These include a lack of training in home hemodialysis, especially nocturnal dialysis, making physicians reluctant to recommend it to patients. Funding for home hemodialysis training is inadequate, and physicians and staff aren't promoting it, he added.

But Congress passed legislation last year that could influence the popularity of that option. Effective Jan. 1, 2010, patients with chronic kidney disease must be counseled about their treatment options. This provision is intended to give patients an opportunity to participate in choosing the therapy that they receive.

"I don't know how much difference that will make, but it's a step in the right direction," Blagg said.

More information

The National Kidney Foundation has more on home hemodialysis.

SOURCES: Christopher R. Blagg, M.D., F.R.C.P., professor emeritus, medicine, University of Washington, and executive director emeritus, Northwest Kidney Centers, Seattle; Michael V. Rocco, M.D., M.S.C.E., professor, internal medicine-nephrology, Wake Forest University Baptist Medical Center, Winston-Salem, N.C.; National Kidney Foundation, New York City; National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md.

Copyright©2009 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Fresh-Meat Additives May Be Dangerous for Kidney Patients
2. Baking Soda May Be Key Ingredient for Kidney Patients
3. Sunitinib Benefit Explored in Poor-Prognosis Kidney Cancer
4. Ochsner 1st in Louisiana to use Robotics in Living-Donor Kidney Transplant for Faster Recovery
5. Why African-Americans are at greater risk of hypertension and kidney disease
6. Johns Hopkins leads first 16-patient, multicenter domino donor kidney transplant
7. Kidney Paired Donation: 16 Patients, Four Hospitals, Four States
8. Drugs May Not Slow Kidney Damage in Diabetes
9. DaVita Celebrates the Opening of Its 1,500th Outpatient Kidney Care Clinic in the United States
10. Satellite Healthcare Supports Kidney Wellness in Chicago
11. Common Weight-Loss Surgery May Double Risk of Kidney Stones
Post Your Comments:
(Date:6/26/2016)... ... , ... Brent Kasmer, a legally blind and certified personal trainer is helping to develop a ... fitness app plans to fix the two major problems leading the fitness industry today:, ... type program , They don’t eliminate all the reasons people quit their exercise ...
(Date:6/25/2016)... ... June 25, 2016 , ... Experts from the ... AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the Hynes Convention Center in ... topics including advance care planning, healthcare costs and patient and family engagement. , ...
(Date:6/25/2016)... , ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library on ... Observer , brings up a new, often overlooked aspect of head lice: the parasite’s ability ... fumigation is not a common occurrence, but a necessary one in the event that lice ...
(Date:6/25/2016)... ... 25, 2016 , ... First Choice Emergency Room , the largest network ... the Medical Director of its new Mesquite-Samuell Farm facility. , “We are pleased ... location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency Room. ...
(Date:6/25/2016)... City, Oklahoma (PRWEB) , ... June 25, 2016 ... ... helping both athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic ... the Oklahoma City area —Johnson is one of the first doctors to perform ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... 2016 One of Australia,s successful ... of a new biotechnology company, Noxopharm Limited [ABN 50 608 966 ... and to list on the ASX. Noxopharm is a ... enter a Phase 1 clinical study later this year. ... of the biggest problems facing cancer patients - the ability of ...
(Date:6/26/2016)... -- Jazz Pharmaceuticals plc (Nasdaq: JAZZ ) ... Improvements Act of 1976, as amended ("HSR"), with respect ... Nasdaq: CPXX ) expired effective June 24, ... As previously announced on May 31, 2016, Jazz Pharmaceuticals ... which Jazz Pharmaceuticals has commenced a tender offer for ...
(Date:6/26/2016)... , June 27, 2016  VMS Rehab Systems, Inc. ... will take whatever measures required to build a strong ... which is currently listed on the OTC Markets-pink current ... Chairman and CEO, "We are seeing an anomaly in ... understand, not only by the Company, but shareholders and ...
Breaking Medicine Technology: