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Long overnight dialysis may be superior to conventional dialysis

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – If anybody needed more hours in their day it would probably be a patient on chronic hemodialsys – spending their productive hours confined to a recliner. How about rescheduling dialysis during sleeptime? Long overnight hemodialysis (LOH) sessions are well tolerated and may be more effective than conventional hemodialysis, based on a recent report in the Clinical Journal of the American Society of Nephrology.

The authors compared renal-related outcomes of 53 patients who underwent LOH for at least 1 year versus 53 matched controls who received conventional hemodialysis.

Compared to conventional daytime hemodialysis, LOH was associated with significant increases in the urea reduction ratio and mean hemoglobin level. Trends toward a lower average erythropoietin index and fewer phosphate binder tablets were also encountered. LOH and regular hemodialysis had similar effects on serum phosphate, blood pressure, and number or prescribed antihypertensive medication.

The authors conclude: “Our experience of LOH in the last 10 years shows that it is a practical way for dialysis units to offer longer dialysis that is well tolerated by a substantial proportion of the hemodialysis population and does not need to be restricted to the fittest patients,” Research is now underway to explore the impact of LOH on morbidity and mortality.

Reference:
Clin J Am Soc Nephrol 2009.