For Some Kidney Patients, Home Dialysis Is Better

Evidence suggests nighttime treatment yields better results

By Karen Pallarito
HealthDay Reporter

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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.

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"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.

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