Nephrol Dial Transplant (1999) 14: 2835-2840
© 1999 European Renal Association-European Dialysis and Transplant Association
Dialysis and Transplantation News
Nocturnal home haemodialysis: an update on a 5-year experience
Humber River Regional Hospital, University of Toronto, Toronto, Ontario, Canada
Correspondence and offprint requests to: Dr Andreas Pierratos MD, FRCPC, 2221 Keele St. #315, North York, Ontario, Canada M6M 3Z5. e-mail: a.pierratos@utoronto.ca.
Introduction
Nocturnal haemodialysis, done nightly at home was started by our group about five and a half years ago in an effort to provide a high-quality, low-cost haemodialysis devoid of all the major handicaps of in-centre haemodialysis done three times a week [1]. In this review, I will present our updated experience.
Background
Dialysis treatment for end-stage renal disease is characterized by high morbidity, mortality, low quality of life and high cost. Despite the recent encouraging trends (USRDS) in the US [2], patient mortality is still unacceptably high. The excellent long-term survival results reported by the Tassin group on patients haemodialysed for 8 h three times a week have been the yardstick of successful haemodialysis. Their success was ascribed to both increased length and quantity of dialysis [3]. The separate effect of these two parameters is difficult to decipher, but duration of dialysis seems to be
Rationale for nocturnal haemodialysis
History
Technique description
Dialysate prescription
Access
Remote monitoring
Dialyser reuse
Patients
Clearance (urea/phosphate/ß2 microglobulin)
Quality of life
Sleep
Cognitive function
BP control
Epo use
Calcium/phosphate control/bone disease
Nutrition
Complications
Finances
What does the future hold?
References
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