Comparison of biochemical, haematological and volume parameters in two treatment schedules of nocturnal home haemodialysis

Mahadevan, Kumar; Pellicano, Rebecca; Reid, Alistair; Kerr, Peter G.; Polkinghorne, Kevan R.; Agar, John

doi:10.1111/j.1440-1797.2006.00670.x

Cited by 19 publications

(15 citation statements)

References 17 publications

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“…Little was published about the outcomes of NHHD with an alternate night schedule. In Australia, where NHHD on alternate night has been performed in some centers, there was no significant difference in hemoglobin level or erythropoietin requirement between NHHD performed 3.5 times per week (i.e., alternate night) and that performed six times per week …”

Section: Discussionmentioning

confidence: 96%

Effect of alternate night nocturnal home hemodialysis on anemia control in patients with end‐stage renal disease

Poon

Tang

Wong

et al. 2014

Hemodialysis International

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Nocturnal home hemodialysis (NHHD) has shown promising results in various clinical parameters. Whether NHHD provide benefit in anemia management remains controversial. This study aims to investigate whether anemia and erythropoiesis-stimulating agent (ESA) requirement are improved in patients receiving alternate night NHHD compared with conventional hemodialysis (CHD). In this retrospective controlled study, a clinical data of 23 patients receiving NHHD were compared with 25 in-center CHD patients. Hemoglobin level, ESA requirement, iron profile, and dialysis adequacy indexes were compared between the two groups. Hemoglobin level increased from baseline of 9.37 ± 1.39 g/dL to 11.34 ± 2.41 g/dL at 24 months (P < 0.001) and ESA requirement decreased from 103.44 ± 53.55 U/kg/week to 47.33 ± 50.62 U/kg/week (P < 0.001) in NHHD patients. ESA requirement further reduced after the first year of NHHD (P = 0.037). Standard Kt/V increased from baseline of 2.02 ± 0.28 to 3.52 ± 0.30 at 24 months (P < 0.001). At 24 months, hemoglobin level increased by 1.98 ± 2.74 g/dL in the NHHD group while it decreased by 0.20 ± 2.32 g/dL in the CHD group (P = 0.007). ESA requirement decreased by 53.49 ± 55.50 U/kg/week in NHHD patients whereas it increased by 16.22 ± 50.01 U/kg/week in CHD patients (P < 0.001). Twenty-six percent of NHHD patients were able to stop ESA compared with none in the CHD group. Standard Kt/V showed greater increase in the NHHD group. (1.49 ± 0.36 in NHHD vs. 0.18 ± 0.31 in CHD, P = 0.005). NHHD with an alternate night schedule improves anemia and reduces ESA requirement as a result of enhanced uremic clearance. This benefit extended beyond the first year of NHHD.

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Section: Discussionmentioning

confidence: 96%

Effect of alternate night nocturnal home hemodialysis on anemia control in patients with end‐stage renal disease

Poon

Tang

Wong

et al. 2014

Hemodialysis International

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“…Daily HD allows for increased clearance of middle‐molecules because of less rebound; and NHD increases middle‐molecule removal as a result of higher frequency and duration of HD. The relative increase in total solute removal with NHD is greatest for middle‐molecules such as phosphate and β2‐microglobulin, compared with small solutes such as urea and creatinine; and greater convective removal is also seen as a result of higher weekly ultrafiltration 42–45 . On conversion from conventional HD to NHD, one study reported serum β2‐microglobulin levels decreased from 27.2 to 13.7 mg/dL after 9 months with an increase in β2‐microglobulin mass removal from 127 to 585 mg 46 .…”

Section: Differences In Assessment Of Adequacymentioning

confidence: 99%

Review: Differences in prescription between conventional and alternative haemodialysis

Toussaint

2010

Nephrology

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SUMMARY AT A GLANCELonger hours dialysis has several challenges -one of these -modifying the dialysate composition is addressed in this article. ABSTRACT:There is growing interest worldwide in the beneficial effects of increasing the frequency and/or time of haemodialysis (HD) sessions. Alternative HD regimens to incorporate these changes, also called 'quotidian' HD schedules, likely offer advantages over conventional thrice-weekly HD. Alternative regimens include short-daily HD (typically performed 1.5-3 h, 5-7 days per week) and nocturnal HD (typically 6-8 h, 3-7 nights per week). Both regimens can be performed at home or in the hospital setting, although in Australia and New Zealand the predominant alternative regimen is nocturnal HD at home. Dialysis prescriptions for alternative schedules vary in many aspects when compared with conventional HD and this review describes differences in dialysate concentrations, blood and dialysate flow rates, ultrafiltration rates, vascular access issues and adequacy of HD between the different HD modalities. An international quotidian dialysis registry has also recently been created to capture observational data on patients receiving alternative HD regimens and provides further information on dialysis prescriptions for these therapies.

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“…A prospective nonrandomized study of 11 patients on short daily, 12 patients on nocturnal, and matched controls receiving conventional hemodialysis for 5-36 months confirmed improvements in quality of life and bloodpressure control for both quotidian modalities and better phosphate control with nocturnal hemodialysis [10][11][12][13]. The main advantages of long intermittent hemodialysis are the favourable financial profile, the known improved hemodynamic benefits, and the increased middle molecule removal [4,7]. There is only limited use of quotidian incenter hemodiafiltration or home hemofiltration for both adults and children [14,15].…”

Section: Patient Selection and Modality Choicementioning

confidence: 90%

“…Despite some recent reports [7][8][9], there are no systematic studies comparing different forms of intensive hemodialysis. The advantages of quotidian nocturnal hemodialysis must be weighed against the requirement for long and frequent treatments, the potential for deficiency syndromes, long exposure to dialysis membranes and heparin, as well as night-time safety concerns.…”

Section: Patient Selection and Modality Choicementioning

confidence: 99%

Intensified hemodialysis regimens: neglected treatment options for children and adolescents

et al. 2008

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During recent years, the importance of intensified dialysis regimens has gathered increasing interest, especially after the Hemodialysis (HEMO) Study Group reported that a higher dose of thrice-weekly hemodialysis failed to improve clinical outcomes. Long nocturnal hemodialysis (three to six times per week) or short daily hemodialysis are the currently used forms of intensified dialysis. There is substantial evidence for cardiovascular and quality-of-life improvements as well as financial benefits with intensified hemodialysis. Preliminary experience with daily hemodialysis and hemodiafiltration in children has been reported. Given the continuing shortage of donor organs for kidney transplantation, the increasing incidence of end-stage renal disease (ESRD) and recognition of the deleterious effects of long-lasting ESRD, growth retardation, and poor social rehabilitation, more intensified dialysis regimens are a much-needed therapeutical option in both adults and children.

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Comparison of biochemical, haematological and volume parameters in two treatment schedules of nocturnal home haemodialysis

Cited by 19 publications

References 17 publications

Effect of alternate night nocturnal home hemodialysis on anemia control in patients with end‐stage renal disease

Effect of alternate night nocturnal home hemodialysis on anemia control in patients with end‐stage renal disease

Review: Differences in prescription between conventional and alternative haemodialysis

Intensified hemodialysis regimens: neglected treatment options for children and adolescents

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