Home Dialysis Central:

For more information on NND, including several published articles that support the concept of "More is Better" please visit Home Dialysis Central, "a one-stop, online source of up-to-date, unbiased information about home dialysis."

Additional Links:

With standard in-center dialysis treatment, an average patient in the US receives three 4-hour dialysis treatments per week – either dialyzing on a Monday-Wednesday-Friday schedule or a Tuesday–Thursday–Saturday schedule. This schedule means that once per week, every patient goes two full days without a dialysis treatment. In this dialysis modality, patients accumulate waste products and fluid in their bodies over a period of 44 hours.  The process of removing 44 hours of fluid build-up in a mere 4 hour treatment is very harsh on the body and often results in painful side effects.

By contrast, patients who dialyze on Nightly Nocturnal Dialysis (NND) accumulate waste products and fluid for a period of 16 hours, then have those accumulated substances slowly removed over an eight hour treatment.  This gentler process eliminates many treatment side effects while greatly improving its effectiveness. A recent study has shown that within one month of starting NND it only took 7 minutes, on average, for them to feel better after a dialysis treatment. These same patients reported that it took over six hours to feel better after a treatment when they were dialyzing three times per week.¹


Improved Fluid Control

Patients on dialysis are often hypertensive because they carry a lot of extra fluid in their bodies between dialysis treatments. NND often reduces or eliminates the need for blood pressure medication due to the improved level of fluid control.²  Click For Chart


Improved Phosphorus Control

Control of phosphorus is virtually impossible in patients undergoing standard in-center dialysis. The phosphorus molecule is too big to be removed in a short dialysis treatment. The impact of phosphorus on a patients heart muscle can be very harmful. When patient go onto NND, the phosphorus level is controlled so well almost all patients get to stop taking their phosphate binders.^2,3,4 Click For Chart


Improved Toxin Removal

Getting adequate dialysis is very important to the health of dialysis patients. Studies have shown that NND is much more effective at providing adequate dialysis based on the measurement of urea removal as determined by Kt/V.^2,5 Click For Chart

Improved Red Blood Cell Health

Because patients on NND are better dialyzed, their red blood cells tend to live longer than patients who dialyze in-center. Studies have shown that in most cases, patients are able to maintain a higher hematocrit, and do this using less EPO medication.^2,6  Click For Chart

Improved Well-Being

Here is one of the best parts about NND. Almost all dialysis patients report that they feel very "washed out" after a dialysis treatment. This is because their bodies have just gone through a very dramatic physiological shift - from being fluid overloaded and having high waste and electrolyte levels to being fluid depleted and having abnormally low electrolyte levels.⁷

References

1. Heidenheim AP, Muirhead N, Moist L, Lindsay RM. Patient quality of life on quotidian dialysis. Am J Kid Dis 2003; 42(1, Suppl 1):S36-S41.

2. Lockridge RS, Home Hemodialysis International, May 1999

3. DeSoi CA, Umans JG. Does the dialysis prescription influence phosphate removal? Semin Dial 1995; 8(4):201-203.

4. Lindsay RM, Alhejaili F, Nesrallah G, Leitch R, Clement L, Heidenheim AP, Kortas C. Calcium and phosphate balance with quotidian dialysis. Am J Kid Dis 2003; 42(1, Suppl 1):S24-S29.

5. Suri R, Depner T, Blake P, Heidenheim AP, Lindsay RM. Adequacy of quotidian hemodialysis. Am J Kid Dis 2003; 42(1, Suppl 1):S42-S48.

6. Rao M, Muirhead N, Klarenbach S, Moist L, Lindsay RM. Management of anemia with quotidian dialysis. Am J Kid Dis 2003; 42(1, Suppl 1):S18-S23.

7. Kjellstrand CM, Evans RL, Petersen RJ, Shideman JR, von Hartitzsch B, Buselmeier TJ. The “unphysiology” of dialysis: a major cause of dialysis side effects? Kidney Int Suppl. 1975;2:30-34.