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Dialysis
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In-center Nocturnal Hemodialysis: Another Option in the Management of Chronic Kidney Disease

Ann Bugeja, Niki Dacouris, Alison Thomas, Rosa Marticorena, Philip McFarlane, Sandra Donnelly and Marc Goldstein
CJASN April 2009, 4 (4) 778-783; DOI: https://doi.org/10.2215/CJN.05221008
Ann Bugeja
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Niki Dacouris
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Alison Thomas
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Rosa Marticorena
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Philip McFarlane
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Sandra Donnelly
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Marc Goldstein
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Abstract

Background and objectives: Some patients are not optimally treated by conventional in-center hemodialysis (HD) and are unable to perform home HD. We examined the effect of in-center thrice-weekly nocturnal HD (INHD) on patient outcomes.

Design, setting, participants, & measurements: Patients who were not optimally treated on conventional HD were offered INHD. Thirty-nine patients’ laboratory data and medication use were analyzed for the 12 mo before and after conversion to INHD until September 1, 2007. Quality of life on conventional HD and INHD was compared.

Results: After conversion to INHD, median values for phosphorus decreased from 5.9 to 3.7 mg/dl (P < 0.01), alkaline phosphatase level increased from 84 to 161 U/L (P < 0.01), and percentage reduction in urea increased from 74 to 89% (P < 0.01). The mean number of antihypertensive drugs prescribed declined from 2.0 to 1.5 (P < 0.05) during the course of INHD, and the mean daily dosage of phosphate binders declined from 6.2 to 4.9 at study end (P < 0.05). There was a significant reduction in erythropoietin-stimulating agent use of 1992 U/wk (P < 0.01). There was no significant change in median hemoglobin, iron saturation, corrected calcium, or parathyroid hormone levels. Overall, quality of life, sleep, intradialytic cramps, appetite, and energy level all improved significantly on INHD.

Conclusions: INHD offers an effective form of HD for long-term dialysis patients who are unable to perform home HD.

  • Received October 8, 2008.
  • Accepted December 22, 2008.
  • Copyright © 2009 by the American Society of Nephrology
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Clinical Journal of the American Society of Nephrology
Vol. 4, Issue 4
April 2009
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In-center Nocturnal Hemodialysis: Another Option in the Management of Chronic Kidney Disease
Ann Bugeja, Niki Dacouris, Alison Thomas, Rosa Marticorena, Philip McFarlane, Sandra Donnelly, Marc Goldstein
CJASN Apr 2009, 4 (4) 778-783; DOI: 10.2215/CJN.05221008

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In-center Nocturnal Hemodialysis: Another Option in the Management of Chronic Kidney Disease
Ann Bugeja, Niki Dacouris, Alison Thomas, Rosa Marticorena, Philip McFarlane, Sandra Donnelly, Marc Goldstein
CJASN Apr 2009, 4 (4) 778-783; DOI: 10.2215/CJN.05221008
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More in this TOC Section

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  • Cardiac Geometry in Children Receiving Chronic Peritoneal Dialysis: Findings from the International Pediatric Peritoneal Dialysis Network (IPPN) Registry
  • Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients
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Cited By...

  • Long-term clinical parameters after switching to nocturnal haemodialysis: a Dutch propensity-score-matched cohort study comparing patients on nocturnal haemodialysis with patients on three-times-a-week haemodialysis/haemodiafiltration
  • Survival with Three-Times Weekly In-Center Nocturnal Versus Conventional Hemodialysis
  • Intermittent Peritoneal Dialysis: Urea Kinetic Modeling and Implications of Residual Kidney Function
  • Kinetic Model of Phosphorus Mobilization during and after Short and Conventional Hemodialysis
  • Hemodialysis Treatment Time: A Fresh Perspective
  • Outcomes Associated with In-Center Nocturnal Hemodialysis from a Large Multicenter Program
  • More Intensive Hemodialysis
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