Night Time Nocturnal Dialysis

Trauma Columnist · Apr 25, 2012

I have a pt who often visits Chicago and they have nocturnal in-center hemodialysis. It affords her the ability to live a much fuller life.

anurseadvocate · Apr 25, 2012

It is my opinion and much research has supported such that home diaysis, including nocturnal is the best route to go for patients -- (1) need for medications often decreases when doing more dialysis, (2) quality of life is improved (3) less dietary restrictions (4) more indepenence..... and, in my opinion often safer than incenter care... Patients take on a different responsibility when they are doing their own treatments.. Thing of this, our kidneys work 24/7 while someone on incenter dialysis has kidneys that work 9-15 hours a week, depending upon the length of their treatment. I advise patients, if they can, to do home dialysis

Tish88 · Apr 25, 2012

In addition to doing home hemo, there are many patients out there that should be doing PD!

I always ask, why are these "young" patients receiving hemo?- they should save their veins for whenever they need to switch to hemo.

Look at European studies and how many patients receive PD as opposed to hemo. Their mortality and morbitity rates are lower than those of our in United States.

That Guy, BSN, RN, EMT-B · Apr 25, 2012

At my old hospital we had a lot of people on PD. They all said it was the absolute best thing that had happened to them regarding dialysis. Only problem we saw was infections from the caths which is hard to avoid sometimes.

anurseadvocate · Apr 26, 2012

Yes, infections can be a problem - and this is why patient-education/training is so vital... PD works well for many and I know alot of patients that have done well with PD and many who have acquired an infection and had to return to incenter HD. Many patients can work with PD.

NDXUFan · Apr 27, 2012

Agreed, with nocturnal and PD, it would eliminate or greatly reduce many issues in dialysis.

anurseadvocate · May 1, 2012

An article was released today about increased infections/hospitalizations with PD.. However, many articles/research have been released, from recall, over the last few weeks -- related to positive aspects of home dialysis versus 3x/week incenter -- e.g. quality of life, etc.. Well known, ofcourse that often less dietary restrictions and medications when doing home dialysis. Not until the QIP was initiated did many providers push home dialysis as has been noted by many....