Advantages of Nocturnal Home Hemodialysis
- Better blood pressure management—less need for blood pressure medications.
- Avoidance of intradialytic hypotension (i.e. low blood pressure during dialysis), something relatively common in IHD.
- More energy and less 'wash-out' after treatment.
- Decreased prevalence of sleep apnea or improvement in severe cases of sleep apnea - sleep better.
- Less expensive overall for the health system due to lower rates of hospitalization and savings on nursing.
- Less dietary restrictions—e.g., phosphate binders, renal failure food restrictions.
- More control over the dialysis treatment schedule and greater life satisfaction.
- Live longer, according to a case-cohort study.
- Cardiovascular disease in ESRD patients is the leading cause of mortality. Nocturnal hemodialysis is thought to improve ejection fraction (an important measure of cardiac function) and lead to a regression in left ventricular hypertrophy. Recently a benefit of 6x/week nocturnal hemodialysis on left ventricular hypertrophy was demonstrated in a randomized controlled trial.
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“When the manipulations of childhood are a little larceny, they may grow and change with the child into qualities useful and admire in the grown-up world. When they are the futile struggle for love and concern and protection, they may become the warped and ruthless machinations of adults who seek in the advantages of power what they could never win as children.”
—Leontine Young (20th century)
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