Daily hemodialysis: a nursing perspective

Daily hemodialysis can be performed in the center or at home for varying lengths of time. Short daily hemodialysis (SDHD) can be defined as one and one half- to three-hour treatments performed 6 days per week. Nocturnal hemodialysis (NHD) is performed for 6 to 10 hours, 5 to 7 nights per week. Patient selection criteria can range from basic requirements, such as the ability to communicate, to medical necessity related to comorbid conditions. Central venous catheters (CVCs), mature arteriovenous fistulas, and synthetic grafts have been used successfully for daily dialysis therapies, although documented experience with grafts is somewhat limited. Documented nursing issues surrounding these therapies are very limited. Few changes are required to adapt daily dialysis to the in-center environment. Patient training strategies and scheduling for the home application vary between institutions, but the core approaches remain the same. Daily hemodialysis therapies can be integrated easily into existing home hemodialysis programs with very little extra effort. This article discusses nursing issues and provides relevant information for those who are interested in incorporating daily hemodialysis (DHD) therapies into their program.