Is there a magic in long nocturnal dialysis?

Area of Science:

• Nephrology
• Internal Medicine

Background:

• Long hemodialysis (HD) has been practiced for 35 years with consistent success.
• This method demonstrates superior morbidity and mortality outcomes compared to standard HD treatments.

Purpose of the Study:

• To evaluate the long-term effectiveness and outcomes of a specific long hemodialysis regimen.
• To identify the key factors contributing to the success of this HD protocol.

Main Methods:

• Utilizing a 3x8 hours/week hemodialysis schedule, adaptable for daytime or overnight sessions.
• Focusing on strict extracellular volume normalization via ultrafiltration and low-salt diet for blood pressure control.
• Administering high doses of small and middle molecules to ensure nutritional adequacy and correct anemia.

Main Results:

• Significantly lower cardiovascular morbidity and mortality rates observed in patients undergoing this HD regimen.
• Effective control of blood pressure and serum phosphate levels achieved.
• Minimal need for medications due to high solute clearance, leading to satisfactory nutrition and anemia correction.

Conclusions:

• Long hemodialysis, particularly overnight, provides optimal correction of renal failure abnormalities.
• The regimen is cost-effective and yields excellent patient outcomes.
• While patient suitability for overnight HD may decrease, the benefits remain substantial.