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Hemodialysis I: Introduction01:25

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Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
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Measurement of Tissue Oxygenation Using Near-Infrared Spectroscopy in Patients Undergoing Hemodialysis
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Nocturnal hemodialysis: an underutilized modality?

James O Burton1,2,3, Matthew P M Graham-Brown1,2,3

  • 1Department of Infection Immunity and Inflammation, University of Leicester.

Current Opinion in Nephrology and Hypertension
|October 4, 2018
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Nocturnal hemodialysis offers significant survival and quality-of-life benefits for patients undergoing maintenance hemodialysis. This extended-hours dialysis regimen, available at home or in-center, is underutilized despite its proven advantages.

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Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Dialysis Therapy

Background:

  • Extended-hours dialysis regimens are increasingly linked to better outcomes in maintenance hemodialysis.
  • Home hemodialysis provides overnight extended-hours dialysis but faces significant patient barriers.
  • In-center nocturnal hemodialysis offers an alternative for patients unable to use home-based programs.

Purpose of the Study:

  • To review the evidence supporting extended-hours dialysis, particularly nocturnal hemodialysis.
  • To highlight the benefits and underutilization of nocturnal hemodialysis.
  • To encourage the investigation of nocturnal hemodialysis implementation strategies.

Main Methods:

  • Review of recent data and evidence on nocturnal dialysis programs.
  • Analysis of survival advantages and quality-of-life improvements.
  • Assessment of cardiovascular remodeling associated with nocturnal dialysis.

Main Results:

  • Nocturnal dialysis programs show a significant survival advantage over standard and short-daily dialysis.
  • Improvements in quality-of-life measures and social well-being are strongly associated with nocturnal dialysis.
  • Cardiovascular remodeling is a proposed mechanism for the survival benefits of nocturnal dialysis.

Conclusions:

  • Nocturnal hemodialysis is an underutilized modality in both home and in-center settings.
  • Growing evidence necessitates exploring implementation strategies for nocturnal dialysis.
  • Adoption of nocturnal hemodialysis can improve patient outcomes and care experience.