At-Home Dialysis Proves Beneficial
Nighttime administration lends itself to lengthier treatment

(HealthDay News) -- Although the thought of performing dialysis at home might seem daunting at first, it's an option that appears to improve the health of some people with serious kidney disease.

Research published in the Journal of the American Medical Association found that at-home dialysis, which is sometimes referred to as nocturnal dialysis because it's done at night, improved heart health, lowered the need for certain blood pressure medications and improved the quality of life of those undergoing dialysis.

"The advantage of nighttime dialysis is that, if you add the hours up, you get more dialysis delivered," Dr. Robert Provenzano, chairman of the Nephrology Department at St. John Hospital in Detroit , said. "Weekly, you get between 10 and 12 hours on regular dialysis, but on nighttime [dialysis] you get about 24. The blood is cleaner, and a lot of the restrictions placed on dialysis patients are lessened. They often use less medicine and can have a more liberal diet."

Simply put, he explained to HealthDay , "the more dialysis, the better."

Getting enough dialysis can be difficult with the traditional method of people going to a dialysis center three times a week for several hours, explained Dr. Dylan Steer, a nephrologist with Scripps Memorial Hospital in La Jolla , Calif.

"One of the major problems with dialysis done in the traditional sense is that it tries to provide a lot of therapy in a short period of time, and it's difficult to clear toxins and fluid in that time," Steer told HealthDay . "Nocturnal dialysis provides a greater amount of toxin removal over a long period of time."

When functioning normally, the kidneys filter about 200 quarts of fluid daily, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Filtering produces about two quarts of waste and some excess water each day. But if the kidneys are not working properly, they don't filter the fluid, causing a build-up of waste that makes the person sick.

Dialysis machines attempt to artificially do the work of the kidneys. At a dialysis center, a person is hooked up to a dialysis machine for about three and a half hours, three times a week, usually during the day.

But at-home dialysis has become an option for some people. Training takes between three to eight weeks, according to the institute. The dialysis clinic provides a machine for at-home use, and dialysis solution and other supplies are delivered to the home.

"The machines are much smaller, and all you have to do is plop a cartridge in," Provenzano said. "It's much less complicated than it used to be."

The risks of at-home dialysis are the same as the risks for in-center dialysis and include low blood pressure, infection and air embolism, according to the institute.

But the benefits of at-home dialysis exceed those of in-center dialysis, its proponents say. People can set their own schedules, performing dialysis when it's convenient for them, and they can give themselves dialysis for much longer time periods, more closely mimicking the natural work of the kidneys.

"This is available. It's something patients can do themselves that improves the amount of delivered dialysis, and patients do fantastic on it," Provenzano noted.

On the Web

To learn more about at-home dialysis, visit the National Kidney Foundation.

SOURCES: HealthDay News ; Robert Provenzano, M.D., chairman, Department of Nephrology, St. John Hospital, Detroit; Dylan Steer, M.D., nephrologist, Scripps Memorial Hospital, La Jolla, Calif.; Sept. 19, 2007, Journal of the American Medical Association ; National Institute of Diabetes and Digestive and Kidney Diseases (www.kidney.niddk.nih.gov)
Author: Serena Gordon
Publication Date: Oct. 31, 2008
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