Blog entry by Meguid El Nahas
Nocturnal Dialysis May Provide Cardiovascular Benefits over Conventional Hemodialysis
Conversion from conventional hemodialysis (CHD) to in-center nocturnal hemodialysis (INHD) was associated with a 14.2 g reduction in left ventricular mass after 1 year as compared with continuation on CHD. Investigators also observed a trend toward larger reductions in systolic blood pressure (9.8 mm Hg) among INHD patients with fewer antihypertensive medications prescribed over time. Serum phosphate concentration declined by 0.40 mmol/L among INHD recipients, but there were no differences in patients’ requirements for phosphate binders. The Canadian Journal of Cardiology study included 67 prevalent CHD (4 hours/session, 3 times/week) recipients, of whom 37 converted to INHD (7–8 hours/session, 3 times/week).
Why go on about NOCTURNAL HD, versus daytime HD, and its benefits when all there is has been known since the 70s and 80s...LONGER HD is benefical...it improves ultrafiltration volume, improves BP control by reducing intravascular volume and ultimately reduces LVH (LVMI)...
This was also observed with FREQUENT HD (FHN Study) where all the benefits could be ascribed to LONGER dialysis time, with better UF, BP and LVMI...
IT IS HIGH TIME THOSE WHO PUBLISH THESE PAPERS STOP TRYING TO FOOL PUBLISHERS AND READERS...NEPHROLOGISTS BEWARE; TIME IS GOLDEN!