Overnight hemodialysis dramatically improves patients’ survival

November 8th, 2008 - 4:03 pm ICT by IANS  

Washington, Nov 8 (IANS) Undergoing dialysis eight hours overnight, three times weekly, reduces the risk of death by nearly 80 percent, compared to conventional, four-hour dialysis as many times, according to a study. In a study led by Ercan Ok, Ege University in Izmir, Turkey, 224 dialysis patients were switched to overnight dialysis. The patients spent three nights a week at the dialysis centre where they underwent eight hours of continuous hemodialysis.

Most patients in the overnight hemodialysis group mentioned an increase in appetite. They gained weight, and their serum protein (albumin) levels increased. Many patients were able to return to work, reporting improved job performance and better mental (cognitive) functioning.

Previous studies of overnight, thrice-weekly hemodialysis have shown impressive results, with 10-year survival rates as high as 75 percent.

The new trial is the first prospective, controlled study to compare the results of eight-hour versus four-hour hemodialysis, performed at the dialysis centre.

The patients adjusted well to overnight hemodialysis. “After an adaptation period of a month, all patients slept during the night without any complaint,” says Ok.

The patients remained on overnight hemodialysis for about one year. Their outcomes were compared with those of a similar group of patients who continued on conventional dialysis: four hours, three days per week.

Overnight dialysis led to improvements in a wide range of outcomes. “The hospitalisation rate during follow-up was a fourth of that observed in patients treated with four-hour conventional hemodialysis,” informed Ok.

“Most importantly, our results confirmed that longer dialysis produces significantly better patient outcomes, with a 78 percent reduction in mortality rate,” he added.

Patients receiving overnight hemodialysis had better blood pressure control, leading to a two-thirds reduction in blood pressure medications. They were also at lower risk of blood pressure drops during dialysis, a common problem with conventional hemodialysis.

Levels of the mineral phosphate decreased toward normal, despite a 72 percent reduction in medications used to lessen phosphate absorption.

The need for other medications decreased as well. All of these outcomes either did not change or deteriorated in patients on four-hour conventional dialysis, said a release of American Society Nephrology.

The study was supported by a grant from the European Nephrology Dialysis Institution. This research is being presented at the American Society of Nephrology’s 41st Annual Meeting and Scientific Exposition in Philadelphia, Pennsylvania.

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