dialysis at night

[Guest guest]

Dear all,

It has been a long time since I had any time at all to read and write

any messages I'm affraid :-(. You know, busy family life and a

demanding job, but I thought the following might be interesting for

those of you who are on dialysis.

Today I read about an experiment in a hospital in my home town in the

Netherlands. They are letting patients that need dialysis sleep over

at the hospital 4 nights a week so they can get a " slow " dialysis of

8 hours instead of the usual three times a week " quick " dialysis of 4

hours during the day.

The doctors expect that this will be better for dialysis patients in

respect to amount of medication needed, amount of fluid patients may

drink and in general a better condition of the patients involved.

Furthermore they see as a benefit that patients will be able to have

a more " normal " life during the day and even may be able to work.

The experiment will run with about 6 to 8 patients during the coming

6 months.

Does anyone in this group ever hear about dialysis during the night?

Has it been done in other parts of the world and does anyone know

what the experiences with " night dialysis " are?

I'm (luckely) far away from dialysis myself, but I think the above

might be interesting for those of you who are.

Doortje

[Guest guest]

Our clinic has nocturnal dialysis. The dialysis treatment itself is

more efficent and does allow the patient slightly more freedom. But,

as dialysis is hard on the body to begin with dialyzing for eight

hours has it's set backs. Many of our patients are working during

the day and were unable to change their schedules to accomidate

dialysis and work. Like Pierre has said many times, it works for

some but not for all. - Shara

> Dear all,

>

> It has been a long time since I had any time at all to read and

write

> any messages I'm affraid :-(. You know, busy family life and a

> demanding job, but I thought the following might be interesting

for

> those of you who are on dialysis.

>

> Today I read about an experiment in a hospital in my home town in

the

> Netherlands. They are letting patients that need dialysis sleep

over

> at the hospital 4 nights a week so they can get a " slow " dialysis

of

> 8 hours instead of the usual three times a week " quick " dialysis

of 4

> hours during the day.

> The doctors expect that this will be better for dialysis patients

in

> respect to amount of medication needed, amount of fluid patients

may

> drink and in general a better condition of the patients involved.

> Furthermore they see as a benefit that patients will be able to

have

> a more " normal " life during the day and even may be able to work.

> The experiment will run with about 6 to 8 patients during the

coming

> 6 months.

> Does anyone in this group ever hear about dialysis during the

night?

> Has it been done in other parts of the world and does anyone know

> what the experiences with " night dialysis " are?

> I'm (luckely) far away from dialysis myself, but I think the above

> might be interesting for those of you who are.

>

> Doortje

[Guest guest]

The people who do their own hemodialysis at home, at night or otherwise,

generally use what is called the " buttonhole " technique for putting the

needles in. This means that they use exactly the same hole, at exactly the

same angle each time. I know some people who have done it, and I'm told it's

actually fairly easy to do. In a dialysis centre, they don't use that

technique, simply because it would be impossible for a nurse or dialysis

tech to know your needle site as well as you do. So, they use more of a

" ladder " technique - ie. a slightly different location each time, going up

and down in a ladder-like fashion, which lets the previous hole heal more

completely. With the buttonhole technique, you have to insert the needle at

the same angle every time, so only the patient him/herself can really do

that.

Some patients I know even needle themselves at the dialysis unit. Me, I have

no interest in doing that whatsoever. That's what nurses are for

Pierre

Re: dialysis at night

> Hi Doortje,

>

> Good to hear from you! I just went to my first renal care team visit this

> Monday to learn about the types of dialysis and they mentioned nocturnal

> dialysis as an option. I have piles of reading to do, so I can't say for

sure how

> beneficial it is, but I do think that the longer dialysis may be easier on

the

> body.

>

> They also mentioned a home hemodialysis where you have dialysis overnight

> that may keep you more even than having hemodialysis 3 days a week. For

me, I am

> leaning towards hemodialysis, but I am not sure if I will look to the home

> hemo. I can give myself epo shots, but I don't know about sticking needles

into

> the fistula. I guess I will cross that bridge when I get there.

>

> Take care and thanks for letting us know about this.

>

>

>

[Guest guest]

Hi

What I've found is that people tend to become evangilists for whatever

method of dialysis they chose. I like not having to think about dialysis on

the in between days, and I also love the " long weekend " I get every weekend

(since dialysis is 3 times per week, there's an extra day off on weekends).

With PD, it's every single day, without any breaks. I also really didn't

want to have a catheter in my abdomen. With my own nephrologist thinking

hemodialysis would be better for my particular case due to digestive

problems, that's how the decision was made. But, to be honest, it was still

up in the air until the appointment with my neph when she decided it was

time to order the access. It had to be either a fistula or a PD cath, and I

had to decide by that time. My wife was with me at that particular

appointment, and she was leaning towards hemo as well.

Some people who are on the small side do very well with PD though, so, I

really would not try to influence anyone either way. It's just too personal

a decision. But as I've said before, it's not cast in stone. You can always

change later. Knowing that, it's really not a choice I agonized over.

Another thing for me, which I didn't really think of before, is that I often

look at a going to dialysis as a welcome break. It's one time I don't have

to feel guilty about just sitting there vegetating in front of the TV

watching whatever is on (it does help that they have cable too. :-)

I see and talk to the other patients who are either going in at the same

time or coming out, I talk to the nurses etc. Just doing it at home every

day would seem like a lonely thing to me, at this point.

The only change I would jump at if and when the opportunity came along would

be to try the new hemofiltration machines. I think that has more promise for

esrd patients than anything else like tinkering with treatment times,

night-time dialysis, etc.

Pierre

Re: dialysis at night

> Thanks for your feedback Pierre. That is exactly how I am leaning.

Having 4

> days off every week sounds pretty good to me.

>

> I hope the move is going ok for you and that you are not tiring yourself

out

> too much.

>

>

>