Overnight Dialysis

Dialysis can take a grueling toll on patients with poor kidney function. In a traditional clinic setting, the treatment generally takes upwards of 12 hours a week to complete, meaning that patients spend valuable time waiting for waste and extra water to be filtered from their blood.

Researchers are excited about overnight dialysis, which not only saves patients time but also decreases their risk of heart disease. Nocturnal home hemodialysis (NHD) could become the preferred treatment for patients, rather than conventional intermittent hemodialysis (IHD), according to a new study published in the Canadian Journal of Cardiology and presented at the Canadian Cardiovascular Congress.

What’s the Difference?

The benefits of NHD have long piqued the interest of medical researchers hoping to improve comfort and quality of life for patients who require dialysis. Traditional dialysis generally takes three sessions a week of three to four hours each, but when done at home while the patient is asleep, more dialysis sessions can take place for longer periods of time. It’s a surprisingly straightforward concept with the potential to change the nature of dialysis treatment as patients know it.

"Patients with end-stage renal disease have at least a five-fold increase in cardiovascular complications," said Dr. Christopher Overgaard, one of the study's authors and a cardiologist at Toronto General Hospital, in a press release. "Longer dialysis, done while patients are sleeping, may improve the health of arteries and could lower the risk of developing heart disease."

While they sleep, patients are clearing their systems of more waste in a less disruptive manner than they would be by going to a clinic several times a week.

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What Does This Mean for You?

The study authors examined 17 patients using diagnostic coronary angiography, which is a procedure that uses dye in combination with X-rays to see how blood is moving through a person's arteries. The study included five people in the control group who did not have end-stage renal disease (ESRD). Researchers measured changes in the diameter of the patients' blood vessels using angiography.

The scientists found that coronary endothelial responsiveness—or how well the layer of cells along the inner lining of blood vessels functions—was partially improved with overnight dialysis. This finding is crucial for patients with impaired endothelial function, which is linked to accelerated atherosclerosis—or the hardening of arteries leading to the heart—in kidney disease patients.

“Greater oxidative stress in IHD patients may contribute to the impaired endothelial responsiveness of this high cardiovascular risk population,” the researchers wrote.

With the knowledge that in-home, overnight dialysis may not only be more comfortable but also more effective than traditional dialysis in terms of coronary artery function, more patients could be turning to this method. 

"This could be revolutionary for kidney patients," said Dr. Beth Abramson, Heart and Stroke Foundation spokesperson, in a press release. "A simple change in the way we deliver care can make a significant difference. In addition to benefits to kidney function and quality of life, it could lower their risk of heart disease." 

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