Overnight HD Could Improve Outcomes

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Patients undergoing hemodialysis overnight for eight hours thrice weekly had a reduced death risk.

PHILADELPHIA—Hemodialysis (HD) patients who undergo dialysis for eight hours overnight three times a week may reduce their death risk by nearly 80% compared with conventional four-hour HD three times a week, data suggest.

In a study led by Ercan Ok, MD, professor of medicine and nephrology at Ege University in Izmir, Turkey, investigators switched 224 patients receiving conventional HD to a regimen in which they spent three nights at a dialysis center receiving eight hours of continuous HD. The patients remained on this regimen for about one year and adjusted well to it, Dr. Ok said. “After an adaptation period of a month, all patients slept during the night without any complaint,” he said.

He and his colleagues observed that overnight dialysis was associated with improvements in various outcomes. “The hospitalization rate during follow-up was one-fourth that observed in patients treated with four-hour conventional hemodialysis,” Dr. Ok said.  “Most importantly, our results confirm that longer dialysis produces significantly better patient outcomes, with a 78% reduction in mortality rate.”

Patients receiving overnight HD had better BP control, leading to a two-thirds reduction in BP medication use, Dr. Ok reported. Phosphate levels decreased toward the normal range despite a 72% reduction in phosphate binder use. In addition, patients had a lower risk of hypotension during dialysis. All these outcomes either did not change or deteriorated in patients on conventional HD.
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