Outcomes Associated with In-Center Nocturnal Hemodialysis from a Large Multicenter Program
Eduardo Lacson,Weiling Wang,Keith Lester,Norma J. Ofsthun,J. Michael Lazarus,Raymond M. Hakim +5 more
TLDR
Patients who were on INHD exhibited excellent quality indicators, with better survival and lower hospitalization rates, and the relative contributions of patient selection versus effect of therapy on outcomes remain to be elucidated in prospective clinical trials.Abstract:
Background and objectives: The objective of this study was to evaluate epidemiology and outcomes of a large in-center nocturnal hemodialysis (INHD) program.
Design, setting, participants, & measurements: This case-control study compared patients who were on thrice-weekly INHD from 56 Fresenius Medical Care, North America facilities with conventional hemodialysis patients from 244 facilities within the surrounding geographic area. All INHD cases and conventional hemodialysis control subjects who were active as of January 1, 2007, were followed until December 31, 2007, for evaluation of mortality and hospitalization.
Results: As of January 1, 2007, 655 patients had been on INHD for 51 ± 73 d. Patients were younger, there were more male and black patients, and vintage was longer, but they had less diabetes compared with 15,334 control subjects. Unadjusted hazard ratio was 0.59 for mortality and 0.76 for hospitalization. After adjustment for case mix and access type, only hospitalization remained significant. Fewer INHD patients were hospitalized (48 versus 59%) with a normalized rate of 9.6 versus 13.5 hospital days per patient-year. INHD patients had greater interdialytic weight gains but lower BP. At baseline, hemoglobin values were similar, whereas albumin and phosphorus values favored INHD. Mean equilibrated Kt/V was higher in INHD patients related to longer treatment time, despite lower blood and dialysate flow rates.
Conclusions: Patients who were on INHD exhibited excellent quality indicators, with better survival and lower hospitalization rates. The relative contributions of patient selection versus effect of therapy on outcomes remain to be elucidated in prospective clinical trials.read more
Citations
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Effects of in-center nocturnal versus conventional hemodialysis on endothelial dysfunction.
TL;DR: Compared with CHD, in‐center nocturnal hemodialysis improves endothelial function, and control of serum phosphorus is associated with the improvement of endothelialfunction.
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Meeting the 2012 QIP (Quality Incentive Program) clinical measures: strategies for dialysis centers.
Steven Fishbane,Azzour Hazzan +1 more
TL;DR: An overview of the 3 clinical measures and the QIP scoring methodology is provided, as well as a description of patient claims that are excluded when the scores for these measures are calculated.
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Nutritional Status in Nocturnal Hemodialysis Patients – A Systematic Review with Meta-Analysis
Karin J. R. Ipema,Simone Struijk,Annet van der Velden,Ralf Westerhuis,Cees P. van der Schans,Cees P. van der Schans,Carlo A. J. M. Gaillard,Wim P. Krijnen,Casper F. M. Franssen +8 more
TL;DR: NHD is associated with significantly higher protein and energy intake as well as increases in serum albumin and nPCR, however, the data on body composition are inconclusive.
Journal ArticleDOI
Eight-Year Experience with Nocturnal, Every-Other-Day, Online Haemodiafiltration.
Francisco Maduell,Raquel Ojeda,Marta Arias-Guillén,Florencia Rossi,Néstor Fontseré,Manel Vera,Nayra Rico,Leonardo Nicolás Gonzalez,Gastón J Piñeiro,Mario Jiménez-Hernández,Lida Rodas,José Luis Bedini +11 more
TL;DR: Nocturnal, every-other-day OL-HDF could be an excellent therapeutic alternative since it is well tolerated and leads to clinical and social-occupational rehabilitation with satisfactory morbidity and mortality.
Journal ArticleDOI
Nocturnal hemodialysis: an underutilized modality?
James O. Burton,James O. Burton,James O. Burton,Matthew P M Graham-Brown,Matthew P M Graham-Brown,Matthew P M Graham-Brown +5 more
TL;DR: Nocturnal haemodialysis is an underutilized way of offering extended-hours dialysis to patients in both the home and in-centre environments, and clinicians and dialysis providers are becoming increasingly obliged to investigate implementation strategies for nocturnal dialysis services to improve patient outcomes and experience of care.
References
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Istvan Mucsi,Gavril Hercz,Robert Uldall,Michaelene Ouwendyk,Robert Francoeur,Andreas Pierratos +5 more
TL;DR: NHD is more effective in controlling serum phosphate levels than CHD, allowing patients to discontinue their phosphate binders completely and to ingest a more liberal diet.
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The Intensity of Hemodialysis and the Response to Erythropoietin in Patients with End-Stage Renal Disease
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Rita S. Suri,Amit X. Garg,Glenn M. Chertow,Nathan W. Levin,Michael V. Rocco,Tom Greene,Gerald J. Beck,Jennifer J. Gassman,Paul W. Eggers,Robert A. Star,Daniel B. Ornt,Alan S Kliger +11 more
TL;DR: The Frequent Hemodialysis Network Trials Group is conducting two multicenter randomized trials of 250 subjects each, comparing conventional three times weekly HD with (1) in-center daily HD and (2) home nocturnal HD, during which feasibility of randomization, ability to deliver the interventions, and adherence will be evaluated.
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