Overnight Home Hemodialysis: Eight Patients and Six Years of Experience in Sakairumi Clinics

Abstract

We started our home hemodialysis (HHD) program in July 2005 and have been promoting overnight HHD. As more than 6 years have passed since we started our HHD program, we review our HHD program and 8 overnight HHD patients (5 males and 3 females). Their underlying disease differs in each and none have diabetic nephropathy. Their average age was 49.2 ± 6.0 years (mean ± SD). Average duration of dialysis treatment, HHD, and overnight HHD was 9.4 ± 4.4, 3.5 ± 2.4, and 2.2 ± 1.7 years, respectively. Average treatment time per dialysis session was 6.9 ± 0.8 h/treatment, average treatment days weekly was 4.5 ± 0.8 days/week, and average treatment time weekly was 31.2 ± 7.0 h/week. Laboratory data were good and their blood pressure was well controlled without any antihypertensive drugs excluding a patient who was recently introduced to dialysis with some residual kidney function. Severe problems did not occur in these 6 years except for blood access infection twice, slipping out of a needle during dialysis with small blood loss once, and a drop in blood pressure at the end of dialysis once, which was recovered by her assistant's help. According to our HHD training program, the average training duration for HHD was 106 ± 42 days. The shortest was 60 days and longest 198 days. These differences among training durations might be because of the frequency of training and having a better hand of puncturing. We did not instruct any additional issues and points for overnight HHD, because performing overnight HHD is similar to standard HHD. Some patients moved to overnight HHD slowly starting with once weekly and the others started overnight HHD several days after they had started HHD.