Despite advances in dialysis and medical therapies, patients with end-stage renal disease (ESRD) have annual rates of death that exceed 15 percent. Cardiovascular disease, specifically heart failure or sudden death, is responsible for the majority of deaths. Some recent studies have suggested that nocturnal haemodialysis might improve clinical outcomes in ESRD patients.
Bruce F. Culleton, M.D., M.Sc., formerly of the University of Calgary, Alberta, Canada, and colleagues conducted a study to determine the effects of frequent nocturnal haemodialysis compared with conventional haemodialysis on certain outcomes, including left ventricular (LV) mass, health-related quality of life (HRQOL), blood pressure and mineral metabolism.
The randomized controlled trial was conducted at two Canadian university centers between August 2004 and December 2006. A total of 52 patients undergoing haemodialysis were recruited. Participants were randomly assigned to receive nocturnal haemodialysis six times weekly or conventional haemodialysis three times weekly.
“Our findings indicate that frequent nocturnal haemodialysis improves LV mass, systemic blood pressure, abnormalities of mineral metabolism, and possibly HRQOL compared with conventional thrice-weekly haemodialysis,” the authors of the study write.
LV mass decreased by an average of 13.8 grams in the nocturnal haemodialysis group and increased by 1.5 grams in the conventional haemodialysis group. Frequent nocturnal haemodialysis was associated with a reduction in or discontinuation of antihypertensive medications (16/26 patients in the nocturnal haemodialysis group vs. 3/25 patients in the conventional haemodialysis group). No benefit in anaemia management was seen with nocturnal haemodialysis.
MEDICA.de; Source: JAMA