Overnight Dialysis Could Prove Beneficial for Kidney Failure

Kidney failure, without treatment or transplant, is fatal. Dialysis (also called hemodialysis) is one measure used to treat failed kidneys and can be performed on an inpatient or outpatient basis. This treatment, which extracts waste products produced in the blood, such as urea and potassium, is the most common means of the removal of fluid intervention for patients with kidney failure.

According to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, most patients that undergo dialysis usually do so on a three times a week schedule for approximately 3 to 5 hours per treatment, however new evidence shows that by doing dialysis for eight hours overnight, three times per week, reduces the risk of death for patients that suffer from kidney problems by nearly 80 percent.

Dr. Ercan Ok, lead researcher from the department of nephrology at Ege University in Izmir, Turkey, believes that study results show that “alternative, more frequent and/or longer hemodialysis regimens seem promising.” For this new study, Ok and his team tracked approximately 224 Turkish dialysis patients that were the average age of 45. These patients were switched from conventional dialysis to a routine of three nights weekly, for 8 hour sessions at a dialysis center. The researchers noted that the patients generally experienced an “adaption period” that was a month long, after which they were able to get some sleep during their treatments.

After just one year, the researchers then compared the overnight group with a similar pool of patients that maintained the regular regimen for four hours of treatment weekly. The overnight patients experienced approximately a 78 percent drop in mortality compared to the patients using standard dialysis treatment. This group also experienced marked improvements in their blood pressure control, which translated into a two-thirds drop in the use of medications for blood pressure, and their levels of mineral phosphate declined to normal levels among the overnight patients, which led to a 72 percent decline in the use of the drugs to help lower phosphate absorption.

The overnight group also reported an increase in their appetite, a desirable weight gain, and a boost in their blood protein levels. Many of the patients returned to work and reported that they improved job performance and had better metal functioning.

However, Dr. Robert Provenzano the chairman of the department of nephrology at St. John’s Hospital and Medical Center in Detroit, stated that while this study “has merit, it needs to be validated.” What we do know that is proven fact is that longer dialysis treatments are better. That should be intuitive, since our kidneys do function seven days a weeks, 24 hours per day. Also,  looking at the data from the U.S. and Europe, more frequent dialysis has already shown improvements across the board in blood pressure, cardiovascular status, a better sense of well-being, anemia, and less patients in the hospitals.

However, the problem in this study is that the patients were self-selected, so this was not a randomized controlled study. In developing countries such as India, Turkey, and China, patients who have received this kind of procedure tend to be much healthier and wealthier than most. It is not known how this fact impacts the study’s results. This is why we need, now, to do more randomized research, concluded Provenzano.