Pierratos A, Ouwendyk M, Francoeur R, Heiferty M, Wallace L,
Vas S, Uldall R
Experience with prolonged nocturnal hemodialysis
XVIth Annual CAPD Conference
Perit Dial Int Suppl 2
(Feb) 16:S77 1996
Pierratos and colleagues describe their preliminary experience with 5
patients, each treated 7-17 months using a system of 6x/week nocturnal
hemodialysis (8 hours per treatment) developed by Dr. Uldall. Blood flow is
only 100 ml/min, and access is via a Cook intrajugular catheter. The weekly
Kt/V is 7.7 Kt/V units, and weekly phosphate removal averages
5 gm (versus 2.8 with conventional HD). All patients are off phosphate
binders. Blood pressure appears to be better controlled, with little need for
phosphate supplements.
Comment: This therapy probably will not be widely used in the United
States. It is unclear why, with a mean daily fluid gain of 1.9 kg, such a
long, slow treatment is required. It would appear to be more logical to
treat for about 90-120 min/day using a faster blood flow rate. Then the
dialysis could be performed with the patient awake, allowing unencumbered
sleep.
(John T. Daugirdas, M.D., Univ. of
Illinois at Chicago)
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XVIth Annual CAPD Conference
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