Long nocturnal dialysis: A single-centre experience
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692014000400004 |
Resumo: | The institution of intensified dialysis regimens (as long treatment time, with reduced ultrafiltration per hour) has been associated with decreased morbidity and mortality in patients with end-stage chronic kidney disease. The performance of the haemodialysis session during the night interval emerged as logical, since it is an idle period, and has been associated with better small molecule dialysis, better blood pressure control, reduced medication requirements and improved quality of life. Recently, our centre initiated a long nocturnal dialysis programme and a prospective observational analysis was designed to evaluate the results of this approach. Mean values of clinical and laboratory variables were compared in 2 consecutive semesters: prior and after transition from haemodiafiltration to long nocturnal dialysis. After 6 months of switching, there was an increase in dialysis efficiency (reduction in pre-dialysis urea (129.74 ± 28.7 vs. 114.53 ± 23.94 mg/dl, p = 0.01) and an increase in Kt/V (1.75 ± 0.37 vs. 2.09 ± 0.39, p = 0.005)), improved hyperphosphatemia control (5.05 ± 0.9 vs. 4.23 ± 0.93 mg/dl; p = 0.01) and anaemia control, with a significant reduction in the use of darbepoetin alfa (38.5 ± 24.18 vs. 30.83 ± 22.54 μg/week; p = 0.04) and of intravenous iron (189.33 ± 117 vs. 116 ± 67 mg/month; p = 0.04) and a much better correction of overhydration (evaluated by the BCM-Body composition monitor: 10.2% ± 8.63 vs. 4.6% ± 7.2; p = 0.01), reflecting the patients overall better nutritional status. These excellent results were amplified by the patients perception of improvement in their quality of life. Our findings are consistent with the studies that favour long nocturnal dialysis over conventional regimens, but randomized controlled trials are needed to validate these findings. |
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Long nocturnal dialysis: A single-centre experienceAnaemiablood pressuremineral and bone diseasenocturnal dialysisoutcomequality of lifeThe institution of intensified dialysis regimens (as long treatment time, with reduced ultrafiltration per hour) has been associated with decreased morbidity and mortality in patients with end-stage chronic kidney disease. The performance of the haemodialysis session during the night interval emerged as logical, since it is an idle period, and has been associated with better small molecule dialysis, better blood pressure control, reduced medication requirements and improved quality of life. Recently, our centre initiated a long nocturnal dialysis programme and a prospective observational analysis was designed to evaluate the results of this approach. Mean values of clinical and laboratory variables were compared in 2 consecutive semesters: prior and after transition from haemodiafiltration to long nocturnal dialysis. After 6 months of switching, there was an increase in dialysis efficiency (reduction in pre-dialysis urea (129.74 ± 28.7 vs. 114.53 ± 23.94 mg/dl, p = 0.01) and an increase in Kt/V (1.75 ± 0.37 vs. 2.09 ± 0.39, p = 0.005)), improved hyperphosphatemia control (5.05 ± 0.9 vs. 4.23 ± 0.93 mg/dl; p = 0.01) and anaemia control, with a significant reduction in the use of darbepoetin alfa (38.5 ± 24.18 vs. 30.83 ± 22.54 μg/week; p = 0.04) and of intravenous iron (189.33 ± 117 vs. 116 ± 67 mg/month; p = 0.04) and a much better correction of overhydration (evaluated by the BCM-Body composition monitor: 10.2% ± 8.63 vs. 4.6% ± 7.2; p = 0.01), reflecting the patients overall better nutritional status. These excellent results were amplified by the patients perception of improvement in their quality of life. Our findings are consistent with the studies that favour long nocturnal dialysis over conventional regimens, but randomized controlled trials are needed to validate these findings.Sociedade Portuguesa de Nefrologia2014-12-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692014000400004Portuguese Journal of Nephrology & Hypertension v.28 n.4 2014reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692014000400004Navarro,DavidFerreira,Ana CarinaGonçalves,CarinaJorge,CristinaGil,CéliaAires,InêsMatias,PatríciaMendes,MarcoAzevedo,AnaGomes,FernandaFerreira,Aníbalinfo:eu-repo/semantics/openAccess2024-02-06T17:04:46Zoai:scielo:S0872-01692014000400004Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:18:53.285768Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Long nocturnal dialysis: A single-centre experience |
title |
Long nocturnal dialysis: A single-centre experience |
spellingShingle |
Long nocturnal dialysis: A single-centre experience Navarro,David Anaemia blood pressure mineral and bone disease nocturnal dialysis outcome quality of life |
title_short |
Long nocturnal dialysis: A single-centre experience |
title_full |
Long nocturnal dialysis: A single-centre experience |
title_fullStr |
Long nocturnal dialysis: A single-centre experience |
title_full_unstemmed |
Long nocturnal dialysis: A single-centre experience |
title_sort |
Long nocturnal dialysis: A single-centre experience |
author |
Navarro,David |
author_facet |
Navarro,David Ferreira,Ana Carina Gonçalves,Carina Jorge,Cristina Gil,Célia Aires,Inês Matias,Patrícia Mendes,Marco Azevedo,Ana Gomes,Fernanda Ferreira,Aníbal |
author_role |
author |
author2 |
Ferreira,Ana Carina Gonçalves,Carina Jorge,Cristina Gil,Célia Aires,Inês Matias,Patrícia Mendes,Marco Azevedo,Ana Gomes,Fernanda Ferreira,Aníbal |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Navarro,David Ferreira,Ana Carina Gonçalves,Carina Jorge,Cristina Gil,Célia Aires,Inês Matias,Patrícia Mendes,Marco Azevedo,Ana Gomes,Fernanda Ferreira,Aníbal |
dc.subject.por.fl_str_mv |
Anaemia blood pressure mineral and bone disease nocturnal dialysis outcome quality of life |
topic |
Anaemia blood pressure mineral and bone disease nocturnal dialysis outcome quality of life |
description |
The institution of intensified dialysis regimens (as long treatment time, with reduced ultrafiltration per hour) has been associated with decreased morbidity and mortality in patients with end-stage chronic kidney disease. The performance of the haemodialysis session during the night interval emerged as logical, since it is an idle period, and has been associated with better small molecule dialysis, better blood pressure control, reduced medication requirements and improved quality of life. Recently, our centre initiated a long nocturnal dialysis programme and a prospective observational analysis was designed to evaluate the results of this approach. Mean values of clinical and laboratory variables were compared in 2 consecutive semesters: prior and after transition from haemodiafiltration to long nocturnal dialysis. After 6 months of switching, there was an increase in dialysis efficiency (reduction in pre-dialysis urea (129.74 ± 28.7 vs. 114.53 ± 23.94 mg/dl, p = 0.01) and an increase in Kt/V (1.75 ± 0.37 vs. 2.09 ± 0.39, p = 0.005)), improved hyperphosphatemia control (5.05 ± 0.9 vs. 4.23 ± 0.93 mg/dl; p = 0.01) and anaemia control, with a significant reduction in the use of darbepoetin alfa (38.5 ± 24.18 vs. 30.83 ± 22.54 μg/week; p = 0.04) and of intravenous iron (189.33 ± 117 vs. 116 ± 67 mg/month; p = 0.04) and a much better correction of overhydration (evaluated by the BCM-Body composition monitor: 10.2% ± 8.63 vs. 4.6% ± 7.2; p = 0.01), reflecting the patients overall better nutritional status. These excellent results were amplified by the patients perception of improvement in their quality of life. Our findings are consistent with the studies that favour long nocturnal dialysis over conventional regimens, but randomized controlled trials are needed to validate these findings. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-12-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692014000400004 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692014000400004 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692014000400004 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Nefrologia |
dc.source.none.fl_str_mv |
Portuguese Journal of Nephrology & Hypertension v.28 n.4 2014 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799137279052087296 |