DIABETES
June 10, 2009

Nighttime is the Right Time

For kidney patients who need dialysis, the option of undergoing treatment overnight can be an appealing alternative to the standard daytime sessions.

For patients who require frequent dialysis, a new study showing the benefits of undergoing the treatment during the night may offer an appealing alternative to conventional daytime sessions. The study, published in the Clinical Journal of the American Society of Nephrology was carried out by researchers at the Western Infirmary, in the UK.

Many kidney patients require as many as three dialysis treatments per week, ranging from three to five hours each - but for some, even this schedule isn't sufficient to keep healthy. Joanna Ruth Powell and her team set out to determine how the longer nighttime treatments that are offered by some clinics measure up to the conventional daytime schedule.

Patients who underwent the nighttime treatment had fewer incidents of anemia (low red blood cell count) and lower levels of urea in their blood.

The overnight schedules consisted of three nights of six-hour sessions. Of the study's participants, about 11% (146 individuals) opted for nighttime treatment. Once data was collected, the team analyzed several health measures from 52 participants from the nighttime treatment group and 52 patients from the daytime group.

Patients who underwent the nighttime treatment had fewer incidents of anemia (low red blood cell count) and lower levels of urea in their blood. Decreasing urea content is one of the main purposes of dialysis. The patients in this group also tended to require fewer phosphate-binding tablets, which indicates that the blood was being better filtered during the nighttime treatment sessions. On other measures there were no differences between the two groups (e.g., blood pressure and need for hypertensive medications and blood phosphate levels were comparable in both groups).

About a third of the patients originally in the nighttime treatment group switched back to conventional daytime treatment after more than two years; but this was mostly due to personal preference rather than medical need.

The authors conclude that overnight treatments offer a nice alternative to conventional treatment, and may provide several significant health benefits to the patient in the process.

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