Nursing issues related to patient selection, vascular access, and education in quotidian hemodialysis.

Background: Increased interest in quotidian hemodialysis (HD) programs requires that nephrology nurses have a larger role in transitioning patients to more frequent HD. Nursing issues include the selection, training, and education of patients before they begin more frequent HD therapy.

Methods: The London Daily/Nocturnal Hemodialysis Study directly compared data from patients undergoing either short daily HD (n = 11) or long nocturnal HD (n = 12) with those undergoing conventional thrice-weekly HD (n = 22).

Delayed Dialyzer Reprocessing for Home Hemodialysis.

Although dialyzer reuse for home hemodialysis (done by patients at home) has been in practice since the 1960s, it is now almost completely abandoned. The need for dialyzer reuse resurfaced with the renewed interest in daily/nightly forms of home hemodialysis and the associated increase in operating costs. We describe a method of dialyzer reuse based on reprocessing of dialyzers at the center, after they had been stored in a refrigerator at home for 1 week by the patient.

Experience With Nocturnal Hemodialysis.

In order to provide a highly efficient, long-duration form of hemodialysis, we developed nocturnal hemodialysis. Patients were dialyzed nightly at home for 8 - 10 hours, 6 - 7 nights/week. We kept the dialysate flow at 100 mL/min and the blood flow at 250 - 300 mL/min.