Nocturnal hemodialysis: three-year experience.

There is evidence that high frequency, as well as long duration, hemodialysis provides better clinical outcomes. We developed nocturnal hemodialysis, a new innovative form of renal replacement therapy, which is performed six to seven nights per week for 8 to 10 h during sleep at home. Blood flow was set at 300 ml/min and dialysate flow at 100 ml/min.

Control of serum phosphate without any phosphate binders in patients treated with nocturnal hemodialysis.

We compared the efficacy and the long-term effects of nocturnal hemodialysis (NHD) versus conventional hemodialysis (CHD) in controlling serum phosphate levels in patients with end-stage renal disease (ESRD). Patients underwent thrice weekly CHD and were subsequently switched to NHD six nights weekly. In the "acute" study serum and dialysate phosphate were measured during and after dialysis, and the total dialysate was collected to calculate mass solute removal.

Slow nocturnal home hemodialysis at the Wellesley Hospital.

To alleviate the overcrowding of in-center hemodialysis (HD) facilities, we have developed slow nocturnal home hemodialysis (SNHHD), an innovative form of renal replacement therapy. SNHHD is performed 5 to 7 nights/week for 8 hours, during sleep, with a blood flow of 300 mL/min and a dialysate flow of 100 mL/min. The vascular access is by means of the Uldall-Cook catheter, which allows for easy patient access with low infection rates.

Percutaneously inserted silastic jugular hemodialysis catheters seldom cause jugular vein thrombosis.

To find out whether internal jugular vein cannulation with a soft silastic hemodialysis access catheter causes jugular vein thrombosis, the authors carried out Doppler ultrasound examinations on 96 patients receiving hemodialysis who had undergone 144 separate catheter insertion episodes in 116 veins. Two internal jugular vein thromboses were found in 101 veins that had been the site of percutaneous insertions only. In addition, 5 internal jugular vein thromboses were identified in 15 veins that had been cannulated surgically with the Quinton PermCath.