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All About In-Center Nocturnal Dialysis

In decades past, it was standard for patients with kidney failure to receive hemodialysis for up to eight hours a treatment. As technology improved and more people needed to receive dialysis treatment to replace renal function, hemodialysis times were shortened to the current four-hour sessions, three times a week. Recently, DaVita has added a nocturnal shift to some of their dialysis centers across the U.S. The nocturnal shift begins at night and patients are treated for a longer period of time, usually six to eight hours while they sleep. DaVita nocturnal shift health care team has noticed that in-center nocturnal dialysis patients are benefiting from the extended dialysis treatments.

In addition to feeling better, people who choose the longer, gentler nocturnal dialysis treatments are also generally reporting a better quality of life. This is partly attributed to the schedule of receiving dialysis overnight while patients sleep. By turning nonproductive sleeping hours into hemodialysis treatment time, patients can receive the longer treatment in their dialysis centers during the night and wake up to have their entire day free to work, attend school, take care of family members or anything else they choose to do.

How is in-center nocturnal dialysis different?

In-center nocturnal dialysis is performed overnight while the patient sleeps. The hemodialysis treatment time for nocturnal dialysis is usually six to eight hours as opposed to the typical four-hour sessions that people do for traditional daytime dialysis. Because the hemodialysis treatment time is extended over more time, the dialysis machine settings are more relaxed providing a slower, gentler treatment. Fluid is being pulled out of the body at a slower pace, so patients are less likely to experience cramping during treatment. Blood is cleaned for a longer period of time so more toxins are being removed throughout the night. With traditional daytime hemodialysis, a patient generally receives about 12 hours of hemodialysis a week, while the typical in-center nocturnal dialysis patient will have about 24 hours of treatment.

There are also many similarities between in-center nocturnal dialysis and traditional daytime hemodialysis. Patients will still go to a dialysis center to be treated by health care professionals. The doctor will prescribe the treatment time, dialyzer size and dialysis machine settings, along with managing the patient’s treatment. A renal dietitian will be available to review lab results, give diet advice and answer patient’s questions about the renal diet. A dialysis social worker will also be available to answer insurance questions and help with lifestyle issues.

What are the lifestyle benefits of in-center nocturnal dialysis?

Free time during the day

Having days free to take care of children and family, go to work, attend school and participate in other daytime activities is the lifestyle benefit patients generally enjoy most. In many cases people choose in-center nocturnal dialysis so they can keep their job or take care of small children.

Improved lifestyle

By receiving their lifesaving treatment at night while sleeping, patients can wake up to a “normal” day and will not have to fit dialysis into their daytime schedule. Typically, patients leave dialysis before morning traffic and are able to get to work on time, take children to school, schedule lunches with friends, walk the dog, wash and wax the car and countless other activities that are best done during the day. Patients have reported that the nocturnal schedule makes them feel that no one has to know they are on dialysis because they have a more “normal” lifestyle — they have days free and are able to use sleeping time as dialysis time.

Feel better to do more

While having more energy can be a clinical benefit, most patients see it as an improvement to their lifestyle. Patients on in-center nocturnal dialysis generally say they feel better than they did on traditional hemodialysis. One of the benefits is that they don’t have the “washed out” feeling some people experience during the traditional treatments. Nocturnal patients say they wake up and are ready to start the day, whereas before they may have had to go home and take a nap after daytime dialysis.

Enjoy the taste of food again

Patients usually find their life is happier because foods taste good again. In addition to having a better appetite, patients are delighted that they can distinguish flavors and enjoy them as they did before getting kidney disease.

More positive attitude

In-center nocturnal dialysis patients who were formerly on traditional daytime dialysis report an overall happier feeling about their lives after making the switch. Benefits including: experiencing more freedom during the day, being able to perform daily tasks without fitting dialysis into their schedule and feeling better have contributed to a more positive outlook about life and treatment for in-center nocturnal dialysis patients.

What are the clinical benefits of in-center nocturnal dialysis?

In-center nocturnal dialysis allows patients to dialyze for a longer period of time than traditional daytime hemodialysis. Research has shown that this can lead to better clinical results.

Clinical benefits of in-center nocturnal dialysis include:

  • Improved appetite and taste
  • Better albumin levels
  • More energy
  • Better phosphorus and potassium control
  • Better blood pressure control
  • Reduction in prescribed medicines
  • Fewer reports of cramping during treatment
  • Fewer reports of feeling “washed out”

Longer treatment times help clean blood more thoroughly removing more toxins and fluid. This can allow people on hemodialysis to enjoy the flavor of foods more and increase appetite, which helps raise albumin levels. Cleaner blood can also reduce the effects of anemia, so people experience more energy. People who receive in-center nocturnal dialysis report that their lab results for phosphorus and potassium in range and easier to maintain than with traditional daytime dialysis.

The longer, gentler treatment has been reported to be easier on patients’ bodies. Studies have shown better blood pressure control and reduced doses of blood pressure medicines have been attributed to the longer treatment times.

The slower removal of fluid also reduces the probability of cramping during treatment and feeling washed out after treatment.

Who can do in-center nocturnal dialysis?

People on hemodialysis who are considering the in-center nocturnal dialysis program should be in stable condition and follow the advice of their doctor and other health care professionals. Reliable transportation is necessary. In-center nocturnal dialysis patients should also be courteous to the other patients sleeping around them.

Why choose DaVita’s In-Center Nocturnal Dialysis Program?

DaVita is a leading provider of dialysis services in the U.S. and employs a team of highly-trained health care professionals who care about their patients’ health and well-being. In addition, DaVita provides education and support for people with chronic kidney disease as well as those on dialysis. By offering the In-Center Nocturnal Dialysis Program, DaVita gives you the opportunity to dialyze at night while you sleep so you can take advantage of the longer, gentler hemodialysis treatment to enhance your health and lifestyle.

What our patients are saying

“I was going downhill before and now I feel excellent.” – Anna

“I have more energy. I even painted my kitchen today. And, I have an appetite for the first time in so long—I haven’t had an appetite in forever.” – Jonathan

“Nocturnal allows me to work full time. The fact I didn’t have symptoms like with daytime hemodialysis was a major change, too. I feel great.” – Paola

How do I start in-center nocturnal dialysis?

Call 1-866-994-SLEEP (1-866-994-7533) and talk to a DaVita Guest Services Specialist. You can find out if there is a DaVita In-Center Nocturnal Dialysis Program in your area and learn more about the benefits of in-center nocturnal dialysis.

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