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Kansas — Julie learned about the in-center nocturnal dialysis option from her Facility Administrator, Lorraine. What she found out made her interested in researching more about nocturnal dialysis treatment. “When I heard how well people were doing on nocturnal dialysis, I was very interested in being a part of it,” shares Julie. She was especially interested in the improved lab results and psychosocial outcomes.
Julie found that the nocturnal dialysis lab results in her DaVita center were not as good as some of the research, but she thinks that’s because nocturnal dialysis patients are under the impression that because they dialyze longer — and usually feel better — that they don’t have to watch their dialysis diet and fluid intake. Julie says, “Most issues are related to fluid retention and increased appetite. She was surprised that people were drinking more but feels there is a solution, “It boils down to education and alerting them to temptations.” Julie is hoping that with more diet education, in-center nocturnal dialysis patients will begin paying closer attention to their consumption, which may help improve their lab results.
“Nocturnal dialysis patients feel better physically, have more energy and more zest for living,” says Julie. As a social worker, Julie was very interested in her patients’ psychosocial changes. She states, “People told me they felt closer to ‘normal’ because they had the whole day free and didn’t have to get off work early or make special arrangements. They had no problems getting their kids from school. One patient is a social butterfly with activities during the day; she likes the nocturnal schedule to have her days free to spend with her friends. Some patients say that with nocturnal, ‘I don’t have to tell people I’m on dialysis.’”
Being a dialysis social worker, Julie sees a lot of hardships for patients having to balance their lives and their treatments. She notes, “Nocturnal dialysis is a program where most people consistently do well.” Partly, she attributes this to the in-center nocturnal dialysis schedule. Julie reports, “Patients come in around 7:30 p.m. and dialyze over night to 4:00 a.m. or 4:15 a.m. People bring in a sandwich or dinner, if they want, and there’s lights out around 11:00 p.m.”
Julie says she’s heard patients say about their nighttime dialysis, “It’s like a big slumber party.” Julie describes the nocturnal dialysis setup. “The patients sleep in their recliners; they bring blankets and pillows with them. They get snuggled in and can watch TV with earphones. They need to vibrate cell phones as not to disturb those sleeping. The chairs are turned for a little more room and privacy.”
She has noticed that it usually takes about a week or so for patients to get into the nocturnal groove with the less restful sleep. Julie says, “For the people who fall out of the program; it’s generally because they can’t sleep at dialysis.”
People considering in-center nocturnal dialysis should have reliable transportation, and should be able to take care of themselves. Patients who have a stabilized lifestyle and are compliant with their dialysis are good in-center nocturnal dialysis candidates. Julie says, “People who want to do nocturnal dialysis at our center know what to expect — the teammates talk to them and go over the guidelines.
Julie has also noticed that her health care teammates enjoy the nocturnal schedule. It gives caregivers a chance to have free days to spend with their families, and the pace at night is more relaxed than during the day.
Overall, Julie says nocturnal dialysis provides independence for patients. “The extended treatment cleanses their systems better and offers them increased energy, freedom, flexibility in lifestyle and a little more hope and zest for living, “Julie says, adding, “Nocturnal dialysis is not for everyone, but it sure is great for those who can do it.”
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