Kidney Failure - Nocturnal Dialysis

Author

Nocturnal Dialysis

Judanne

2006-08-18, 8:36 am

Geelong (about an hour from Melbourne) has been running nocturnal dialysis
for nearly 10 years (I think). Here is their website

http://www.nocturnaldialysis.org/

Judanne

"Paul Bartram" <p.bartram AT OR NEAR optusnet.com.au> wrote in message
news:44e51c5d$0$22362$afc38c87@news.optusnet.com.au...
>
> "Dave" <Someboby@someplace.com> wrote
> because they have
>
> They are just doing the preliminary work needed to introduce it in
> Queensland (Aus). They have surveyed all the patients to see how many
> would
> be prepared to do nocturnal HD, but I have not heard what the results
> were.
>
> The staff were less than enthusiastic, I do know that. Besides the
> increased
> stress of having to adjust to a 24 hour spread of shifts, they are worried
> about personal safety and that of their vehicles, which have to be parked
> on
> the street (mine was stolen from there last year!)
>
> Paul
>
>

Paul Bartram

2006-08-19, 2:25 am

"Judanne" <judanne@westnet.com.au> wrote

> Geelong (about an hour from Melbourne) has been running nocturnal
dialysis
> for nearly 10 years (I think).

Up here in Queensland we tend to swing through the trees and eat bananas (in
other words, we're a little behind in some things.) We are about to elect a
new bunch of monkeys to govern the state, so our health services *might* get
a bit better

Here is their website http://www.nocturnaldialysis.org/

That is an excellent site, thank you.

Paul

Dave

2006-08-19, 4:26 pm

Paul,

Do you know how they run the treatment? Before my unit started the
shift, the other units here in the states used slow flow, about 200-250
ccm blood flow rate. The docs in my unit wanted to try something
different, so they run the blood rate at 350-400 ccm. The data seems to
be better. The big noise heard when this was proposed is that it would
be too much work for the heart, but there has been no evidence that it
is any more difficult for the heart. The biggest difference has been in
Phosphate removal rates and in KT/V values. This actually makes
physical sense. During a normal 4 hour treatment at 500 blood flows,
120,000 cc of blood flow through the dialyzer, which is the identicle
amount of blood that flows through the dialyzer with slow flow Nocturnal
dialysis at 250 blodd flows. At 400 cc blood flow for 8 hours, the
amount is 192,000 cc of blood through the dialyzer. This helps the
phosphate because it moves through the dialyzer membrane at a very slow
rate, and helps the KT/V because it starts to pull the BUN that is
stored in the cells of your body, which doesn't happen very much during
a shorter treatment time. Normally during a shorter treatment, you have
a rebound of BUN after the treatment has ended. Whil this also occurs
with the faster blood flow nocturnal, it happens less. By the way, the
KT/V values I have quoted in the past correspond to Urea Removal Rates
of: 1.2 KT/V ~= 65%, 3.0 ~= 90%, and my high of 3.47 ~= 95%.

95% URR seems to be about as far as you can go, but I don't have studies
to prove this.

Dave

"Paul Bartram" <p.bartram AT OR NEAR optusnet.com.au> wrote in
news:44e6aa6d$0$11408$afc38c87@news.optusnet.com.au:

>
> "Judanne" <judanne@westnet.com.au> wrote
>
> dialysis
>
> Up here in Queensland we tend to swing through the trees and eat
> bananas (in other words, we're a little behind in some things.) We are
> about to elect a new bunch of monkeys to govern the state, so our
> health services *might* get a bit better
>
> Here is their website http://www.nocturnaldialysis.org/
>
> That is an excellent site, thank you.
>
> Paul
>
>
>

Judanne

2006-08-20, 2:24 am

Hi Dave,

Our renal unit ran a DVD or video about this programme a few years ago and,
from memory, I believe that they were running at the lower rate you mention,
200 - 250. The patients interviewed loved the fact that they no longer had
to restrict either their food or fluid intake so strictly.
That seemed to be the greatest advantage.

Judanne

"Dave" <Someboby@someplace.com> wrote in message
news:Xns9824AECC53742Somebobysomeplacecom@66.150.105.230...
> Paul,
>
> Do you know how they run the treatment? Before my unit started the
> shift, the other units here in the states used slow flow, about 200-250
> ccm blood flow rate. The docs in my unit wanted to try something
> different, so they run the blood rate at 350-400 ccm. The data seems to
> be better. The big noise heard when this was proposed is that it would
> be too much work for the heart, but there has been no evidence that it
> is any more difficult for the heart. The biggest difference has been in
> Phosphate removal rates and in KT/V values. This actually makes
> physical sense. During a normal 4 hour treatment at 500 blood flows,
> 120,000 cc of blood flow through the dialyzer, which is the identicle
> amount of blood that flows through the dialyzer with slow flow Nocturnal
> dialysis at 250 blodd flows. At 400 cc blood flow for 8 hours, the
> amount is 192,000 cc of blood through the dialyzer. This helps the
> phosphate because it moves through the dialyzer membrane at a very slow
> rate, and helps the KT/V because it starts to pull the BUN that is
> stored in the cells of your body, which doesn't happen very much during
> a shorter treatment time. Normally during a shorter treatment, you have
> a rebound of BUN after the treatment has ended. Whil this also occurs
> with the faster blood flow nocturnal, it happens less. By the way, the
> KT/V values I have quoted in the past correspond to Urea Removal Rates
> of: 1.2 KT/V ~= 65%, 3.0 ~= 90%, and my high of 3.47 ~= 95%.
>
> 95% URR seems to be about as far as you can go, but I don't have studies
> to prove this.
>
> Dave
>
> "Paul Bartram" <p.bartram AT OR NEAR optusnet.com.au> wrote in
> news:44e6aa6d$0$11408$afc38c87@news.optusnet.com.au:
>
>