Apr 3, 2020

Cardiovascular Benefits of Extended-Time Nocturnal Hemodialysis

Current Vascular Pharmacology
Athanasios RoumeliotisAndreas Pierratos

Abstract

Hemodialysis (HD) remains the most utilized treatment for End Stage Kidney Disease (ESKD) globally, mainly as conventional HD administered in 4 h sessions thrice weekly. Despite advances in HD delivery, patients with ESKD carry a heavy cardiovascular morbidity and mortality burden. This is associated with cardiac remodeling, left ventricular hypertrophy (LVH), myocardial stunning, hypertension, decreased heart rate variability, sleep apnea, coronary calcification and endothelial dysfunction. Therefore, intensive HD regimens closer to renal physiology were developed. They include longer, more frequent dialysis or both. Among them, Nocturnal Hemodialysis (NHD), carried out at night while asleep, provides efficient dialysis without excessive interference with daily activities. This regimen is closer to the physiology of the native kidneys. By providing increased clearance of small and middle molecular weight molecules, NHD can ameliorate uremic symptoms, control hyperphosphatemia, improve quality of life by allowing a liberal diet and free time during the day facilitates vocational rehabilitation. Lastly, it improves reproductive biology leading to successful pregnancies. Conversion from conventional to NHD is followed by improved...Continue Reading

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Mentioned in this Paper

Dialysis Procedure
Vocational Rehabilitation
Hypertensive Disease
Hyperphosphatemia (Disorder)
Vasodilation
Blood Pressure
Abnormal Renal Function
Treatment Protocols
Extracellular Fluid
Kidney Failure, Chronic

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