Avtor/Urednik		Gubenšek, Jakob; Buturović-Ponikvar, Jadranka; Knap, Bojan; Marn-Pernat, Andreja; Benedik, Miha; Ponikvar, Rafael
Naslov		Effect of switching to nocturnal thrice-weekly hemodialysis on clinical and laboratory parameters
Tip		članek
Vir		In: Special issue : contributions from the 5th Slovenian Congress of Nephrology with international participation [S. l.] : International Society for Apheresis
Leto izdaje		2013
Obseg		str. 412-415
Jezik		eng
Abstrakt		Long or frequent hemodialysis schedules are reported to improve clinical outcomes. We report here our experience with an in-center, nocturnal, thrice-weekly hemodialysis program. We retrospectively analyzed the effect of switching 10 patients (8 male, age 4511 years, renal replacement therapy vintage 128 years) from regular, 45h, thrice-weekly hemodialysis to 8h nocturnal, in-center hemodialysis as regards dialysis efficiency, chronic kidney disease-metabolic and bone disease (CKD-MBD) parameters, blood pressure, and anemia. With more intense dialysis, the mean predialysis creatinine and urea decreased significantly (1092195 vs. 961154mol/L, P<0.01 and 30.84.6 vs. 25.52.9mmol/L, P<0.01), while the decrease in potassium was insignificant (5.90.7 vs. 5.60.5mmol/L), but in 3/10 patients, dialysate potassium was increased. Three months after starting nocturnal hemodialysis, no significant influence on pre-dialysis blood pressure was observed (143/80 vs. 140/80mmHg), but antihypertensive medications were reduced in two patients. The mean dry weight reduced (7412 to 7212kg) and the mean ultrafiltration increased insignificantly (31231174 to 34341341mL). Serum calcium was stable, while phosphate reduced insignificantly (1.50.5 to 1.20.2mmol/L), but 6/10 patients were able to discontinue phosphate binders, the dose was reduced in one, and phosphate was added to dialysate in 3/10 patients. Intact parathyroid hormone values were within the target range, except in patients post-parathyroidectomy. There were no differences in hemoglobin (1216 vs. 1228g/L), and the mean epoetin dose decreased insignificantly (59503947 vs. 52504238IU/week). To conclude, improved phosphate and potassium control and reduction in phosphate binders were observed after switching to nocturnal hemodialysis. There was an insignificant reduction of epoetin dose and antihypertensive medications.
Proste vsebinske oznake		anemia hemodialysis hypertension outcome assessment phosphates metabolic and bone disease