Advise Please regarding Nocturnal Home HD

Hi my mother has been taking dialysis 3 times in a week for more than 1 year. I think it is standard in-center HD. She has diabetes,high blood pressure etc. She is facing some side effects from the dialysis.
She has sleeping disorder, eating disorder,body swelling and paining, digestion and irregular or insufficient urine.She is becoming weak day by day. I just have come to know about Nocturnal Home HD from this article.I think it’s very useful option.
Please let me know is it possible to switch treatment option from Standard in center HD to Nocturnal Home HD?
What Home Machines are available for Nocturnal Home HD?
Please give me information and links.

Regards

Nocturnal haemodialysis is a highly effective, gentle, and deep cleansing form of dialysis that is best when performed at least alternate nightly [i.e. no long breaks as always must occur in 3 times weekly regimens] at home. But - while it is regarded as the ‘Rolls Royce’ of dialysis options, it is not suited to [or available for] all.

Some centres offer a centre-based, sleep-over, 3 x weekly [usually 6 hour] option, though in my view this is an inferior choice to alternate [or more] nightS treatment at home. However, as I do not know your mother, her history, her capabilities, her location, or anything about her, I cannot [nor would] offer any opinion as to whether or not your mother is individually suited to either form - centre-based or home.

This is a decision that can ONLY be taken by and with her managing team. I suggest you make a time with her managing unit to discuss whether nocturnal dialysis - at home or in-centre - is a viable option for her.

Dear Sir,Thanks for your answer. My mother is 65 years old. She has been suffering from diabetes, high blood pressure for almost 20 years. And she got the recommendation from the doctor for dialysis in 2019. She started her dialysis on February 2019 for the first time after the long conservative treatment by the doctor in my country Bangladesh. She is in my country Bangladesh. She has been taking dialysis 3 times in a week in center hemodialysis. I already mentioned about the side effect on the previous message. I can send you her very recent medical report for reviewing if you would give your valuable time. The problem is that I am not residing in my country now. I am in Barcelona Spain. I am not sure about wheather there is nocturnal HD medical option exist in my country or not. I can do search. And I also appreciate your valuable comment.

Regards

I am afraid I know nothing of the dialysis services available in Bangladesh … nor whether nocturnal dialysis is even an option there.

That said, home haemodialysis - and especially nocturnal dialysis - requires a specialised training program, meticulous home support chains, and a dedicated and home HD-experienced nursing staff who can (and must) be available 24/7 - and particularly whilst any patient in their care is actually ON dialysis, to troubleshoot, and advise. I suspect this is not available in Bangladesh, as I have not heard (even on the grapevine) or nocturnal haemodialysis (NHD) patients in that country.

While NHD is an exceptionally smooth dialysis modality, it is not available in all countries - even large swathes of the US do not offer it - and the only free access to it is in ANZ, the UK and some EU countries.

I am sorry, but I doubt I can offer more on this to you.

It’s not uncommon for people on dialysis to produce less urine, but it is worrisome that your mother is having swelling, and the other symptoms you mention. She may not be getting enough dialysis.

There is another option for dialysis called peritoneal dialysis. Has her doctor talked about that with her? From what I read online, it’s not a common dialysis treatment in Bangladesh. However, I did find these clinics that offer it:

You may be able to find out where else it’s offered by contacting:
Bangladesh Society for Peritoneal Dialysis
House # 06, Road # 04, Dhanmondi
Dhaka, Bangladesh 1205
+880 1755-909900

Or

National Institute of Kidney Diseases and Urology (NIKDU)
Sher-e Bangla Nagar, Mirpur Rd
Dhaka 1212
https://www.nikdu.org.bd/ (I couldn’t get the link to work)

You might want to contact the Kidney Foundation of Bangladesh to ask where nocturnal hemodialysis and peritoneal dialysis are offered.

  • Hotline : +8801623324850
  • Call us : +88-02-44807447, +88-02-44807448
  • Email : info@kidneyfoundationbd.com
    Address: Plot No. - 5/2, Road No.-1 (Main Road), Section-2, Mirpur, Dhaka-1216.