Fluid removal with 3x nocturnal vs 6x

I read where someone was asking if patients on 3x nocturnal feel as well as those who do daily sdd or snd as far as fluid not mounting up. I do sdd and fluid still mounts up by supper time each day. I feel well most of the day, but once I have supper, I am very anxious to do my tx as I am at my limit and feel uncomfortable. I keep wondering now how I used to make it between txs and on weekends when I was in-center. It does not seem like 3x nocturnal would allow someone to feel as well as someone on 6x nocturnal as far as getting fluid off daily. Has anyone tried both 3x nocturnal and 6x nocturnal so they can describe whether or not fluid mounts up with 3x nocturnal?

How much fluid (and sodium) do you take in each day? Do you weigh yourself from day-to-day? What is your weight gain from one day to the next? Although patients who are on SDHD have more freedom that patients on conventional 3 times a week dialysis, it seems from what I’ve heard that they don’t have quite as much freedom so far as drinking fluid as those on frequent nocturnal. I would assume (but it would be interesting to hear) that those doing nocturnal 3 times a week still have a similar fluid restriction to those doing conventional HD because they’re still having days off between treatments.

From my observation. When I was running a nocturnal treatment every other day; dad didn’t complain about the extra fluid. Even running every other day you can have more fluid than in-center as you have a lot longer to remove the fluid during the next treatment. However, he did feel a drop in his bounce back time so we went back to 5 days a week. Most nocturnal patients I know run 6 days a week so there is always once a week when they are going to have more fluid to take off.


I do 3 Nocturnals of 8 plus hours and 1 shorter Sunday run. On my 2 Nocturnal runs where I have missed a day i usually take off between 2.5 to 3 litres. I run the blood pump at 235 mls/min and dialysate rate of 300. I feel “great” and don’t limit my fluids, but I probably wouldn’t guzzle an large smoothie or juice on these days. My blood tests are great and nlood pressure excellent. No meds other than cholesterol lowering, EPO every fortnight and iron monthly. I add “Fleet” to my dialysate on Nocturnal runs as my phophate is low.
On my Monday night Nocturnal run I would usually be only taking off around 1.8 litres as i have done the short run sometime on Sunday as well. I do drink a bit more on this day. I run the blood pump at 225 (just for fun) and generally I would say I feell “terrific” rather than “great” on Tues morning when I come off and can go for a brisk walk a bit quicker and generally get into things quicker because I have taken off less.
I guess I could limit my fluids if i had to but can’t see the point at present. Also it is hot here, I do a lot of exercise and still wee a bit so we will “suck it and see”.
Sleeping whilst attached to a washing machine is still a big issue for me so I am very happy to be just doing 3 nights.

Hmmm…I was on a very similar ‘regime’ . I miss it, currently doing in-center, where they have been moaning this past week about my fluid gains …
Sine the crew over in Seppoland on NxStage only seem to do shortish evening runs, I can’t see where there is any advantage in fluid gain/loss, except that it is daily. If you put on about 1.5 liters a day, then you’ll be taking it off at 500 an hour, at least(plus washback over 3+hours)… if you put on 3.0 over 2 days, then on 3x nocturnal you’ll be taking off…500 an hour, at most (allowing for 400 washback & 2x200mil drinks while on overnight over 8 hours+).
I’d say Beachie & I had the edge…especially if you include large molecule dialysis, which only occurs at the end.
IF I end up with a graft, as I suspect I will, I guess I won’t be going back onto nocturnal, but doing 4 sessions a week of 5-6 hours. So I’ll never get back the relative ‘luid freedom’ I had on nocturnal… B-(

The ole Bear!
Nice to see you alive and well again buddy. You have been missed!
PS Drinks are on me.

In the U.S., people are doing nocturnal dialysis 5-6 nights a week using all kinds of accesses – fistulas, grafts, and catheters. Why can’t you do nocturnal with a graft?

Hi Bear, Pleasant surprise to have you post again. There are people using grafts in our program. I’d have to check into it further to be sure my information is 100% accurate but I think the patients useing grafts run with a single needle on nocturnal. I think the reason is so the graft doesn’t get punctured as much. If your interested, let me know and when I go to clinic again, I’ll get the specifics.