Looking at the list of nocturnal programs , it appears FMC has the majority of programs with 15 in Penn. alone. I’m assuming these are 3x week programs, whether at home, or in center. Could we get a spokesperson for FMC to give us a report on their nocturnal program? Would like to know how these 3x a week programs compare to the 6x week nocturnal programs.
I contacted FMC and learned the following things:
– FMC’s nocturnal program is every other night for 8 hours (7 treatments every 2 weeks).
– Patients are monitored via the Internet.
– FMC has not yet published studies on their nocturnal programs’ outcomes but plan to do so in the next year.
Here’s an abstract from a Canadian study that compared patients using different treatments:
Am J Kidney Dis. 2003 Jul;42(1 Suppl):36-41.
Patient quality of life on quotidian hemodialysis.
Heidenheim AP, Muirhead N, Moist L, Lindsay RM.
Optimal Dialysis Research Unit, London Health Sciences Center, London, Ontario, Canada.
BACKGROUND: Studies have shown improved quality of life for hemodialysis (HD) patients after changing from conventional thrice-weekly HD treatment to more frequent HD.
METHODS: In the London Daily/Nocturnal Hemodialysis Study, 23 patients (11 patients, short daily HD; 12 patients, long nocturnal HD) were compared with 22 conventional thrice-weekly HD patients serving as controls. All patients completed 3 sets of quality-of-life assessment tools: (1) a locally developed renal disease-specific questionnaire that assessed dialysis symptoms, uremic symptoms, psychosocial stress, and social-leisure activity; (2) the generic Medical Outcomes Survey 36-Item Short Form (SF-36); and (3) the global Health Utilities Index (HUI). As a supplement to the HUI, a subset of patients was asked to complete the Time Trade-Off assessment.
RESULTS: Overall, the reduction in symptoms shows better fluid management because quotidian HD patients reported experiencing fewer and less severe cramping during dialysis, fewer headaches, less hypotension, fewer episodes of dizziness, decreased fluid restrictions, fewer blood pressure problems, decreased interdialytic weight gains, fewer episodes of shortness of breath, and a reduction in the sensation of easily feeling cold. HUI results showed that quotidian HD patients maintained functionality throughout the study period, whereas control patients showed a significant loss. Given the choice, all patients chose to remain on quotidian HD therapy after switching from conventional HD therapy. The Time Trade-Off analysis indicated that study patients were willing to trade far less time on quotidian HD therapy and much more time on conventional HD therapy in exchange for “perfect” health.
CONCLUSION: As more studies focus on improved patient outcomes and appropriate funding mechanisms are established, more frequent home HD treatment should become a standard treatment option for patients with end-stage renal disease.
I currently work for FMC in their Technical department. I have seen the results of nocturnal with increased kt/v URR that are unheard of, less medications along with more veriety of foods. If I were to ever go on dialysis, I would pick nocturnal.
There are so many back ups with the monitoring that the patient is protected at all times. Some of the protection is water alarms incase there is a leak. If the internet provider goes off line they can dial into the machine and manauly read the pt’s vitals.