Nocturnal Better than Short Daily Home HD?

Discussions for Patients, Family, and Friends HD For Patients
1

Hi y’all,

Here’s a new WellBound press release about how many folks choose home when they actually get education about their options (hint: vastly more than choose it without!)–and also some data on folks who switched from short daily to daily nocturnal & felt even better! The emphasis in here is mine…

WellBound Presents Positive Results from Multiple Self-Care Dialysis Studies at the Annual Dialysis Conference

Data Demonstrates Patient Preference for Self-Care Treatments, As Well As Clinical and Lifestyle Benefits Related to More Frequent and Longer Self-Care Regimens

MOUNTAIN VIEW, CA, February 19, 2007 – WellBound, the first company focused exclusively on supporting the full spectrum of self-care dialysis therapies, today announced results of a study supporting increased adoption of self-care dialysis therapies. Findings from the study demonstrated that a large number of chronic kidney disease (CKD) patients chose a home-based therapy over traditional in-center hemodialysis when provided with early education on all therapy options. These findings, which are consistent with the results of a similar study previously conducted by WellBound, were presented today at the Annual Dialysis Conference in Denver, Colorado.

Researchers analyzed the dialysis therapy selections of 986 patients with stage 4 CKD after they received early education on all available treatment options, including conventional in-center hemodialysis (HD), peritoneal dialysis (either CAPD or CCPD), renal transplant, and various home hemodialysis regimens. Results showed that 45.8% of these patients selected a self-care (home) therapy. Of these 452 patients who chose a self-care therapy, 358 (79.2%) selected peritoneal dialysis and 94 (20.8%) selected home hemodialysis. Nationally, only about 7% of all new dialysis patients select home dialysis as their therapy choice.*

“Our ongoing research into the area of patients’ dialysis therapy selections continues to support the position that a large number of patients will select a self-care treatment if they are fully educated on all therapy options in advance of needing dialysis and given a treatment choice,” said John Moran, M.D., WellBound’s chief medical officer and a leading expert on self-care dialysis. “At the same time, we are seeing an increase in the acceptance of self-care therapies within the industry, providing more and more patients access to the clinical, quality of life and convenience benefits associated with these treatments.”

In two separate studies also presented today at the Annual Dialysis Conference, WellBound reported that:

1.****** Patients who switched from short daily home hemodialysis (three hours per day; six days per week) to nocturnal home hemodialysis (eight hours per day; six days per week) reported significant improvements in restless legs (a common problem in dialysis patients), energy and activity levels, and the ability to work and exercise. The same patients unanimously reported an improvement in their overall quality of life with the ability to pursue a “normal” lifestyle being the greatest benefit.

  1. Patients who dialyze six times each week require significantly lower doses of erythropoietin (EPO) to maintain healthy hemoglobin levels when compared to patients who dialyze every other day.

“The results of these two important studies further validate the concept that longer and more frequent dialysis therapy provides patients significant clinical and quality of life benefits,” stated Dr. Moran. “As interest in, and adoption of, self-care dialysis continues to increase, it is critical that we conduct studies such as these in order to compare and contrast the benefits of individual self-care therapy options and regimens. We hope that these findings will provide important points of consideration for the time when therapy selections are made.”

About Self-Care Dialysis

The term self-care dialysis refers to those dialysis therapies which patients are able to self-administer outside the confines of hemodialysis centers, including peritoneal dialysis and all types of home hemodialysis. A growing collection of clinical research clearly demonstrates that the more frequent, more consistent dialysis associated with self-care provides patients with improved health outcomes such as improved mortality rates, reduced hospitalizations and improved cognitive function. Home dialysis also offers significant quality of life advantages including greater convenience, more flexible schedules, and fewer fluid and dietary restrictions.

About WellBound

Founded in 2003, WellBound is an affiliate of dialysis industry leader Satellite Healthcare. As the first company focused exclusively on the full continuum of self-care dialysis options, WellBound frees chronic kidney disease (CKD) patients from in-center dialysis treatment regimens by offering multiple, state-of-the-art “self-care” treatment options. The company’s unique expertise in personalized self-care training and patient wellness facilitates a higher quality of life and improved clinical outcomes for CKD patients, while enabling physicians to offer a new, superior level of care.

The company has established nine operational self-care dialysis facilities and is actively engaged in launching a network of WellBound “Centers of Excellence” designed to deliver the full spectrum of self-care dialysis options, including peritoneal dialysis and daily home hemodialysis. To learn more about WellBound, please visit http://www.wellbound.com or contact the company directly at 1.800.476.5450.

#

2

[QUOTE=Dori Schatell;12685]Hi y’all,

Here’s a new WellBound press release about how many folks choose home when they actually get education about their options (hint: vastly more than choose it without!)–and also some data on folks who switched from short daily to daily nocturnal & felt even better! The emphasis in here is mine…

WellBound Presents Positive Results from Multiple Self-Care Dialysis Studies at the Annual Dialysis Conference

Data Demonstrates Patient Preference for Self-Care Treatments, As Well As Clinical and Lifestyle Benefits Related to More Frequent and Longer Self-Care Regimens

MOUNTAIN VIEW, CA, February 19, 2007 – WellBound, the first company focused exclusively on supporting the full spectrum of self-care dialysis therapies, today announced results of a study supporting increased adoption of self-care dialysis therapies. Findings from the study demonstrated that a large number of chronic kidney disease (CKD) patients chose a home-based therapy over traditional in-center hemodialysis when provided with early education on all therapy options. These findings, which are consistent with the results of a similar study previously conducted by WellBound, were presented today at the Annual Dialysis Conference in Denver, Colorado.

Researchers analyzed the dialysis therapy selections of 986 patients with stage 4 CKD after they received early education on all available treatment options, including conventional in-center hemodialysis (HD), peritoneal dialysis (either CAPD or CCPD), renal transplant, and various home hemodialysis regimens. Results showed that 45.8% of these patients selected a self-care (home) therapy. Of these 452 patients who chose a self-care therapy, 358 (79.2%) selected peritoneal dialysis and 94 (20.8%) selected home hemodialysis. Nationally, only about 7% of all new dialysis patients select home dialysis as their therapy choice.*

“Our ongoing research into the area of patients’ dialysis therapy selections continues to support the position that a large number of patients will select a self-care treatment if they are fully educated on all therapy options in advance of needing dialysis and given a treatment choice,” said John Moran, M.D., WellBound’s chief medical officer and a leading expert on self-care dialysis. “At the same time, we are seeing an increase in the acceptance of self-care therapies within the industry, providing more and more patients access to the clinical, quality of life and convenience benefits associated with these treatments.”

In two separate studies also presented today at the Annual Dialysis Conference, WellBound reported that:

1.****** Patients who switched from short daily home hemodialysis (three hours per day; six days per week) to nocturnal home hemodialysis (eight hours per day; six days per week) reported significant improvements in restless legs (a common problem in dialysis patients), energy and activity levels, and the ability to work and exercise. The same patients unanimously reported an improvement in their overall quality of life with the ability to pursue a “normal” lifestyle being the greatest benefit.

  1. Patients who dialyze six times each week require significantly lower doses of erythropoietin (EPO) to maintain healthy hemoglobin levels when compared to patients who dialyze every other day.

“The results of these two important studies further validate the concept that longer and more frequent dialysis therapy provides patients significant clinical and quality of life benefits,” stated Dr. Moran. “As interest in, and adoption of, self-care dialysis continues to increase, it is critical that we conduct studies such as these in order to compare and contrast the benefits of individual self-care therapy options and regimens. We hope that these findings will provide important points of consideration for the time when therapy selections are made.”

About Self-Care Dialysis

The term self-care dialysis refers to those dialysis therapies which patients are able to self-administer outside the confines of hemodialysis centers, including peritoneal dialysis and all types of home hemodialysis. A growing collection of clinical research clearly demonstrates that the more frequent, more consistent dialysis associated with self-care provides patients with improved health outcomes such as improved mortality rates, reduced hospitalizations and improved cognitive function. Home dialysis also offers significant quality of life advantages including greater convenience, more flexible schedules, and fewer fluid and dietary restrictions.

About WellBound

Founded in 2003, WellBound is an affiliate of dialysis industry leader Satellite Healthcare. As the first company focused exclusively on the full continuum of self-care dialysis options, WellBound frees chronic kidney disease (CKD) patients from in-center dialysis treatment regimens by offering multiple, state-of-the-art “self-care” treatment options. The company’s unique expertise in personalized self-care training and patient wellness facilitates a higher quality of life and improved clinical outcomes for CKD patients, while enabling physicians to offer a new, superior level of care.

The company has established nine operational self-care dialysis facilities and is actively engaged in launching a network of WellBound “Centers of Excellence” designed to deliver the full spectrum of self-care dialysis options, including peritoneal dialysis and daily home hemodialysis. To learn more about WellBound, please visit http://www.wellbound.com or contact the company directly at 1.800.476.5450.

# #[/QUOTE] This is so true… amazing how many people really do not know about nocturnal… the more that people truly have the choice the more people will opt for the superior form of therapy… which is by far nocturnal … Richard C/O Jessie

3

Nocturnal is better!! Hubby switched to short daily for about 2 weeks. The biggest difference in his blood work was phos. It went way up-2.89 pre He was on a diet worse than when he was in center until he started binders again. he has been back on nocturnal for about 2 weeks now and the last blodwork phos was down again-1.62pre no binders. He is eating everything he wants now. He still has nights he doesn’t sleep much but that happens whether or not he is hooked to the machine. He is doing 7 hours a night 2 nights in a row and then a night off. Much better lifestyle for him than 3,5 hours 6 dys a week . seemed then like you were constantly doing dialysis.

4

This is just my opinion, but that is one of the benefits I see to nocturnal. You can take an extra night off and still feel good because you are getting so much dialysis when you are doing a treatment.

Marty

5

[QUOTE=Country Girl;12802]This is just my opinion, but that is one of the benefits I see to nocturnal. You can take an extra night off and still feel good because you are getting so much dialysis when you are doing a treatment.

Marty[/QUOTE]

The part I don’t yet understand is, how is it possible to feel well when taking a day off considering there will be fluid buildup?

6

You just have to watch your fluid intake for that day.

7

Yay, WellBound in the news! You go WellBound! I really think Nocturnal will be quite nice once they miniturize our home dialysis machines…perhaps like that wearable dialysis machine. Wear it on the wrist and go to sleep eh?

8

We tried nocturnal when my husband first started home hemo. We were not sucessful for a number of reasons. I am off all summer and I really want to try it again. We started out with 8 hours and he had lots of clots. I am going going to try him on 6 hours and see if I can get him up to 8 hours by next fall. We more than likely won’t beable to skip more than one day because he has no kidneys and he need to dialysize 6 days a week. I love the idea of having the machine on your wrist ( I hope that happens before too long, but I am not going to hold my breath.

Berkeley_Barb

9

Wow a dialysis machine you could wear on your wrist!! That would be the ultimate.

Hubby was doing 8 hrs a night 3 nights in a row skip a night and do 2 nights skip a night. he is now doing 2 nights with 7 hrs skip a night then another 2 nights 7 hrs. Blod work is not much different.

10

What is your husband’s average fluid gain following the nights he dialyzes and following the nights he does not?

11

On the nights when he gos on again after getting off in the morning he usually has about one or less on. After his night off he usually has bout 2 on. He drinks a fair bit and doesn’t be thirsty. They told him that h wouldn’t be as thirsty on nocturnal because you are less uremic. I often hav to remind him to drink so that we will have some fluid to take off.

12

I am guessing it would depend on how well one holds fluid as to how comfortable one would be doing less than 6x nocturnal. Factors like patient’s size and sex might determine how much fluid can be tolerated. Also, how long one has been on dialysis, output etc. It sounds like your husband is doing well with his routine. I would be interested to hear how others feel in relation to holding fluid when doing less than 6x nocturnal. I do short daily txs 6 straight one off and by getting the fluid off each day, I sleep better at night and have a better appetite. Eventhough my gains are very low, fluid buildup and I don’t get along :slight_smile:

13

Hi Jane,
Nice to see you posting again.
I feel terrific the second day after Nocturnal! Much better than the first 4 - 5 hours after I come off the Freni. I average around 2.2 - 2.6 litres to remove every second day as I don’t limit my fluids but do exercise and hence sweat a fair bit.
As Pierre used to keep insisting, I wouldn’t have this downtime straight after Nocturnal and would probably sleep better, if I did Nocturnal every night and have less fluid to come off but…until they bring those little machines out to Australia where you don’t have to spend so much time setting up and stripping down I am happy the way things are.

Cheers

14

Hubby has never had any problem with fluid gain. When he was in center 3x a week he very rarely had any more than 2 kilos on - no urine output at all. He is always doing something and sweats a lot and that helps. Now on nocturnal he doesn’t even get thirsty - hungry but not thirsty. He says he is starving al the time. He is the type that can eat and eat and not gain weight. I get soooo mad because allI have to do is think about food and I gain!!