Daily and Nocturnal Hemodialysis

As the frequency of hemodialysis sessions has always been a concern, it is not astonishing that interest in quotidian (daily) hemodialysis appears to be growing worldwide. The main reasons for more frequent dialysis are to maximize well-being and minimize both intra- and interdialytic symptoms, as well as to improve the treatment of patients with severe underlying medical problems, particularly cardiovascular disease. Moreover, studies also indicate overall potential cost savings as compared with current conventional hemodialysis. There are two options available, namely short daily and long nightly treatments. The main difference centers on the ability of the nightly regimen to remove greater amounts of phosphate and beta-2-microglobulin. Even so, there is no doubt that both treatments are highly preferable to conventional three times weekly dialysis. Further issues which are discussed include the requirements necessary to run dialysis programs, vascular access requirements, and the management of complications and risks such as calcium and phosphorus control. This is the first publication devoted solely to daily hemodialysis therapies: Concentrating on clinical and technical issues, it is an important contribution to the practical development of daily hemodialysis and is highly recommended to nephrologists, nurses, managers of renal programs and others involved in renal care.