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Short Daily Versus Long Nocturnal Hemodialysis

Interest in quotidian (daily) hemodialysis (HD) seems to be growing. A number of groups have advocated short, high efficiency daily HD, e.g., Buoncristiani and the group at Perugia, Italy,1,2 and a few have advocated long slow HD while the patient is asleep, so-called nocturnal HD. The leader in this area is the Toronto group that was headed by the late Dr. Uldall and now by Dr. A. Pierratos.3, 4 Several presentations have been made at major nephrologic meetings and there are a number of publications that purport improvement in the outcomes of HD patients who are treated with these methods.5 Unfortunately, there are as yet, no randomized prospective studies comparing outcomes in patients who are dialyzing with conventional three times per week HD and either the short daily or long slow nocturnal HD methods. This is the first daily/nocturnal HD study to obtain comparative data in this field. This study commenced in November of 1998 and will be complete by the end of 2001. This article gives, for the first time, preliminary results from the study.