It is estimated that by the end of this decade close to 500,000 patients in the United States will require some form of dialysis to sustain life. This is primarily due to an aging population, demographics, life style and diabetes.
Currently the "conventional" method for providing this treatment is three times a week dialysis with an average of 3-4 hours per treatment performed at a hospital based or a freestanding clinic.
Under these "conventional" modalities, patients often experience certain predictable problems. Nephrologists across the country face the same issues with these types of modalities. They include fluid overload, hypertension, depression, prolonged post dialysis hypotension, fatigue, disability, hyperkalemia(high potassium), hyperhosphatemia (high phosphor), bone disease, sexual dysfunction, accelerated heart disease, thickening of heart muscle and premature calcification of blood vessels.
Although dialysis in its "conventional" way has improved through better anemia management, delivery of adequate dialysis dose (Kt/V), non-reuse of dialyzers and the use of more biocompatible dialyzer membranes, patients continue to have compromised quality of life.
Over the past two years, a strong interest in the United States has developed throughout the nephrology community for intensified more frequent dialysis regimens. This could either be done through slow nocturnal or short daily dialysis. Though Daily Home Hemodialysis (DHHD) is a "new modality" to most in the US, European and especially Canadian patients have benefited from DHHD/Nocturnal Home hemodialysis for many years.
An increasing number of scientific publications regarding slow nocturnal and short daily dialysis indicate that increased length and frequency of dialysis has several advantages and significantly improves patient's quality of life in particular with nocturnal dialysis while offering an overall reduction in total annual cost of care for ESRD patients. These savings are seen in reduced hospitalization and medication costs.
