Thrice-weekly in-center nocturnal hemodialysis: an effective strategy to optimize chronic dialysis therapy

Int J Artif Organs. 2009 Jan;32(1):12-9. doi: 10.1177/039139880903200102.


Objectives: Daily nocturnal hemodialysis (NHD) has been proposed as a valuable strategy to improve outcomes for patients on conventional hemodialysis (CHD), but it is burdened by high costs and logistic issues. Thrice NHD might represent a more affordable approach to improve hemodialysis patient outcome.

Methods: Here we retrospectively analyzed the data on blood pressure, body weight, and hematochemical parameters in a cohort of 7 patients (mean age 50.4-/+11.0 years, duration of CHD 14.3-/+11.5 years) who registered in the NHD program at the dialysis unit of Ospedali Riuniti, Bergamo, Italy. Data for the 2 first years of NHD were compared with those of the last year on CHD.

Results: At 2 years after start of NHD, we found a significant decrease in systolic (149.4-/+16.6 vs. 128.4+/-26.0 mm Hg, p<0.001) and diastolic (87.7-/+11.1 vs. 79.6-/+16.7 mm Hg, p<0.05) blood pressure, along with a significant reduction in the use of per-patient antihypertensive agents (1.17-/+1.19 vs. 0.47-/+0.89, p<0.05 and an increase in dry body weight (61.4-/+21.8 vs. 67.1-/+16.4 kg, p<0.001). Moreover, patients had a significant reduction in phosphate levels (6.2-/+2.4 vs. 5.4-/+3.0 mg/dL, p<0.01). The procedure was safe and well tolerated and did not require extra cost for ad hoc facilities.

Conclusion: NHD is an effective approach to optimize chronic dialysis therapy.

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use
  • Biomarkers / blood
  • Blood Pressure / drug effects
  • Body Weight
  • Calcium / blood
  • Female
  • Hemodialysis Units, Hospital
  • Humans
  • Italy
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Phosphates / blood
  • Program Evaluation
  • Renal Dialysis / adverse effects
  • Renal Dialysis / methods*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome


  • Antihypertensive Agents
  • Biomarkers
  • Phosphates
  • Calcium