Types of HHD

   
 


 

 

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Types Of Home HemoDialysis

Nocturnal Home Hemodialysis(NHHD) is usually 8 hours (but can be even 6 hours) is given usually for 6 nights (but for few 5 times a week) as slow long Hemodialysis. Patients are usually able to sleep and get adjusted to the noise of the machine, without interrupting their sleep pattern. Accidental dislodgement of the needle occurs rarely. Alarm devices exist and can be incorporated. When NHHD Slow Long Hemodialysis is given 6 times a week at night, good dialysis adequacy is achieved in all parameters when compared to other forms of home dialysis including Short Hemodialysis of 3-4 hours 6 times a week It has been noted due to efficiency of ‘NHHD’, phosphate level if elevated is brought to normal levels. If phosphate level is already normal due to efficiency of Long Slow NHD phosphate supplementation is needed in the dialysate fluid in these patients. 

Frequent Short Home or Centre Based Hemodialysis (FSHD) is usually given for 3-4 hours (but can be of shorter duration)  for 6 days a week and this HD can be suitable in day time due to the short duration. This ‘SHD’ is suitable for selected few patients and can be easily provided in the patient’s home but such facility is not offered yet in any hospital dialysis centre due to the logistics involved including the cost factor if done in hospital dialysis centres. If ‘SHD’ is done at home, cost is not increased by making the choice for ‘SHD’.  Any mode of Hemodialysis done more often and for more hours will yield better results. Several studies are in progress to assess the full impact of these forms of ‘HD’ and results will emerge in the coming years.  

Long Hemodialysis sessions can be provided on more frequent basis, either in the hospital centre or at home. Subjective benefits accrue on several aspects and in particular in the ‘quality of life’. It is logical to consider that these benefits are definitely attributable to better efficiency of Hemodialysis, due to the longer duration of Hemodialysis hours in NHHD.