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People on dialysis spend many hours every week getting their blood cleaned. Peritoneal dialysis, but especially hemodialysis in the center, often interferes with daily life when conducted during the day. This blog article describes the possibility of so-called night dialysis - dialysis while you sleep - which allows working people, for example, to free up some of their time during the day.
Here's what you need to know
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  • Night dialysis often offers working people in particular more freedom to organize their daily lives more freely during the day
  • Medically, nocturnal therapy can generally be considered equivalent; the basic rule with dialysis is that longer, gentler dialysis is also healthier, which is often the case with nocturnal dialysis.
  • If you are considering nocturnal dialysis, you should find out which centers in your area offer nocturnal dialysis, and be sure to discuss the issue with your dialysis team.
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What is night dialysis?

1. Hemodialysis

In most countries of the world, the majority of people requiring dialysis do hemodialysis in the center, 3 times a week for 4 to 5 hours during the day. However, some dialysis centers also offer the possibility to do hemodialysis during the night. In this case, you usually come to the dialysis center for treatment 3 times a week as well - but only around 9 pm. Then you do dialysis at night for about 8 hours. When you wake up the next morning, you are done with the treatment and can start the day with clean blood values. Some people also go straight to work afterwards. Other than the longer dialysis time, this procedure is no different than the traditional form of hemodialysis.

If you dialyze at home (=home hemodialysis), you have complete freedom to arrange your dialysis times in consultation with your doctor.

2. Peritoneal dialysis

With peritoneal dialysis, too, there is the possibility of shifting dialysis completely to the night, especially with automated peritoneal dialysis (APD). This procedure uses a so-called cycler. This is a machine that regularly exchanges the dialyzing fluid in your abdominal cavity over a period of usually 8 to 9 hours. Since the machine works almost silently, it should hardly affect your sleep at night.

What are the advantages of nocturnal dialysis?

As you may have already noticed, nighttime hemodialysis differs mainly in that the dialysis time is slightly longer. Compared to dialysis during the day, it's gentler on your body because the fluid removal takes place over a longer period of time. So the treatment is more like the activity of healthy kidneys, which are also working 24/7. Many report feeling less fatigued and more efficient after nocturnal hemodialysis. In addition, nocturnal dialysis is considered particularly effective because of the longer dialysis time. 

In addition to physical health, nocturnal dialysis can also have a positive effect on psychological and social well-being. Shifting treatment to the night leaves more free time during the day for work, family, friends and leisure activities. Basically, you are more flexible both privately and professionally and can manage your time more freely.

Does nocturnal dialysis also have disadvantages?

You think the advantages of nocturnal dialysis sound tempting and are now asking yourself where there might be a catch? There are two points in particular to consider:

Is there a center nearby that offers nocturnal hemodialysis? One challenge with nocturnal hemodialysis in particular is that a good percentage of dialysis centers do not have night shifts. So it can be difficult to find a suitable center in some circumstances. Check directly with the dialysis centers in your area regarding this.

Venous needle loss - A still unresolved safety issue with dialysis machines is the so-called venous needle loss. Theoretically, the needle that returns the clean blood to the body (=venous needle) could come loose during sleep and then get caught in the bed mattress, for example. The machine would not notice whether the blood was being returned to the body or going elsewhere. This could result in blood loss. Since the whole thing happens at night, it might not be noticed right away. Also, the dialysis team may not be able to fully monitor due to reduced light conditions. For this reason, increased safety measures, such as particularly good fixation of the accesses, are given increased attention during night dialysis. But there is no need to panic: in practice, the risk of such a case is extremely low.

Other reasons - In addition, you may not be able to fall asleep with the noise of the machine, or you may simply not want to spend the night in the dialysis center. In these cases, night dialysis is not the right procedure for you anyway.

Off to night dialysis?

After reading this article, you can certainly imagine that night dialysis treatment can bring a great deal of quality of life, especially for working people. However, not every center offers night dialysis. Additionally, more factors than just the time of day play into your considerations. You should discuss whether night dialysis is a suitable solution for you with your dialysis team.

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