Nocturnal hemodialysis: Pros and cons

The beneficial effects of increasing the frequency and/or time of hemodialysis sessions is becoming of increasing interest worldwide. Alternative hemodialysis regimens to incorporate these changes, also called "quotidian" hemodialysis schedules, likely offer advantages over conventional thrice-weekly treatments. Nocturnal hemodialysis (typically 6-8hrs, 3-7 nights/week) can be performed either at home on in-centre, with lower blood and dialysate flows, and is more effective at clearing small and middle-molecule retention products than conventional hemodialysis. Growing evidence highlights the advantages of nocturnal hemodialysis with improvement of surrogate cardiovascular endpoints and quality of life. This chapter describes the history, current international trends, and the results of studies evaluating clinical outcomes related to nocturnal hemodialysis.