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Dialysis during sleep gets good marks

SAN FRANCISCO, Oct. 15 (UPI) -- Teaching patients how to undergo kidney dialysis at home while they sleep not only is feasible, but it may improve their overall health, researchers suggested Monday.

Doctors in Toronto compared patients who went through dialysis at home during daylight hours and those who went through the procedure at night and found those who slept through it had lower blood pressure and improved blood counts -- conditions that can reduce the impact of enlarged hearts, a common problem that can cause early death.

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"About 10 to 20 percent of patients who undergo home hemodialysis are likely to be able to have nocturnal dialysis done," said Dr. Christopher

Chan, a senior research fellow in the division of nephrology at Toronto General Hospital, Ontario. He said it takes about six weeks to train a person to successfully perform nocturnal dialysis.

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Home dialysis is performed frequently in Canada, but is not as widely accepted in the United States where most dialysis is done in specialized clinics.

"You've got to realize," said Dr. John Dufton, a nephrologist in Prince George, British Columbia, "that a kidney specialist in the area where I work covers an area the size of France. These people can't go to a clinic hundreds of miles away so they have to learn to perform the dialysis at home."

Dufton said he is considering setting up a nocturnal dialysis program in northern British Columbia. "Getting people to do this at home is

what we want to do. I would think about 15 percent of people would be able to do this, and it is something we should try especially because the data

is so posiitve."

Chan said that during nocturnal dialysis the treatment is slowed down so that it takes eight hours to complete as opposed to the three to four hour daytime sessions.

"We teach the patients to doubly secure the lines that exchange the blood -- we have had no leaks -- and we show them how to secure the lines so that their arm remains in one position during the

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procedure and doesn't disrupt the blood flow by kinking the lines," he told United Press International.

"We think we are getting better results because the nocturnal dialysis can be performed six to seven nights a week," he said, making the procedure

a more natural way to eliminate waste products from the blood.

In his study, Chan compared 28 patients over two years who were using the nocturnal dialysis and compared their blood pressure and other blood levels

with 13 patients who remained on "self-care" dialysis. Night dialysis lowered blood pressure without use of medications and the heart size

returned to a more normal configuration, he said at the World Congress of Nephrology, co-sponsored by the Washington, D.C.-based American Society of

Nephrology and Amsterdam, the Netherlands-based International Society of Nephrology.

"Nocturnal dialysis is a pretty neat idea," said Hank Michael of North Miami Beach, Fla., a regional director for DaVita Inc., a kidney dialysis

center operator in 32 states. "It makes a lot of sense."

However, Michael said the procedure is likely to have more impact in Canada than in the United States, where only about 1 percent to 2 percent of dialysis patients have the procedure done at home. He also said he would like to see further studies on the procedure.

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"Like anything that is new, the inventors want to

make it work so the first reports generally are positive," he told UPI.

Michael also said there would be questions under the U.S. federal reimbursement policies questions about who would pay for the procedure and

who would pay to train people to perform the procedure.

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