Sunday, 19 December 2010 09:39

Nocturnal Dialysis

Written by  Steve Bone
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There is no doubt, and much research shows, that nocturnal dialysis, using single needle but extended sessions every day, or 6 out of 7, has huge beneficial effects, almost removing any recovery time, and dramatically changing the impacts on your body of ‘clean’ and ‘dirty’ blood cycles, which for some patients results in a pattern of feeling better or worse during their average week.

The NHS is meant to be actively promoting the extension of home hemo and self care in general, although the localised management and enthusiasm to achieve this appears to be mixed by region.

There can be many barriers to encouraging patients to become self caring. Some of these are emotional, some are practical. However, an intelligent approach to achieving self care whether on your own at home or even in a unit, including offering overnight hemo daily dialysis, is needed that can be applied countrywide. Areas to consider are very simple preparation of machines and needles etc for those that are reluctant to needle themselves, to self caring on a unit where the patient either cannot go home for practical reasons, or simply for lack of a carer at home. Beyond this of course, then home hemo is the real winner as this allows daily dialysis, but of course, nocturnal daily dialysis would open up huge benefits for many also.

Most UK dialyis units are standing idle overnight, so how about a concerted programme of daily nocturnal dilaysis combined with self preparation? Yes, there are issues of staff coverage, costs, but for many this will provide an improved dialysis regime with better health benefits. For those that can or are able to go home, then encouraging daily dialysis either as a night time function or during the day if they can work from home at the same time, is a potential no-brainer, but needs motivation to establish the programme.

It is clear that more could be done for a majority of hemo patients and involve many of them more closely in their treatment, so who do we turn to to get this moving more effectively? Locally it needs motivated and innovative managers, doctors and senior nursing staff to get things moving, but they should be backed by a top down drive to do better in this area. So, NHS, more than just a target, how about concerted action? How about involving patients and patient groups in the development – believe it or not, but many of your patients have brains and excellent business experience – use this free resource to help.

So, the shopping list is:

  • Teach preparation
  • Teach self care on the units
  • Actively recruit more for home hemo and use innovative technologies to get over provision of equipment issues.
  • Develop nocturnal facilites around the UK – improve health as a result
  • Encourage daily dialysis for all home hemo patients with a pattern of treatment to suit the individual life style.

Clock’s ticking, let’s get started……

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Steve Bone

Steve Bone

Hi, I'm Steve and have been a dialysis patient on some form of self-care or other since 1990. I've dialysed at home, abroad, in hospital, oh and had a transplant for 7 years. I work in the insurance industry for a City based business, but am very fortunate to be able to work from home 4 days a week. I hope, with my experiences, I can help others on dialysis or those facing dialysis in the future! It ain't so bad! Steve

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