@article{6ceba9a5e37f418eac4adfa84e89d2f5,
title = "The effects of frequent nocturnal home hemodialysis: The Frequent Hemodialysis Network Nocturnal Trial",
abstract = "Prior small studies have shown multiple benefits of frequent nocturnal hemodialysis compared to conventional three times per week treatments. To study this further, we randomized 87 patients to three times per week conventional hemodialysis or to nocturnal hemodialysis six times per week, all with single-use high-flux dialyzers. The 45 patients in the frequent nocturnal arm had a 1.82-fold higher mean weekly stdKt/Vurea, a 1.74-fold higher average number of treatments per week, and a 2.45-fold higher average weekly treatment time than the 42 patients in the conventional arm. We did not find a significant effect of nocturnal hemodialysis for either of the two coprimary outcomes (death or left ventricular mass (measured by MRI) with a hazard ratio of 0.68, or of death or RAND Physical Health Composite with a hazard ratio of 0.91). Possible explanations for the left ventricular mass result include limited sample size and patient characteristics. Secondary outcomes included cognitive performance, self-reported depression, laboratory markers of nutrition, mineral metabolism and anemia, blood pressure and rates of hospitalization, and vascular access interventions. Patients in the nocturnal arm had improved control of hyperphosphatemia and hypertension, but no significant benefit among the other main secondary outcomes. There was a trend for increased vascular access events in the nocturnal arm. Thus, we were unable to demonstrate a definitive benefit of more frequent nocturnal hemodialysis for either coprimary outcome.",
author = "Rocco, {Michael V.} and Lockridge, {Robert S.} and Beck, {Gerald J.} and Eggers, {Paul W.} and Gassman, {Jennifer J.} and Tom Greene and Brett Larive and Chan, {Christopher T.} and Chertow, {Glenn M.} and Michael Copland and Hoy, {Christopher D.} and Lindsay, {Robert M.} and Levin, {Nathan W.} and Ornt, {Daniel B.} and Andreas Pierratos and Pipkin, {Mary F.} and Sanjay Rajagopalan and Stokes, {John B.} and Unruh, {Mark L.} and Star, {Robert A.} and Kliger, {Alan S.}",
note = "Funding Information: The FHN Nocturnal Trial was a multicenter, randomized, prospective trial of frequent home nocturnal hemodialysis sponsored by the National Institute of Health, National Institutes Diabetes, Digestive and Kidney Diseases (NIDDK), and the Center for Medicare and Medical Services (CMS). The design of the FHN Nocturnal Trial has been previously described. 19 , 21 Patients were enrolled between March 2006 and May 2009 and the trial concluded in May 2010. The study was approved by the local institutional review board at each participating site. An independent data safety monitoring board provided oversight. Funding Information: This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, the Centers for Medicare and Medicaid Services, and the NIH Research Foundation. The investigators and sponsors are grateful for the support of contributors to the NIH Foundation: Amgen, Baxter, and Dialysis Clinics, and support from Fresenius Medical Care. We are indebted to the patients who participated in the study, and to the United States Renal Data System for providing additional hospitalization data. This trial was registered at Clinical Trials.gov #NCT 00271999. ",
year = "2011",
month = nov,
day = "2",
doi = "10.1038/ki.2011.213",
language = "English",
volume = "80",
pages = "1080--1091",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Elsevier Inc.",
number = "10",
}