Journal of Clinical Nephrology and Therapeutics

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Perspective - Journal of Clinical Nephrology and Therapeutics (2023) Volume 7, Issue 3

Effectiveness of nocturnal hemodialysis versus conventional hemodialysis in improving anemia and mineral metabolism in End-Stage renal disease patients

Anjay Jane *

Department of Health Research

*Corresponding Author:
Anjay Jane
Department of Health Research
University Hospitals Bristol
UK
E-mail: arastogi@mednet.ucla.edu

Received:30-May-2023, Manuscript No. AACNT-23-102764; Editor assigned:02-June-2023, PreQC No. AACNT-23-102764 (PQ); Reviewed:16-June-2023, QC No. AACNT-23-102764; Revised:21-June-2023, Manuscript No. AACNT-23-102764 (R); Published:29-June-2023, DOI:10.35841/ aacnt-7.3.144

Citation: Cheng F. Local drug delivery systems for bone cancer treatment. J Can Clinical Res. 2023; 6(1):136

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Introduction

End-stage renal disease (ESRD) is a debilitating condition associated with complications such as anemia and disturbances in mineral metabolism. Hemodialysis is a standard treatment for ESRD patients, but the optimal approach for managing anemia and mineral metabolism remains uncertain. This article reviews the effectiveness of nocturnal hemodialysis (NHD) compared to conventional hemodialysis (CHD) in improving anemia and mineral metabolism in ESRD patients [1].

End-stage renal disease (ESRD) is characterized by the progressive loss of kidney function, leading to the accumulation of toxins, fluid overload, and disruption of essential physiological processes. Anemia and mineral metabolism abnormalities are common complications in ESRD patients, contributing to increased morbidity and mortality. Hemodialysis is a widely used treatment modality to manage these complications; however, the optimal dialysis approach for improving anemia and mineral metabolism remains an area of investigation.

Methods

To compare the effectiveness of NHD and CHD in improving anemia and mineral metabolism in ESRD patients, a comprehensive literature search was conducted. PubMed, EMBASE, and Cochrane Library databases were searched for relevant studies published within the last 10 years. The quality of the included studies was assessed using appropriate criteria [2].

h2 class="Sub-title"> Results

Several studies comparing NHD and CHD have demonstrated significant improvements in anemia management and mineral metabolism with NHD. NHD has been associated with increased hemoglobin levels, reduced requirements for erythropoiesis-stimulating agents, and improved iron utilization. Furthermore, NHD has shown favorable effects on mineral metabolism, including better control of phosphate levels, decreased serum parathyroid hormone levels, and improved calcium-phosphorus balance [3].

h2 class="Sub-title"> Discussion

The findings suggest that NHD may offer advantages over CHD in managing anemia and mineral metabolism in ESRD patients. The extended duration and frequency of NHD sessions allow for better removal of uremic toxins and metabolic waste products, leading to improved erythropoiesis and mineral homeostasis. Additionally, NHD provides a more gradual ultrafiltration process, reducing the risk of intradialytic hypotension and allowing for better volume control [4].

NHD has been shown to improve hemoglobin levels in ESRD patients, reducing the need for erythropoiesis-stimulating agents. By providing longer and more frequent dialysis sessions, NHD enhances the removal of uremic toxins, inflammatory cytokines, and inhibitors of erythropoiesis, thus promoting increased red blood cell production. Furthermore, NHD facilitates better iron utilization, which is crucial for erythropoiesis. In terms of mineral metabolism, NHD has demonstrated beneficial effects on phosphate control. Hyperphosphatemia is common in ESRD patients and is associated with cardiovascular complications. NHD allows for improved phosphate clearance, leading to better control of serum phosphate levels and reducing the reliance on phosphate binders. NHD has also shown promise in regulating parathyroid hormone (PTH) levels. Elevated PTH levels contribute to bone mineral disorders in ESRD patients. Studies have reported decreased serum PTH levels with NHD, suggesting improved mineral metabolism and bone health. Additionally, NHD has been associated with better calcium-phosphorus balance, reducing the risk of vascular calcification and cardiovascular events [5].

Despite these positive findings, further well-designed randomized controlled trials are needed to validate the effectiveness and long-term benefits of NHD compared to CHD. Additionally, individual patient characteristics, preferences, and available resources should be considered when selecting the most appropriate dialysis modality for optimal outcomes in ESRD patients.

Conclusion

In conclusion, the available evidence suggests that nocturnal hemodialysis (NHD) may be more effective than conventional hemodialysis (CHD) in improving anemia and mineral metabolism in end-stage renal disease (ESRD) patients. NHD offers several advantages, including extended treatment duration and frequency, which allow for better removal of uremic toxins, improved erythropoiesis, and enhanced mineral homeostasis. The studies reviewed consistently demonstrated that NHD resulted in increased hemoglobin levels, reduced requirements for erythropoiesis-stimulating agents, and improved iron utilization, leading to better management of anemia in ESRD patients. Furthermore, NHD showed positive effects on mineral metabolism, including better control of phosphate levels, decreased serum parathyroid hormone levels, and improved calcium-phosphorus balance. These findings have important implications for the overall health and well-being of ESRD patients.

References

  1. Wong B, Collister D, Muneer M,et al. In-center nocturnal hemodialysis versus conventional hemodialysis: a systematic review of the evidence. Am J Kidney Dis. 2017;70(2):218-34.

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  2. Rivara MB, Adams SV, Kuttykrishnan S, et al. Extended-hours hemodialysis is associated with lower mortality risk in patients with end-stage renal disease. Kidney Int. 2016;90(6):1312-20.

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  3. Rocco MV, Daugirdas JT, Greene T, et al. Long-term effects of frequent nocturnal hemodialysis on mortality: the Frequent Hemodialysis Network (FHN) Nocturnal Trial. Am J Kidney Dis. 2015;66(3):459-68.

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  5. Gura V, Rivara MB, Bieber S, et al. A wearable artificial kidney for patients with end-stage renal disease.. JCI insight. 2016;1(8).

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