title: Ten years experience of in-center thrice weekly long overnight hemodialysis.
abstract: OBJECTIVE
  Published studies suggest that longer hemodialysis (HD) sessions are associated with improved morbidity and mortality, but few centers offer long sessions. The Western Infirmary renal unit has offered long overnight hemodialysis (LOH) (6 to 7 h) thrice weekly since 1998. The aim of this study was to describe patients who chose LOH and compare outcomes with patients on conventional hours (4 to 5 h) HD.
  
  
  METHODS
  Patients who ever had LOH for three or more consecutive sessions were identified (n = 146). Indices of urea reduction ratio (URR), anemia, hyperphosphatemia, and predialysis BP (BP) control in a subgroup of all patients on LOH for at least 1 yr since 2004 were compared with age, sex, and diabetes-matched controls undergoing conventional duration HD.
  
  
  RESULTS
  The mean age at the time of starting LOH was 51.8 yr and 74.7% started with a functioning arteriovenous fistula. Median duration of continuous LOH was 1.6 yr. Of those no longer on LOH, only 33.3% reverted to conventional hours HD (mean duration LOH 2.2 yr). When comparing LOH and conventional HD cohorts, there was increased URR and mean hemoglobin with a trend toward lower mean erythropoietin index. There was a trend toward fewer phosphate binder tablets but no difference in mean serum phosphate, BP, or number of prescribed antihypertensive medicines.
  
  
  CONCLUSIONS
  LOH is a well tolerated hemodialysis option, associated with improved URR and better control of anemia.
authors.affiliation: Renal Unit (Level 7), Western Infirmary, Glasgow, United Kingdom. Joanna.Powell@ggc.scot.nhs.uk
authors.forename: Joanna Ruth
authors.initials: JR
authors.lastname: Powell
authors.forename: Oyeniran
authors.initials: O
authors.lastname: Oluwaseun
authors.forename: Yook Mun
authors.initials: YM
authors.lastname: Woo
authors.forename: Neal
authors.initials: N
authors.lastname: Padmanabhan
authors.forename: Eliyanachii
authors.initials: E
authors.lastname: Narasinghan
authors.forename: Carol
authors.initials: C
authors.lastname: Latta
authors.forename: Julie
authors.initials: J
authors.lastname: Tortolano
authors.forename: Alan G
authors.initials: AG
authors.lastname: Jardine
authors.forename: Colin C
authors.initials: CC
authors.lastname: Geddes
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000378:metabolism / Q000628:therapy*; D001794:Blood Pressure; D016022:Case-Control Studies; D004921:Erythropoietin / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D054559:Hyperphosphatemia / Q000188:drug therapy / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009551:Night Care; D017060:Patient Satisfaction; D010710:Phosphates / Q000097:blood; D006435:Renal Dialysis / Q000379:methods*; D014508:Urea / Q000097:blood
chemical_list: D006454:Hemoglobins; D010710:Phosphates; D004921:Erythropoietin; D014508:Urea