Dialysis at dusk

Published Thursday, February 28, 2008

Dialysis at dusk
Nighttime treatments help patients keep regular work schedules

By Sarah Bruyn Jones
Staff Writer

NORTHPORT

Roy Pate started regular dialysis treatments in 1999.

The 44-year-old had high blood pressure and now admits, “I wasn’t taking care of it.”

Since then, he spent three days a week having his blood cleaned through an artificial kidney, a process that required him to sit in a chair for four and half hours at a time. He left exhausted.

The treatments ate into his day. He couldn’t work all the hours he wanted to.

So when he heard DaVita Dialysis in Northport was planning to offer nocturnal dialysis treatments, Pate made every effort to be one of the night-time patients.

Since December, Pate has been spending three nights a week sleeping at the dialysis center. The dialysis treatments are slower, taking a total of eight hours, but they take place during the night, when Pate would normally be asleep.

Pate said nocturnal dialysis has not only made his treatments more convenient, it has also made him feel better.

“I feel a lot better now,” Pate said. “I have more energy than I had. Before I would go home and take a nap. Now I go home and can do things. I’m up and active for the day.”

He doesn’t just feel better. The medical staff also has watched his blood work improve.

“His blood is staying in the filter longer and it’s being cleaned longer,” said Pam Rohrer, a nurse and the facility administrator at the Northport DaVita clinic. “It’s like a washing machine. ...We are trying to provide our patients with the capacity to continue a regular daily routine, but we are also trying to improve outcomes. We are seeing better outcomes.”

By taking eight hours for treatment, Rohrer said the dialysis machine is coming closer to mimicking a real kidney than it does when the treatments take half the time.

The main function of the kidneys is to eliminate excess fluid and wastes from the body by filtering them out of the blood. When they lose their filtering ability, dangerous levels of fluid and waste accumulate in the body, causing kidney failure. High blood pressure and diabetes are the most common causes of chronic kidney failure.

When end-stage kidney disease develops, which means the kidneys are functioning at less than 10 percent to 15 percent of capacity, dialysis is required. Without it, a person would die.

Dialysis artificially removes waste products and extra fluid from the blood. There are several kinds of dialysis treatments, with hemodialysis being the most common. During hemodialysis, extra fluids, chemicals and wastes from the bloodstream is filtered in the artificial kidney.

Studies have shown better outcomes from nocturnal hemodialysis compared to conventional daytime hemodialysis. Clinics also have reported improvements in blood pressure, hypertension, and overall quality of life, Rohrer said.

That doesn’t mean nocturnal hemodialysis is better for everyone. Rohrer said the Northport clinic is selective in offering it. Only those who regularly attend appointments and meet other requirements are given the opportunity to try the program.

“This is special and we treat it special,” Rohrer said. “We have a reduced staff and we wanted to select those who would truly benefit from the program.”

The Northport clinic started with four patients in December. Now six patients spend the night at DaVita three times a week, and Rohrer said they have room for up to 10 people.

Marcelyn Morrow, 49, strolled into DaVita around 8 p.m. on a recent Tuesday, pulling a small suitcase behind her. Out of the suitcase she pulled a blanket, pillow and CPAP machine that helps her breathe while sleeping.

Morrow, the personnel manager for the Tuscaloosa Symphony Orchestra, was diagnosed with Type II diabetes in 1986. Five years ago she had to start dialysis treatments and said she’s a fan of nocturnal dialysis.

Like Pate, she has seen both medical and lifestyle improvements since she started spending three nights a week at DaVita.

“It allows for me to have the flexibility in my schedule that I want,” she said. “It allows my days to be totally free now. ... I’d much rather have my down time be the time when I have dialysis rather than having to come for treatments during my active time.”

Reach Sarah Bruyn Jones at sarah.jones@tuscaloosanews.com or (205) 722-0209.

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