Hemodialysis is one of the treatment modalities for patients with end stage renal disease (ESRD). In this modality blood circulates out of the patients through the dialysis filter (dialyzer). Within the dialysis filter, special fluid (dialysate) circulates in the opposite direction of the blood flow, which is separated from the dialysate by a thin membrane. Accumulated waste moves from the blood to the dialysate (which is free of waste) and electrolytes (such as sodium, calcium, and potassium) move between blood and dialysate depending on the concentration of each of these electrolytes in blood and dialysate (move from the compartment of high concentration to the compartment of low concentration).
Patients with ESRD usually go to dialysis three times per week, each time for an average of 4 hours (conventional HD). However, some patients may need more frequent or longer dialysis sessions, depending on their clinical status.
There are other variations of HD, such as nocturnal HD, where patients get longer and more frequent sessions of HD that are done at night while the patient is asleep; this could be done at home or in dialysis centers. Nocturnal HD is associated with better blood pressure and phosphorus control. In addition, dietary restrictions are much less with this modality.
Another available home dialysis modality is short daily dialysis. In this modality, the patients do more frequent but shorter dialysis sessions at home. This modality may be associated with better quality of life and better blood pressure control.
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