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Nocturnal Home HD Benefits — ESENeph MCQ

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ModerateHaemodialysisNocturnal Home HD BenefitsESENeph

A 60-year-old man with CKD G5D on haemodialysis has been on standard HD for 5 years. He is offered nocturnal home haemodialysis (6 nights/week, 8 hours). What are the potential benefits?

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Correct answer: B — Better phosphate clearance, improved BP control, reduced LVH, improved quality of life, and potentially improved survival compared to conventional thrice-weekly HD

Nocturnal or extended-hours haemodialysis provides several benefits over conventional thrice-weekly HD: better middle molecule and phosphate clearance (phosphate is time-dependent), improved BP control with reduced antihypertensive medications, regression of LVH, improved quality of life, better sleep, and improved survival in observational studies (FHN trial showed benefit for frequent HD). Challenges include vascular access wear, patient/carer burden, and technical support requirements. UKKA supports extended/frequent HD for suitable patients.

Reference: FHN Trial – NEJM 2010; UKKA 2019 – HD Guideline