Monday, August 20, 2012

I really don't need any studies to tell me whether more frequent dialysis is good for me or not

I keep seeing references to the Frequent Hemodialysis Network study on and off on the internet.

This was a study to study the effects of increasing the frequency of hemodialysis. By looking at the link above, it seems that they did manage to prove that increasing the frequency of hemodialysis does improve heart function that is often impaired in patients on dialysis.

I couldn't care less.

I honestly don't need studies to tell me whether more frequent dialysis is better for me. I have experienced it first hand. I was diagnosed with Left Ventricular Hypertrophy in 2006. My Ejection Fraction (one of the measures of heart function) was 30% which was fairly low. This is a common complication in dialysis patients where the heart function is compromised due to the increased volume of blood in the body (mainly due to the excess fluid in the blood that most dialysis patients have). I was put on some medication for this by the cardiologist. Around the same time, I started daily nocturnal dialysis. After a year when I went back to my cardiologist, the Ejection Fraction had rebounded to 60% which was a perfectly normal value. The cardiologist was surprised and said that they don't normally see such dramatic improvement due to the medication alone. When I told him about my switch to daily nocturnal dialysis, he said it was most likely due to that.

Daily nocturnal home hemodialysis has given me many other benefits. My Restless Legs Syndrome disappeared. My blood pressure control is much better. I need to take Phosphorus supplements (to increase my Phosphorus) where most dialysis patients need to take phosphorus binders (to reduce their Phosphorus)! My blood counts are almost normal. I am on a very small dose of Erythropoietin.

One very important benefit of this dialysis frequency has been practically no diet and fluid restrictions. I eat what I wish and I drink as much fluid as I want. This helps a great deal psychologically as well. I am also able to work full time, exercise and travel. This has been possible only because of the increased frequency. Yes, there are people who do all this even on the regular dialysis regimen of twice or thrice weekly. However, I know myself. I would never be able to take that. I am physically and mentally weaker than them. I need the liberty that comes with increased frequency dialysis.

The point I am trying to make is for me daily nocturnal dialysis does not need to be proved by a study or a clinical trial to see its benefits. I have literally lived the benefits. I do understand however that many doctors need to see these results before recommending this to their patients. That is the most unfortunate truth that is present in the dialysis world today. Thousands of patients who could benefit from this wonderful modality are being deprived because of the lack of a definitive theoretical recommendation in its favor. Sadly, common sense is not enough!

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