Frequently Asked Questions
What is nocturnal home hemodialysis and how is it different from daytime home hemodialysis?
Nocturnal home hemodialysis is the same dialysis treatment used in a center, but delivered more slowly while you sleep at home. Instead of doing shorter, faster treatments during the day, nocturnal treatments usually run 7 to 9 hours, several nights per week. Because the machine works more gently over a longer period, many patients find they feel less “washed out” after treatment and have more energy for daytime activities.
Who is a good candidate for nocturnal home hemodialysis?
Nocturnal home hemodialysis can be a good option for patients who want more flexibility during the day, are comfortable learning hands-on skills, and have a safe place at home to set up a machine and supplies. It may be especially helpful if you work full-time, have childcare responsibilities, or simply prefer to keep medical treatments out of your daytime routine. Your nephrologist will review your medical history, heart health, blood pressure, and support system at home to decide whether nocturnal dialysis is safe for you.
What are the potential benefits of nocturnal home hemodialysis?
Because nocturnal dialysis treatments are longer and more frequent, they may allow for gentler fluid removal and more continuous clearance of toxins. Patients who do well on this schedule sometimes report fewer blood pressure drops during treatment, less cramping and nausea, and improved appetite and energy during the day. Some studies suggest that longer, slower dialysis can also help with blood pressure control and phosphate management compared with standard three-times-per-week treatments. Results vary from person to person, so your care team will track your labs and symptoms closely and adjust the prescription as needed.
Is nocturnal home hemodialysis covered by Medicare or private insurance?
For most people who qualify for dialysis, nocturnal home hemodialysis is covered in the same way as in-center treatment. Medicare, Medi-Cal, and most commercial plans recognize home hemodialysis as an equivalent therapy, whether you dialyze during the day or at night. You may still have deductibles, coinsurance, or secondary insurance requirements, and coverage can vary by plan, so it is important to speak with an insurance specialist before making a change.
What kind of training and support will I receive for nocturnal home hemodialysis?
You will not be sent home and asked to “figure it out” alone. At Home Dialysis Therapies of San Diego, patients who choose nocturnal home hemodialysis receive structured, step-by-step training from experienced home dialysis nurses. During training, you and, if you choose, a care partner learn to prepare the machine, place your needles, respond to alarms, and recognize common issues that require a call to the nurse or nephrologist. Even after you start dialyzing at home, your care team reviews your treatment data, labs, and blood pressure trends every month, and you have 24/7 phone access for urgent concerns.
Is nocturnal home hemodialysis safe while I am asleep?
Safety is a central focus at HDT. During training, your team will teach you how to anchor your lines, position your access arm, and set alarms so that the machine alerts you to any issue, such as a dislodged needle or pressure change. Many patients use comfort items like arm boards or securement devices to keep everything stable overnight. Your nephrologist will also choose a prescription that removes fluid slowly enough to reduce the risk of low blood pressure while you sleep. No medical treatment is risk-free, so your care team will review the specific risks and warning signs with you and your care partner.
