Providing an In-Centre Nocturnal Hemodialysis Program: The Pearls and Pitfalls (Report‪)‬

Description and history Home nocturnal hemodialysis (HNHD) was introduced in Toronto, Ontario, by Dr. Robert Uldall at the Wellesley Hospital in 1994. This pilot project was funded through a grant from the Ministry of Health of Ontario. HNHD, an overnight dialysis modality performed for an extended time frame (eight to 10 hours) in the home daily, five to seven nights per week, results in significantly more hemodialysis than conventional therapy as reflected in higher per cent reduction in urea (PRU) values. Dr. Uldall's vision was to introduce HNHD as a means to increase patient independence by freeing up their daytime hours for work and family activities (Uldall, Ouwendyk, Francoeur, Wallace, Sit, Vas, et al., 1996). In fact, his vision was achieved--and HNHD has also demonstrated a significant improvement in quality of life and improved energy and metabolic parameters (Pierratos, Ouwendyk, Francoeur, Vas, Raj, Ecclestone, et al., 1998), leading to the development of similar programs both province-wide and beyond.