Improved blood pressure control with nocturnal hemodialysis: review of clinical observations and physiologic mechanisms.

Nocturnal hemodialysis (NHD) involves nightly (5-6 sessions per week), long (8-hour) home hemodialysis treatments. NHD therapy has recently attracted considerable attention owing to certain clear cardiovascular advantages with this method over conventional hemodialysis. In this article, we review the clinical reports of improved blood pressure control and normalization of left ventricular geometry associated with NHD therapy. Recent mechanistic studies exploring the reversal of the uremic hemodynamic state with NHD are also reviewed. The implication of these hemodynamic changes for the prospective renal transplant candidate are discussed.