What are the models of care in NHHD?
There are two basic ‘models of care’ in NHHD – 6 nights/week and 3.5 nights/week (i.e. ‘rolling’ alternate night dialysis). Both offer better-documented outcomes when compared to conventional HD. Both give extended hour dialysis (6 x 8 = 48 hrs and 3.5 x 8 = 28 hrs respectively) compared with conventional HD (3 x 4 = 12 hrs). The 6/week option is more expensive than 3.5/week – the consumables double – but 6/week still works out to be cheaper than conventional HD (no nurses, buildings or infrastructure supports are needed). On the outcome side, my personal belief is that 6/week is superior to 3.5/week for several reasons. Primarily, though, in the 6/week NHHD option there are no dietary or fluid restrictions needed. In 3.5/week NHHD option, there is a 2-day gap as distinct from a 1-day gap for 6/week NHHD. This does make a big difference in fluid and potassium balance. The dietary importance and freedoms of 6/week NHHD cannot be emphasised enough. The ‘concertina-like expansion and cont
