What are the nutritional challenges for nocturnal patients?
The beauty of NHHD, particularly 6/week NHHD, is that diet and fluid intake is free! Under normal circumstances and in an otherwise normal day-to-day existence, one simply cannot eat so much potassium or drink so much fluid in a single day that cannot be removed with ease in an 8-9 hour dialysis on the same night. Lets think about fluid first. Most humans drink (comfortably) between 1.75 and 2.5 litres of fluid each day. We sweat, breath and excrete in our motions about 500 mls of fluid each day at average environmental temperatures in a temperate climate. This means the net gain in fluid each day (balanced in normal circumstances by urine losses) is, give or take, 1.25 to 1.75 litres. For this discussion, lets assume an average of 1.5 litres as the required daily urinary loss to balance intake and after other losses have been counted. Of course, most dialysis patients pass little or no urine – though there are some lucky ones who still pass reasonable volumes. The less urine a dialysi
