Research in Leicester to study impact of overnight dialysis on the heart

New research we have funded in Leicester will determine if giving dialysis to kidney failure patients overnight, for an extended period of time, will reduce the damage to their heart.

People living with kidney failure need dialysis, a procedure to remove waste products and excess fluid from the blood, to stay alive. Most patients typically have four hours of dialysis, three times a week, through daytime appointments at a hospital or satellite clinic.

Although dialysis is necessary to keep these people alive, it can lead to scarring of the heart, which can build up over time and cause heart failure.

Researchers believe that this damage is caused by having to remove water and waste products quickly during the standard four-hour treatment. Carrying out this procedure during the day can also have a detrimental impact on a patients’ quality of life.

Impact on heart scarring

The NightLife trial at the University of Leicester, which is funded by the National Institute of Health Research (NIHR) and supported by NIHR Leicester Biomedical Research Centre (BRC), is assessing the effect of dialysis overnight on patient quality of life and costs to the NHS.

The study involves 350 patients and will see 200 of these having around six to eight hours of dialysis whilst they sleep, three times a week. The other patients involved will have dialysis during the daytime, with the outcomes of both sets of patients then compared.

The BHF has now awarded almost £150,000 to researchers in Leicester, who will carry out MRI scans to determine if having dialysis for an extended period overnight reduces heart scarring.

Researchers will carry out the scans on both sets of patients at the start and end of the trial, with the funding also ensuring additional blood tests can be carried out on these patients to identify heart and circulatory diseases.

Likely to improve survival

The research is being led by Dr Matt Graham-Brown, NIHR academic clinical lecturer and honorary consultant nephrologist at the University of Leicester.

Dr Graham-Brown said: “Dialysis is a crucial, life-saving procedure for people living with kidney failure, but it can also have a severe impact on their hearts. The procedure is also very burdensome for patients, who must sacrifice a large amount of time and energy to undergo it.

“By extending the length of time over which the dialysis takes place, the removal of water and waste products can be done more slowly, and this may reduce the build-up of scarring in the heart. If we can improve this, then it is likely to improve survival, as statistics show that heart disease is the leading cause of death in people living with kidney failure.

“Importantly this new way of delivering dialysis frees up time for patients during the day, giving them more free time to socialise, work and care for others. Overall, we expect the NightLife trial to influence the way dialysis is delivered for patients to improve quality of life and important patient outcomes.”

Limiting the impact on hearts

Dr Tian Yu, Research Advisor at the BHF, added: “People living with kidney failure are at a higher risk of developing heart disease.

“Dialysis is a safe procedure for patients, but we need to find ways to limit the impact this can have on their hearts. Our funding ensures researchers can examine whether this different approach will better protect the hearts of these patients.

“The BHF’s vital research is entirely funded by the generous donations of the public. Covid-19 has cut our ability to fund new research in half at a time when it’s needed more than ever - and slowing down now would put more lives at risk. That’s why we urgently need more support.”