Does nocturnal haemodialysis improve heart disease for patients on dialysis?
Kidney failure means patients often need haemodialysis to clean their blood. Standard dialysis usually takes place three times a week for about four hours. Because fluids and waste must be removed quickly, this process can cause strain and scarring in the heart over time. This trial, called NIGHTLIFE-CMR, investigates whether switching to slower dialysis overnight in hospital (lasting 6 to 8 hours while asleep) helps protect the heart. Researchers will compare heart scans of people on night-time dialysis with those on standard daytime dialysis. Participants have an MRI scan of their heart and a small extra blood test at the start and after six months. By spreading dialysis over more hours, doctors hope to reduce heart damage and give people their days back. Taking part helps doctors learn if night-time dialysis could be a healthier option for kidney patients across the UK.
At a glance
What is this study about?
Haemodialysis is a vital, life-saving treatment for people whose kidneys have stopped working. It filters waste and extra water from the blood. However, usual haemodialysis is done in hospital three times a week for about four hours each time. Taking out so much fluid so quickly can put sudden strain on the heart and blood vessels.
Over months and years, this regular stress can cause stiffening and scarring in the heart muscle. In fact, heart problems are the most common cause of illness in dialysis patients. Doctors want to know if cleaning the blood more gently, over 6 to 8 hours overnight while the patient sleeps, can prevent or even reverse this heart scarring.
The NIGHTLIFE-CMR study uses detailed MRI scans to take close-up pictures of the heart. By comparing patients having standard daytime dialysis with those receiving overnight dialysis, researchers hope to see clear proof of whether slower dialysis keeps the heart stronger and healthier.
Key takeaways
- Tests whether slower, 6-8 hour overnight dialysis protects the heart better than standard 4-hour daytime dialysis.
- Open to adults aged 18 and over who have been on haemodialysis for at least 3 months and are in the main NightLife study.
- Involves two 40-minute heart MRI scans (at the start and after 6 months) on non-dialysis days.
- Blood samples are drawn via your normal dialysis lines, so there are no extra needle jabs.
- Participation lasts 6 months, is completely voluntary, and does not affect your standard NHS care.
Who may be eligible?
To take part in this sub-study, you must already be enrolled in the main NightLife trial and have been receiving standard haemodialysis for at least three months. You must also be 18 years or older and able to give your informed consent.
You cannot take part if you have recently received extended daytime or overnight dialysis, or if you are scheduled to receive a kidney transplant from a living donor soon. You also cannot join if your doctor feels extended dialysis is urgently required for another medical reason.
Because the study involves MRI scans, it is not suitable for people who have certain metal implants or devices that are unsafe in an MRI scanner, or for people who experience severe claustrophobia.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- Are you aged 18 or older?
- Have you been having regular haemodialysis for at least 3 months?
- Are you already taking part in (or planning to join) the main NightLife study?
- Are you free from non-MRI-safe metal implants or pacemakers?
- Are you able to lie comfortably inside an MRI scanner for about 40 minutes?
What does participation involve?
If you take part, your participation will last for 6 months. You will be asked to attend the hospital for two heart MRI scans: one at the start of the study and one after 6 months. These scans take place on non-dialysis days so that your body fluid levels are steady. Each scan takes around 40 minutes, during which you lie flat and follow simple breathing instructions. You will also give a small extra blood sample (about 6 teaspoons) at the start and at 6 months. This blood is drawn directly through your dialysis lines during your normal session, so no extra needle pricks are needed. No experimental medicines are involved; only the timing of your dialysis may change if you are placed in the overnight group.
Potential risks and benefits
Locations (3)
- Leicester General HospitalApproximateLeicester, England
- Queen Elizabeth Hospital BirminghamApproximateBirmingham, England
- Queen Elizabeth University Hospital GlasgowApproximateGlasgow, Scotland
Common questions
Will I need extra needle pokes for the blood tests?
No. The extra blood samples are taken directly from your dialysis lines while you are already connected for your usual treatment.
What happens during a cardiac MRI scan?
You lie flat inside a scanner tunnel for about 40 minutes. You will hear tapping noises and will be asked to hold your breath for short moments while images of your heart are taken.
Will the MRI scan results change my routine medical care?
No. The scans are for research purposes only and will be analysed at the end of the trial, so they will not alter your daily treatment.
Can I choose whether I do daytime or overnight dialysis?
No. In the main NightLife trial, participants are allocated to daytime or night-time dialysis by random selection to ensure a fair comparison.
What if I feel anxious inside the MRI machine?
The research staff can talk to you throughout the scan. You will hold an emergency call button and can ask to pause or stop the scan whenever you wish.
How to find out more
Matthew Graham-Brown
Always speak to your GP or specialist before deciding to take part in a study.
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