Shelley Mcintosh is used to going to bed early. But unlike most people who prefer to be asleep well before midnight, she chooses to spend a significant part of her resting hours attached to tubes amid the bright lights and noises of a hospital ward.
The 61-year-old is part of a very small ‘club’, whose members receive life-saving treatment to support their failing kidneys during the night rather than in daytime.
“I used to go to bed at 8.30pm anyway, so all I am doing is getting a taxi over to Epworth Eastern to sleep instead,” Ms Mcintosh said.
The Melbourne hospital started its nocturnal dialysis five years ago, providing an alternative treatment option for patients, most of whom are waiting for a kidney transplant.
“Many of our patients are aged in their 40s, 50s and 60s and are on the transplant list,” Renal Dialysis Nurse Unit Manager Amelia Flowers said.
“They find daytime dialysis is disruptive for work or study, so they come in at night.”
Nephrologist Dr Vatsa Dave said dialysis – which involves fluid being pumped through the patient’s body to filter out waste products – was “essentially a form of life-support treatment”.
“It helps you stay alive and maintain your quality of life,” he said.
Day dialysis takes four to five hours, but night treatment can run over eight hours and is gentler on the body, causing less long-term complications for patients.
“There are lots of studies that show the longer dialysis hours, which we can do overnight, are better for patients,” Dr Dave said.
“It provides better clearing of the toxins and poisons that accumulate in the body when you have kidney failure and it is less stressful for the other organs like the heart, brain and lungs, than to have a shorter, intensive dialysis during the day.”
Ms Mcintosh said she had noticed the benefits of nocturnal treatment since she started the program in December 2021.
“The machine runs at half speed, so I find it’s not as much pressure on my body and I don’t come out of it exhausted like I did with day dialysis,” she said.
However, Ms Flowers acknowledged that people could take a while to adjust to the treatment.
“The patients are sleeping with the noise of the machine, the lights and the alarms. We give them earplugs, and some patients use noise-cancelling headphones to help them sleep,” she said.
Ms Mcintosh said she enjoyed being part of the night-time club, going to the Box Hill-based private hospital in the city’s eastern suburbs up to three times a week.
“The other people that I am with are lots of fun. You get your cup of coffee and sandwiches, watch what you want on TV, then you lay back and go to sleep, and they wake you at five o’clock in the morning,” she said.
Ms Mcintosh is now waiting to join another select group – those who pass the tests that allow them to receive a donor organ.
“Occasionally when one of the overnighters goes missing you think, ‘Okay, they’ve had a transplant’. There have been three who have had transplants since I started," she said.
Read more: Breaking down society’s barriers to kidney care