Humber River patient takes nocturnal dialysis on the road


Nothing is going to stop Carole Evans from travelling the world. Not even the fact that she needs continuous hemodialysis treatment to stay alive.

“I golf, I play tennis, I play bridge, I have five children and I live a normal life,” said Evans – a retired history teacher – from her home in Orillia, Ontario.

But it doesn’t stop there. Last year, Evans – a patient in Humber River Regional Hospital’s renowned nocturnal hemodialysis program – decided to take home dialysis to a new level. She had a custom dialysis trailer built (the first of its kind) so she could spend less time at home and more time visiting out-of-town family and friends.

“When we’re not on the road travelling, we’re at the cottage, it’s really improved our lifestyle; it’s unbelievable,” Evans said.

In the past year, Evans has travelled with her husband through the United States, across Canada’s East Coast and throughout several cities in Ontario for two to three weeks at a time.

But while enhanced mobility is attractive, it also comes with its own set of risks and complications – risks and complications that Evans says were effectively managed by the Humber River Dialysis team.

“They were very supportive right from the beginning. Both the technical and nursing support is excellent and Dr. Andreas Pierratos is one of the most accessible physicians I’ve ever met in my life. It would never have happened at any other hospital,” Evans added.

While compliments like Evans’ are greatly appreciated, they’re nothing new for Dr. Pierratos and the Humber River Dialysis team. After the death of Dr. Robert Uldall (the first doctor to train a patient to self-administer dialysis treatment at home during the night) in 1995, Dr. Pierratos took the lead in building Humber River’s nocturnal dialysis program and elevating it to astounding international success. The program is the first of its kind worldwide and is one of the largest, now serving 57 people.

“We are very proud of our nocturnal program and fortunate to have the support of our President and CEO Rueben Devlin and the Senior Team,” said Dr. David Mendelssohn, Humber River’s Chief of Nephrology.

“Dr. Pierratos has built a mature and leading program and has been the zealous champion of this field around the world; we are very lucky to have him working with us,” he said.

In fact, Humber River’s nocturnal dialysis program is so well established that for years it has attracted medical professionals from the United States, Australia, Japan, the Netherlands and most recently, Dr. Joseph Wong, a nephrologist from Hong Kong.

“Humber River is the original place for nocturnal hemodialysis and it’s an amazing program. I am so grateful to be here and to learn from Dr. Pierratos,” Wong said. I look forward to taking the knowledge I’ve learned here and applying it to the development of a nocturnal program in Hong Kong when I return there in November.”

While the accolades are nice for Dr. Pierratos, his true satisfaction comes from working with a committed and versatile Humber River dialysis team and seeing how his patients receive the major benefits of the Nocturnal program. “Unlike conventional dialysis, nocturnal dialysis allows the body to function more efficiently by cleansing the blood daily over a longer period of time with less intensity. It’s a wellness model that makes patients feel better and limits the time they spend in the hospital. Most of our home dialysis patients come in for a checkup every eight weeks,” Pierratos said.

But even though home dialysis patients receive their treatment outside, most patients are still in very close touch with the hospital through Humber River’s one-of-kind Remote Monitoring System. The system is comprised of computer technology that is linked to home dialysis machines across Ontario. But that’s not all. Because Humber River is the only hospital in Canada equipped with this remote monitoring system, they also monitor patients in Vancouver, as well as pediatric patients from The Hospital for Sick Children in Toronto.

In addition to promoting home dialysis as the first choice for suitable patients, Humber River also believes strongly in educating patients even before they begin dialysis treatment.

“We are very proud of our pre-dialysis clinic and make education a priority in our unit,” said Mendelssohn. “We discuss why the patient has kidney disease, present the treatment options available to them and continue to actively encourage home dialysis where it’s appropriate,” he said.

Nobody is happier about the quality of Humber River’s home dialysis program than Evans, who has already started planning her next big adventure: a cross country trip to Kelowna, British Columbia next summer. Without the expertise and dedication of the Humber River team, Evans is sure that going on the road again would be a lot more difficult.

“The Humber River team is wonderful,” she said. “They work so well and so pleasantly and treat every patient with respect. I would’ve followed them anywhere.”