Abstract: SA-PO755

Impact of Thrice-Weekly In-Centre Nocturnal Hemodialysis on Health-Related Quality of Life

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Dumaine, Chance Skylar, University of Calgary, Calgary, Alberta, Canada
  • Leung, Kelvin C.W., University of Calgary, Calgary, Alberta, Canada
  • MacRae, Jennifer M., University of Calgary, Calgary, Alberta, Canada
Background

Home hemodialysis is associated with improved health-related quality of life (HRQoL); however, few studies have examined the impact of in-centre nocturnal hemodialysis (ICNHD) on HRQoL or on dialysis-related symptoms. We sought to determine whether conversion from conventional hemodialysis to ICNHD (8 hours, thrice weekly) improves HRQoL or reduces the burden of dialysis-related symptoms.

Methods

Prospective cohort study of conventional in-centre HD patients transitioned to ICNHD between October, 2013, and January, 2016. Health-related quality of life and symptoms associated with dialysis were assessed at baseline using the Kidney Disease Quality of Life-36 (KDQOL-36) survey. Follow-up surveys were completed at 12 months and differences from baseline were assessed using paired t-testing.

Results

Thirty-six patients were enrolled in ICNHD during the study period (69% male, mean age 54). Mean time on dialysis prior to enrollment was 31 months and mean Charlson Comorbidity Index score was 2.19 (range 0-4). Twenty-four patients (67%) were included in final analyses. Table 1 shows changes in the domains of the KDQOL-36. Significant improvements were seen in the “Effects of Kidney Disease” and “Mental Health Composite” domains (increase of 17% and 16%, respectively). Analyses yet to be conducted include an assessment of individual symptoms, as well as a sub-analysis using baseline KDQOL-36 scores to divide the cohort into tertiles.

Conclusion

In-centre nocturnal hemodialysis results in improved HRQoL. Previous studies have shown that patients with the lowest HRQoL at baseline derive the most benefit from home hemodialysis; further analyses will examine whether the same is true for ICNHD. Further studies are needed to determine whether improved HRQoL with ICNHD is associated with improved patient survival.

Table 1: Change in Health-Related Quality of Life
 Baseline
Mean (SD)
12-Month Follow-up
Mean (SD)
p-value
Symptoms/Problems73.4 (11.9)77.0 (12.6)0.09
Effects of Kidney Disease48.2 (23.1)56.4 (22.3)0.046
Burden of Kidney Disease29.7 (25.2)31.8 (23.1)0.33
Physical Health Composite34.7 (7.3)36.4 (10.7)0.24
Mental Health Composite43.9 (12.1)51.0 (10.5)0.003

Table 1: Mean and standard deviations for each of the 5 domains of the KDQOL-36. Each domain scored on a scale of 1 to 100, with higher values representing superior HRQoL.