Abstract: SA-PO755
Impact of Thrice-Weekly In-Centre Nocturnal Hemodialysis on Health-Related Quality of Life
Session Information
- Standard Hemodialysis for ESRD - I
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
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/Problems | 73.4 (11.9) | 77.0 (12.6) | 0.09 |
Effects of Kidney Disease | 48.2 (23.1) | 56.4 (22.3) | 0.046 |
Burden of Kidney Disease | 29.7 (25.2) | 31.8 (23.1) | 0.33 |
Physical Health Composite | 34.7 (7.3) | 36.4 (10.7) | 0.24 |
Mental Health Composite | 43.9 (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.