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Abstract: FR-PO540

Physical Performance in Nocturnal Hemodialysis Patients: Systematic Review of the Literature

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical


  • Dam, Manouk, VU University Medical Center, Amsterdam, Netherlands
  • Weijs, Peter Jm, VU University Medical Center, Amsterdam, Netherlands
  • van Ittersum, Frans J., VU University Medical Center, Amsterdam, Netherlands
  • van Jaarsveld, Brigit C., VU University Medical Center, Amsterdam, Netherlands

Hemodialysis (HD) pts have poor physical performance, leading to a diminished quality of life (QOL) and overall health. This low activity level can be explained by lack of energy due to insufficient metabolic clearance and shortage of time by time-consuming HD sessions. Nocturnal hemodialysis (NHD) improves metabolic control and results in largely increased spare time. Whether NHD stimulates pts to a more active lifestyle and increased muscle mass and strength, is unclear. Our aim is to investigate whether physical performance improves when pts switch from conventional HD to NHD.


A systematic literature search, with help of a specialized librarian, was conducted in multiple databases: MEDLINE, Embase, CINAHL, PhycInfo and Web of Science. Databases were searched until January 2018. Primary outcomes of interest were physical performance, activity, strength and muscle mass in NHD, either at home or in-center. Two reviewers performed data extraction and assessment of methodological quality independently, with the Newcastle-Ottawa scale.


The search yielded 10 studies meeting the inclusion criteria including 2 RCTs. A total of 526 NHD pts were evaluated with a mean follow-up duration of 15,3 months. Physical performance was assessed with objective measurements in 7 studies: short-physical performance battery (1x), exercise spirometry (1x), 6-min walk test (6MWT, 1x), (skeletal) muscle mass using dual-energy X-ray absorptiometry (2x) and bioelectrical impedance analysis (BIA, 2x). In 5 studies physical performance was assessed subjectively, with a physical component score (PCS) of a QOL questionnaire. Of the objective outcomes, 3 studies found significant improvements in physical performance using exercise spirometry, 6MWT and BIA. Of the subjective outcomes, 2 studies showed a better PCS. The remaining 6 studies showed no improvement in physical performance nor PCS.


A limited amount of studies investigate whether physical performance improves after switching from CHD to NHD and a minority of these assess physical performance with objective measurements. As current literature regarding physical performance emphasizes the importance of physical activity on clinical outcomes, it is essential to conduct better research in larger study groups, to investigate whether NHD can improve physical performance of pts with ESRD.


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