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Abstract: SA-PO300

Quality of Life and Outcome in Patients on Hemodialysis: The Role of Dialysis Shift

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • El Agroudy, Amgad E., Arabian Gulf University, Manama, Bahrain

Patients with end-stage renal disease (ESRD) undergo hemodialysis (HD) during the morning, afternoon or at night, with time of treatment generally based on space availability or patient preference. This report examines the extent to which hemodialysis treatment time of day was associated with morbidity and quality of life.


Dialysis start time defined dialysis shift: morning beginning between shift 1 (7am and 11am) (n = 38); shift 2 (12pm and 4pm) (n = 38); shift 3 (5pm and 9pm) (n = 43) and shift 4 (10pm and 2am) (n = 56). Outcome measures included quality of life parameters, morbidities, dialysis care or hospitalization.


Out of 300 patients dialyzed at the Dialysis Facility, 175 (116 males and 59 females) met the inclusion criteria (adult patients aged between 18 and 90 years, on maintenance hemodialysis for more than 3 months and with no psychiatric or severe disabling diseases) were studied. Of these patients, shift 4 patients had a significant higher mean age compared to other shifts (p=0.001) and significant higher number of widows (8.6%, P=0.007). Most pf the patients in all shifts were high school educated but with significant trend to loss of their jobs due to employer attitude in shift 4 (28.6% compared to 13.2%,10.5% and 9.3% in sifts 1-3, p=0.001)). The patients in all four groups are comparable in terms of transportation methods, travel abroad, number of missed sessions weekly, nursing vascular access care, hemodialysis session related complications, exercise performance. Shift 4 was associated with more flexible social life, p=0.020). Shifts 1 and 2 have high admission rates to the hospital (31.1% and 26.3%, respectively) compared to (9.3% and 7.2%, in shift 3 and 4, p=0.004)) with no significant difference in the causes of admission being the infections and cardiovascular morbidities are commonest causes. Physician care was significantly missed in shift 4 (28.6%) compared to other shifts p=0.0001). Shift 4 patients’ spouses are more affected by losing their jobs (18%) compared to other groups (p=0.017).


The time of the hemodialysis schedule could affect the social life, social relationships, and income of the patients by losing their jobs. The physician care was not adequate in the evening shifts. Our results of the study provide evidence for medical professionals to prioritize healthcare and effective treatment plans