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Kidney Week

Abstract: TH-OR088

Extended In-Center Nocturnal vs. Conventional Daytime Dialysis: The NightLife Trial

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Burton, James, University of Leicester, Leicester, England, United Kingdom
  • Hull, Katherine Leigh, University of Leicester, Leicester, England, United Kingdom
  • Quann, Niamh, University of Leicester, Leicester, England, United Kingdom
  • Waheed, Ghazala, University of Leicester, Leicester, England, United Kingdom
  • Gray, Laura Jayne, University of Leicester, Leicester, England, United Kingdom

Group or Team Name

  • The NightLife Investigators.
Background

There are increasing observational data demonstrating benefits of in-centre nocturnal hemodialysis (INHD) on health-related outcomes. The multicentre, pragmatic NightLife Trial (ISRCTN 87042063) aimed to test the impact of INHD versus conventional hemodialysis (CHD) on quality of life.

Methods

Prevalent adult HD patients were randomly assigned to receive either 6-months INHD (6-8 hrs) or CHD (3.5-5 hrs; see figure). The primary outcome was Kidney Disease Quality of Life-36 (KDQoL-36) total score between groups over 6-months. Secondary outcome measures presented included intervention adherence, a comparison of KDQoL-36 domain scores between baseline and 6-months, and measures of safety. The trial was stopped early by the funder due to site set-up challenges.

Results

Groups were well matched (100 randomised, 57 INHD, see figure). The INHD group averaged 6.61 hrs/session vs 4.07 hrs/session in the CHD group. INHD had no effect on KDQoL-36 total score over 6-months with an adjusted mean difference between groups of 3.00 (-12.4 to 18.3). The comparison of KDQoL-36 domain scores is shown in the table. Only 2 participants withdrew due to the intervention (see figure). No serious adverse events (SAEs) related to INHD were reported.

Conclusion

Compared to CHD, INHD was not associated with improvements in total KDQoL-36 score over 6-months, however the study was underpowered. In a population with high symptom burden, observed differences in the KDQoL-36 kidney disease component summary score needs further investigation. With no associated SAEs, and good patient adherence to the intervention, INHD may offer an opportunity to increase dialysis capacity whilst also increasing patient choice.

Figure: CONSORT diagram

Table: KDQoL domain scores at baseline and 6-months

Funding

  • Government Support - Non-U.S.

Digital Object Identifier (DOI)