Document Detail


Patient quality of life on quotidian hemodialysis.
MedLine Citation:
PMID:  12830442     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Studies have shown improved quality of life for hemodialysis (HD) patients after changing from conventional thrice-weekly HD treatment to more frequent HD. METHODS: In the London Daily/Nocturnal Hemodialysis Study, 23 patients (11 patients, short daily HD; 12 patients, long nocturnal HD) were compared with 22 conventional thrice-weekly HD patients serving as controls. All patients completed 3 sets of quality-of-life assessment tools: (1) a locally developed renal disease-specific questionnaire that assessed dialysis symptoms, uremic symptoms, psychosocial stress, and social-leisure activity; (2) the generic Medical Outcomes Survey 36-Item Short Form (SF-36); and (3) the global Health Utilities Index (HUI). As a supplement to the HUI, a subset of patients was asked to complete the Time Trade-Off assessment. RESULTS: Overall, the reduction in symptoms shows better fluid management because quotidian HD patients reported experiencing fewer and less severe cramping during dialysis, fewer headaches, less hypotension, fewer episodes of dizziness, decreased fluid restrictions, fewer blood pressure problems, decreased interdialytic weight gains, fewer episodes of shortness of breath, and a reduction in the sensation of easily feeling cold. HUI results showed that quotidian HD patients maintained functionality throughout the study period, whereas control patients showed a significant loss. Given the choice, all patients chose to remain on quotidian HD therapy after switching from conventional HD therapy. The Time Trade-Off analysis indicated that study patients were willing to trade far less time on quotidian HD therapy and much more time on conventional HD therapy in exchange for "perfect" health. CONCLUSION: As more studies focus on improved patient outcomes and appropriate funding mechanisms are established, more frequent home HD treatment should become a standard treatment option for patients with end-stage renal disease.
Authors:
A Paul Heidenheim; Norman Muirhead; Louise Moist; Robert M Lindsay
Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  42     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-06-27     Completed Date:  2004-01-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  36-41     Citation Subset:  IM    
Affiliation:
Optimal Dialysis Research Unit, London Health Sciences Center, London, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Appointments and Schedules
Dyspnea / etiology,  prevention & control
Fatigue / etiology,  prevention & control
Female
Follow-Up Studies
Headache / etiology,  prevention & control
Hemodialysis, Home / methods*,  psychology
Humans
Hypertension / etiology,  prevention & control
Kidney Failure, Chronic / complications,  psychology,  therapy*
Male
Middle Aged
Ontario / epidemiology
Patient Acceptance of Health Care
Prospective Studies
Quality of Life*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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