Patients receiving frequent hemodialysis have better health-related quality of life compared to patients receiving conventional hemodialysis.
Patients receiving frequent hemodialysis have better health-related quality of life compared to patients receiving conventional hemodialysis.
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DOI：
10.1016/j.kint.2016.10.033
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发表时间：
2017-03
影响因子：
19.6
通讯作者：
Frequent Hemodialysis Network Trial Investigators
中科院分区：
文献类型：
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作者：
Garg AX;Suri RS;Eggers P;Finkelstein FO;Greene T;Kimmel PL;Kliger AS;Larive B;Lindsay RM;Pierratos A;Unruh M;Chertow GM;Frequent Hemodialysis Network Trial Investigators
大多数终末期肾病患者重视他们的健康相关生活质量，并想知道他们的透析方式将如何影响他们的健康相关生活质量。我们扩展了先前两个临床试验报告的结果，以评估频繁的血液透析与传统的血液透析对额外的HRQOL测量的影响。每日试验随机分配245名患者接受频繁(每周六次)或常规(每周三次)中心血液透析。夜间试验随机分配87名患者接受频繁夜间(每周6次)或常规(每周3次)家庭血液透析。所有患者在随机分组前都接受了常规血液透析，平均感觉体温计评分为70~75(视觉模拟评分从0到100，其中100表示完全健康)，平均一般健康评分为40到47(从0到100，其中100表示完全健康)，平均透析时间为2至3小时。结果被报告为治疗组之间的HRQL测量一年变化的差异，并使用线性混合效应模型进行分析。在每日试验的一年后，与标准的每周三次透析相比，被分配到频繁中心血液透析的患者报告说，与标准的每周三次透析相比，患者的感觉体温计得分更高，总体健康状况更好，透析会话后的恢复时间更短。在夜间试验一年后，被分配到频繁家庭血液透析的患者也报告说，透析后的恢复时间更短，但与标准的家庭透析计划相比，他们的感觉体温计或一般健康评分没有统计学差异。因此，与常规血液透析相比，接受日间或夜间血液透析的患者平均提前大约一个小时从频繁的血液透析中恢复过来。在中心透析机构接受治疗的患者报告说，与传统的血液透析相比，患者的HRQOL更好，频率更高。
Most patients with end-stage kidney disease value their health related quality of life (HRQoL) and want to know how it will be affected by their dialysis modality. We extended the findings of two prior clinical trial reports to estimate the effects of frequent compared to conventional hemodialysis on additional measures of HRQoL. The Daily Trial randomly assigned 245 patients to receive frequent (six times per week) or conventional (three times per week) in-center hemodialysis. The Nocturnal Trial randomly assigned 87 patients to receive frequent nocturnal (six times per week) or conventional (three times per week) home hemodialysis. All patients were on conventional hemodialysis prior to randomization, with an average feeling thermometer score of 70 to 75 (a visual analog scale from 0 to 100 where 100 is perfect health), an average general health scale score of 40 to 47 (a score from 0 to 100 where 100 is perfect health), and an average dialysis session recovery time of 2 to 3 hours. Outcomes are reported as the between-treatment group differences in one-year change in HRQoL measures and analyzed using linear mixed effects models. After one year in the Daily Trial, patients assigned to frequent in-center hemodialysis reported a higher feeling thermometer score, better general health, and a shorter recovery time after a dialysis session compared to standard thrice weekly dialysis. After one year in the Nocturnal Trial, patients assigned to frequent home hemodialysis also reported a shorter recovery time after a dialysis session, but no statistical difference in their feeling thermometer or general health scores compared to standard home dialysis schedules. Thus, patients receiving day or nocturnal hemodialysis on average recovered approximately one hour earlier from a frequent compared to conventional hemodialysis session. Patients treated in an in center dialysis facility reported better HRQoL with frequent compared to conventional hemodialysis.