Objective To explore the effect of online hemodiafiltration (OL-HDF) once a week and thrice a week on quality of life in patients with maintenance hemodialysis (MHD). Methods Patients who received OL-HDF in Dalian Renal Care Hospital from January 1, 2022 to September 30, 2022 were selected and divided into OL-HDF once a week group and OL-HDF thrice a week group; according to the dialysis age in OL-HDF thrice a week group, dialysis age was matched at a ratio of 1:2. The Kidney Disease Quality of Life short Form (SF-36) was applied. The quality of life was assessed by kidney disease component summary (KDCS), physical component summary (PCS) and mental component summary (MCS). Lean tissue index (LTI) was measured by body composition monitor (BCM). Clinical indicators including quality of life scores, LTI, renal function and β2 microglobulin at baseline and after 6 months were compared between the two groups. Results A total of 102 MHD patients were included in this study, including 68 patients in OL-HDF once a week group and 34 patients in OL-HDF thrice a week group. Comparison of the indicator changes at baseline and after 6 months in the two groups revealed that KDCS score had no change (t=0.754, P=0.453), the sleep assessment in KDCS was better (t=3.082, P=0.003), the scores of PCS and MCS had no changes (t= -0.515 and -1/513, P=0.608 and 0.133), and the general health assessment in PCS was better (t=2.442, P=0.016) in OL-HDF thrice a week group, as compared those in OL-HDF once a week group. Changes of the indicators after 6 months showed that hemoglobin (F=6.682, P=0.011), albumin (F=12.294, P=0.001) and LTI (F=7.898, P=0.007) were higher, β2 microglobulin was lower (25.15±3.26mg/L vs. 26.96±5.15mg/L; F=4.710, P=0.032), and spKt/V was higher (1.31±0.21 vs. 1.19±0.15; F=11.975, P=0.001) in OL-HDF thrice a week group, as compared those in OL-HDF once a week group. Conclusions OL-HDF treatment thrice a week improves the sleep and nutritional status in MHD patients, probably due to the better dialysis adequacy in these patients.
SUN Yan-Ling
,
XIE Hua
,
WANG Jin-Ling
,
XIAO Kun
,
FENG Qing
,
LIN Hong-Li
. A single-center study of online hemodiafiltration with different frequency to improve quality of life in maintenance hemodialysis patients[J]. Chinese Journal of Blood Purification, 2023
, 22(11)
: 821
-825,860
.
DOI: 10.3969/j.issn.1671-4091.2023.11.005
1. Hackett ML, Jardine MJ. We Need to Talk about Depression and Dialysis: but What Questions Should We Ask, and Does Anyone Know the Answers? Clin J Am Soc Nephrol. 2017;12(2):222-4.
2. Ravaghi H, Behzadifar M, Behzadifar M, Taheri Mirghaed M, Aryankhesal A, Salemi M, et al. Prevalence of Depression in Hemodialysis Patients in Iran: a Systematic Review and Meta-analysis. Iran J Kidney Dis. 2017;11(2):90-8.
3. Schouten RW, Haverkamp GL, Loosman WL, Chandie Shaw PK, van Ittersum FJ, Smets YFC, et al. Anxiety Symptoms, Mortality, and Hospitalization in Patients Receiving Maintenance Dialysis: A Cohort Study. Am J Kidney Dis. 2019;74(2):158-66.
4. Lopes AA, Bragg-Gresham JL, Elder SJ, Ginsberg N, Goodkin DA, Pifer T, et al. Independent and joint associations of nutritional status indicators with mortality risk among chronic hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS). J Ren Nutr. 2010;20(4):224-34.
5. Wang H. Maintenance Hemodialysis and COVID-19: Saving Lives With Caution, Care, and Courage. Kidney Med. 2020;2(3):365-6.
6. Ware JE, Jr., Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 1998;51(11):903-12.
7. McCullough KP, Morgenstern H, Saran R, Herman WH, Robinson BM. Projecting ESRD Incidence and Prevalence in the United States through 2030. J Am Soc Nephrol. 2019;30(1):127-35.
8. Jagadeswaran D, Indhumathi E, Hemamalini AJ, Sivakumar V, Soundararajan P, Jayakumar M. Inflammation and nutritional status assessment by malnutrition inflammation score and its outcome in pre-dialysis chronic kidney disease patients. Clin Nutr. 2019;38(1):341-7.
9. Kalantar-Zadeh K, Cano NJ, Budde K, Chazot C, Kovesdy CP, Mak RH, et al. Diets and enteral supplements for improving outcomes in chronic kidney disease. Nat Rev Nephrol. 2011;7(7):369-84.
10. Hoes MF, Grote Beverborg N, Kijlstra JD, Kuipers J, Swinkels DW, Giepmans BNG, et al. Iron deficiency impairs contractility of human cardiomyocytes through decreased mitochondrial function. Eur J Heart Fail. 2018;20(5):910-9.
11. Koc H, Hoser H, Akdag Y, Kendir C, Ersoy FF. Treatment of secondary hyperparathyroidism with paricalcitol in patients with end-stage renal disease undergoing hemodialysis in Turkey: an observational study. Int Urol Nephrol. 2019;51(7):1261-70.
12. Locatelli F, Carfagna F, Del Vecchio L, La Milia V. Haemodialysis or haemodiafiltration: that is the question. Nephrol Dial Transplant. 2018;33(11):1896-904.
13. Lee YH, Shin YS, Lee SY, Kim YG, Lee SH, Moon JY, et al. Effects of online hemodiafiltration on anemia and nutritional status in chronic hemodialysis patients. Kidney Res Clin Pract. 2020;39(1):103-11.
14. Piccoli GB, Lippi F, Fois A, Gendrot L, Nielsen L, Vigreux J, et al. Intradialytic Nutrition and Hemodialysis Prescriptions: A Personalized Stepwise Approach. Nutrients. 2020;12(3).
15. Johansen KL, Lee C. Body composition in chronic kidney disease. Curr Opin Nephrol Hypertens. 2015;24(3):268-75.
16. Zhang H, Tao X, Shi L, Jiang N, Yang Y. Evaluation of body composition monitoring for assessment of nutritional status in hemodialysis patients. Ren Fail. 2019;41(1):377-83.
17. Masoumi M, Naini AE, Aghaghazvini R, Amra B, Gholamrezaei A. Sleep quality in patients on maintenance hemodialysis and peritoneal dialysis. Int J Prev Med. 2013;4(2):165-72.
18. Lindner AV, Novak M, Bohra M, Mucsi I. Insomnia in Patients With Chronic Kidney Disease. Semin Nephrol. 2015;35(4):359-72.
19. Yaffe K, Falvey CM, Hoang T. Connections between sleep and cognition in older adults. Lancet Neurol. 2014;13(10):1017-28.
20. Doan KVD, Nguyen HTM, Nguyen NTH, Dang KC, Yang SH, Duong TV. Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study. Int J Environ Res Public Health. 2020;17(18).
