Key result
Conversion to in-center nocturnal hemodialysis significantly decreased median serum phosphorus levels from 5.9 to 3.7 mg/dl and improved overall quality of life compared to conventional hemodialysis.
Why the study?
Does in-center nocturnal hemodialysis improve laboratory parameters and quality of life in patients not optimally treated on conventional hemodialysis?
Cohort (n=39)
No
Does in-center nocturnal hemodialysis improve laboratory parameters and quality of life in patients not optimally treated on conventional hemodialysis?
Absolute Event Rate: 3.7% vs 5.9%
p-value: p=<0.01
In-center nocturnal hemodialysis improves phosphate control, urea clearance, and quality of life while reducing medication burden in patients unable to perform home hemodialysis.
Nocturnal hemodialysis may improve phosphorus control and QoL in observational cohorts; leaves open confirmation by randomized trials before practice change.
BACKGROUND AND OBJECTIVES: Some patients are not optimally treated by conventional in-center hemodialysis (HD) and are unable to perform home HD. We examined the effect of in-center thrice-weekly nocturnal HD (INHD) on patient outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Patients who were not optimally treated on conventional HD were offered INHD. Thirty-nine patients' laboratory data and medication use were analyzed for the 12 mo before and after conversion to INHD until September 1, 2007. Quality of life on conventional HD and INHD was compared. RESULTS: After conversion to INHD, median values for phosphorus decreased from 5.9 to 3.7 mg/dl (P < 0.01), alkaline phosphatase level increased from 84 to 161 U/L (P < 0.01), and percentage reduction in urea increased from 74 to 89% (P < 0.01). The mean number of antihypertensive drugs prescribed declined from 2.0 to 1.5 (P < 0.05) during the course of INHD, and the mean daily dosage of phosphate binders declined from 6.2 to 4.9 at study end (P < 0.05). There was a significant reduction in erythropoietin-stimulating agent use of 1992 U/wk (P < 0.01). There was no significant change in median hemoglobin, iron saturation, corrected calcium, or parathyroid hormone levels. Overall, quality of life, sleep, intradialytic cramps, appetite, and energy level all improved significantly on INHD. CONCLUSIONS: INHD offers an effective form of HD for long-term dialysis patients who are unable to perform home HD.
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Bugeja et al. (2009) conducted a cohort in Chronic Kidney Disease (n=39). In-center nocturnal hemodialysis vs. Conventional in-center hemodialysis was evaluated on Median serum phosphorus level (mg/dl) (p=<0.01). Conversion to in-center nocturnal hemodialysis significantly decreased median serum phosphorus levels from 5.9 to 3.7 mg/dl and improved overall quality of life compared to conventional hemodialysis.
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