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Nocturnal hemodialysis does not improve overall measures of quality of life compared to conventional hemodialysis.

Authors
  • Manns, Braden J
  • Walsh, Michael W
  • Culleton, Bruce F
  • Hemmelgarn, Brenda
  • Tonelli, Marcello
  • Schorr, Melissa
  • Klarenbach, Scott
Type
Published Article
Journal
Kidney International
Publisher
Elsevier
Publication Date
Mar 01, 2009
Volume
75
Issue
5
Pages
542–549
Identifiers
DOI: 10.1038/ki.2008.639
PMID: 19109588
Source
Medline
License
Unknown

Abstract

We conducted a randomized controlled trial to compare the quality of life of 52 patients undergoing nocturnal hemodialysis and conventional hemodialysis. Quality of life was measured using a number of established methods including the Kidney Disease Quality of Life Short Form and the preference-based Euroqol EQ-5D questionnaire (whose scores varied from 0 to 1). The primary outcome was a change in the Euroqol EQ-5D index scores between baseline and 6 months. We performed additional analyses comparing change in quality of life from pre-randomization (when patients were unaware of treatment allocation) to 6 months. Other analyses considered the impact of nocturnal hemodialysis on four pre-selected Kidney Disease Quality of Life Short Form domains, and the longer term impact of nocturnal hemodialysis on quality of life. Compared with conventional hemodialysis, nocturnal hemodialysis increased Euroqol-EQ-5D index scores by 0.05, which was not significantly different from baseline. When six-month values were compared with pre-randomization values rather than baseline values, the between group difference was larger (0.12) though it was still not statistically significant (P=.06). Nocturnal hemodialysis was associated with clinically and statistically significant improvements in selected kidney-specific quality of life domains (P=.01 for effects of kidney disease; P=.02 for burden of kidney disease). Our primary quality of life analysis did not demonstrate a statistically significant change between nocturnal hemodialysis and conventional hemodialysis, though statistically significant and clinically important changes in some secondary kidney-disease- specific measures were observed.

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