Intensive Hemodialysis and Health-Related Quality of Life

Michael Kraus, Richard J. Fluck, Eric D. Weinhandl, Sheru Kansal, Michael Copland, Paul Komenda, Fredric O. Finkelstein

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Diminished health-related quality of life (HRQoL) is common in dialysis patients and associated with increased risks for morbidity and mortality. Patients may present limitations in both physical and mental HRQoL. Poor physical HRQoL may be defined by limited physical function, role limitations due to physical health, dissatisfaction with physical ability, and impaired mobility. Sleep disorders such as obstructive sleep apnea, restless legs, and fatigue are typical manifestations of poor physical HRQoL in dialysis patients. Poor mental HRQoL may be defined by depressive thinking, lack of positive affect, anxiety, and feelings of social isolation. The prevalence of depression is high in dialysis patients. Intensive hemodialysis (HD) can positively address HRQoL. In 3 randomized clinical trials, relative to conventional HD, intensive HD increased physical and mental component summary scores from the 36-Item Short-Form Health Survey (SF-36), although individual treatment effects of daily nocturnal HD were not statistically significant. In another large prospective study, initiation of short daily HD therapy was followed after 12 months by improvements in all SF-36 domains, sleep quality, and restless legs symptoms. In a small study of nocturnal HD, apnea and hypopnea episodes per hour decreased by almost 70% after conversion from conventional HD. Intensive HD is also associated with a large reduction in postdialysis recovery time. In contrast, 2 randomized clinical trials failed to demonstrate statistically significant effects of intensive HD on the Beck Depression Inventory score despite a significant decrease in Beck Depression Inventory score in the prospective study of short daily HD. Furthermore, intensive HD may not improve objective physical performance and can increase burden on caregivers in the home setting. In conclusion, intensive HD potentially can address both physical and mental aspects of poor HRQoL relative to conventional HD. However, more studies are needed to understand the effects of intensive HD, including specific schedules, on HRQoL.

Original languageEnglish (US)
Pages (from-to)S33-S42
JournalAmerican Journal of Kidney Diseases
Volume68
Issue number5
DOIs
StatePublished - Nov 1 2016

Fingerprint

Renal Dialysis
Quality of Life
Restless Legs Syndrome
Dialysis
Depression
Mental Health
Randomized Controlled Trials
Prospective Studies
Equipment and Supplies
Social Isolation
Aptitude
Obstructive Sleep Apnea
Apnea
Health Surveys
Caregivers
Fatigue
Appointments and Schedules
Sleep
Emotions
Anxiety

Keywords

  • Caregiver
  • chronic kidney disease
  • daily dialysis
  • depression
  • end stage renal disease (ESRD)
  • fatigue
  • Frequent Hemodialysis Network
  • home dialysis
  • intensive hemodialysis
  • nocturnal hemodialysis
  • quality of life
  • restless legs syndrome
  • review
  • short daily hemodialysis
  • sleep apnea

ASJC Scopus subject areas

  • Nephrology

Cite this

Kraus, M., Fluck, R. J., Weinhandl, E. D., Kansal, S., Copland, M., Komenda, P., & Finkelstein, F. O. (2016). Intensive Hemodialysis and Health-Related Quality of Life. American Journal of Kidney Diseases, 68(5), S33-S42. https://doi.org/10.1053/j.ajkd.2016.05.023

Intensive Hemodialysis and Health-Related Quality of Life. / Kraus, Michael; Fluck, Richard J.; Weinhandl, Eric D.; Kansal, Sheru; Copland, Michael; Komenda, Paul; Finkelstein, Fredric O.

In: American Journal of Kidney Diseases, Vol. 68, No. 5, 01.11.2016, p. S33-S42.

Research output: Contribution to journalArticle

Kraus, M, Fluck, RJ, Weinhandl, ED, Kansal, S, Copland, M, Komenda, P & Finkelstein, FO 2016, 'Intensive Hemodialysis and Health-Related Quality of Life', American Journal of Kidney Diseases, vol. 68, no. 5, pp. S33-S42. https://doi.org/10.1053/j.ajkd.2016.05.023
Kraus M, Fluck RJ, Weinhandl ED, Kansal S, Copland M, Komenda P et al. Intensive Hemodialysis and Health-Related Quality of Life. American Journal of Kidney Diseases. 2016 Nov 1;68(5):S33-S42. https://doi.org/10.1053/j.ajkd.2016.05.023
Kraus, Michael ; Fluck, Richard J. ; Weinhandl, Eric D. ; Kansal, Sheru ; Copland, Michael ; Komenda, Paul ; Finkelstein, Fredric O. / Intensive Hemodialysis and Health-Related Quality of Life. In: American Journal of Kidney Diseases. 2016 ; Vol. 68, No. 5. pp. S33-S42.
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