Long-Term In-Center Nocturnal Hemodialysis Improves Renal Anemia and Malnutrition and Life Quality of Older Patients with Chronic Renal Failure

Abstract

Background Older patients with chronic renal failure (CRF) which currently is referred to as end-stage renal disease (ESRD) are associated with higher mortality. In-center nocturnal dialysis (INHD) is a new blood purification model, which is characterized by longer sessions and nighttime administration. However, no data for the efficacy of INHD in older patients with ESRD are available. This study is to analyze the effect of INHD in the treatment of older patients with ESRD. Methods A retrospective, observational study was conducted in a university teaching hospital. Seventy-two patients with ESRD receiving INHD were enrolled. They were divided into the older ESRD patients (age ≥60) group (n = 22) and the non-older ESRD patients (age <60) group (n = 50). The causes of older ESRD patients and non-older ESRD patients receiving INHD were analyzed. Differences of laboratory test indicators of older patients with ESRD before INHD and after INHD were compared. Quality of life for older ESRD patients receiving INHD was assessed by using the Kidney Disease Quality of Life-36 Instrument (KDQOL-36). Results Serum concentration of hemoglobin and serum concentration of albumin of older patients with ESRD increased significantly after INHD ( p < 0.05). There were similar results in the non-older cohort ( p ≤ 0.05). Scores of five KDQOL-36 subscales increased significantly after INHD ( p ≤ 0.001) indicated that the quality of life for old patients with ESRD was significantly improved after INHD. Conclusion INHD is an effective blood purification therapy that can improve the condition of renal anemia, and it may provide a potential positive impact in the malnutrition of older and non-older patients with ESRD. INHD can improve the quality of life of older patients with ESRD. The results will provide a basis for formulating new policies of blood purification therapy for older patients.

The quality of life of hemodialysis patients in Yogyakarta, Indonesia

“…The previous research mentioned that hemodialysis patients experienced mild anemia in 45% of cases, moderate anemia in 25%, and severe anemia in 8% (Senduk et al, 2016). Anemia can also impact the quality of life of hemodialysis patients; therefore, proper management of anemia can improve the quality-of-life scores of hemodialysis patients (Gong et al, 2022).…”

The NightLife study — the clinical and cost-effectiveness of thrice-weekly, extended, in-centre nocturnal haemodialysis versus daytime haemodialysis using a mixed methods approach: study protocol for a randomised controlled trial

“…This increases the total weekly dialysis time to 18 to 24 h, a substantial increase compared to the typical 12 h of daytime in-centre haemodialysis, without impinging on dialysis-free time during the day. There is a growing body of evidence from observational data demonstrating that INHD is associated with improvements in HRQoL [ 17 – 20 ], dialysis adequacy [ 20 – 22 ], surrogates for cardiovascular health [ 23 ], survival [ 21 , 24 ] and clinical parameters (e.g. anaemia and markers of renal bone disease) [ 17 , 21 – 25 ].…”

“…There is a growing body of evidence from observational data demonstrating that INHD is associated with improvements in HRQoL [ 17 – 20 ], dialysis adequacy [ 20 – 22 ], surrogates for cardiovascular health [ 23 ], survival [ 21 , 24 ] and clinical parameters (e.g. anaemia and markers of renal bone disease) [ 17 , 21 – 25 ]. It is probable that the reason for these observed benefits are due to both the increased dialysis dose and the overnight scheduling, which essentially increases the amount of usable dialysis-free time in comparison to usual in-centre daytime haemodialysis [ 26 ].…”