Analysis Of The Achieved Quality Of Life In Patients With End-Stage Ckd Undergoing Online Hemodiafiltration

Abstract

Online hemodiafiltration (OL-HDF), as a renal replacement therapy, has gained significant momentum in recent years due to the added benefit of increased clearance of middle molecules responsible for organ damage and the development of complications in patients with end-stage CKD (ESRD). The beneficial effect of OL-HDF on mortality from a variety of causes, as well as cardiovascular mortality and morbidity, has been reported by some clinical trials. Health-related quality of life (HRQOL) is an important component of care for hemodialysis patients and is of interest to both healthcare providers and patients. Improved quality of life in hemodialysis patients has been associated with a reduced rate of hospitalizations, morbidity and mortality, as well as higher self-esteem, well-being, and psychological comfort. Data on HRQOL in ESRD patients under OL-HDF are scarce and of negligible quality. In the Clinic of Nephrology and Dialysis at the St. Marina University Hospital, Varna, we performed a comparative analysis on 41 patients with HD with an average age of 58.6 ± 12 years (36–70), divided into two groups: Group 1—undergoing conventional HD, and Group 2—undergoing online HDF for a period of 6 months. The main research method is based on a standardized questionnaire on quality of life in kidney disease (KDQOL-SF36), containing 36 elements for assessing eight health concepts of HRQOL, as well as statistics on hospitalizations, morbidity and mortality in patients. The study shows that the use of OL-HDF is associated with a better quality of life related to health in both dimensions: the scale of the physical component and the scale of mental components. There is a reduction in the number of annual hospitalizations, a lower incidence of cardiovascular events, improvement in hypertension, chronic joint pain and stiffness, itching, and improved nutritional status and response to erythropoietin therapy.