MP604INSOMNIA, MUSCULAR CRAMPS AND PRURITUS ARE ABSENT IN HEMODIALYSIS PATIENTS WITH GOOD DIALYSIS EFFICIENCY, LOW INFLAMMATION AND ARTERIOVENOUS FISTULA

Abstract

Introduction and Aims: Insomnia, muscular cramps, pruritus and recovery time after hemodialysis are still controversial quality of life (QoL) parameters in hemodialysis patients. Methods: This was a single center, prospective, transversal and observational study which included 171 end-stage renal disease patients (age: 59.5±15.2 years and dialysis vintage: 89.7±125.6 months). One hundred fifteen patients were on high-flux hemodialysis (HD) and 56 patients were treated with on-line hemodiafiltration (HDF). Patients were asked “How long does it take you to recover from a dialysis session?” and they evaluated the intensity (absent, mild, medium and severe) of insomnia, muscular cramps and pruritus in the past 4 weeks. We studied associations of postdialysis recovery time, insomnia, muscular cramps and pruritus with themselves and age, dialysis vintage, sex, body mass index, hemoglobin, albumin, C-reactive protein (CRP), Daugirdas single-pool Kt/V (Kt/V), ultrafiltration volume, blood processed volume and vascular access type. Results: Absence of insomnia was significantly associated with absence of muscular cramps (p=0.01) and with dialysis on arteriovenous fistula (AVF) (p=0.01). The absence of muscular cramps was associated with the absence of pruritus (p=0.007) and with AVF (p=0.007). Low albumin level was predictive for severe insomnia (p=0.008) and severe pruritus (p=0.04), while CRP was significantly higher in severe vs. absent insomnia (p=0,002). Severe pruritus was associated with significantly lower Kt/V compared to absent pruritus (p=0.01). Conclusions: HD patients with AVF had less insomnia, muscular cramps and pruritus. Inflammation (low albumin and high CRP levels) was associated with severe insomnia and pruritus. Increased dialysis efficiency improved pruritus. Recovery time after HD had no significantly relations with any studied parameter. There was no difference of studied QoL features between HD and HDF patients.