Abstract

BackgroundHealth-related quality of life (HRQOL) is often prioritized over long-term survival in elderly patients. Although a longer dialysis session length (DSL) has been shown to reduce mortality, its effects on improving the HRQOL are unknown.MethodsUsing data from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS), patients aged ≥ 65 years on maintenance hemodialysis were enrolled. DSL was categorized as short (<210 minutes), medium (210–240 minutes), or long (>240 minutes). The primary outcomes were changes in mental health (ΔMH) and physical functioning (ΔPF) scores assessed using the Japanese version of SF-12, in one year. The differences in the ΔMH and ΔPF among the three groups were assessed via regression (beta) coefficients derived using a linear regression model.ResultsOf 1,187 patients at baseline, 319 (26.9%) had a short length, 686 (57.8%) a medium length, and 182 (15.3%) a long length. We assessed the ΔMH data from 793 patients and the ΔPF data from 738. No significant differences in the ΔMH were noted for the short or long groups compared with the medium group (score difference: 0.26, 95% confidence interval [CI]: -4.17 to 4.69 for short; score difference: -1.15, 95% CI: -6.17 to 3.86 for long). Similarly, no significant differences were noted for these groups versus the medium group in ΔPF either (score difference: -1.43, 95% CI: -6.73 to 3.87 for short; score difference: -1.71, 95% CI: -7.63 to 4.22 for long).ConclusionsA shorter DSL might have no adverse effects on MH or PF for elderly patients.

Highlights

  • The mortality rates of hemodialysis (HD) patients continue to improve gradually, and Japanese HD patients in particular have the lowest mortality rates in the world [1]

  • A shorter dialysis session length (DSL) might have no adverse effects on mental health (MH) or physical functioning (PF) for elderly patients

  • Many previous reports have indicated that a longer dialysis session length is associated with a reduced mortality [4,5,6,7,8,9], dialysis session length in daily clinical practice is shortened in elderly patients for any of several reasons, such as reducing the physical burden

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Summary

Introduction

The mortality rates of hemodialysis (HD) patients continue to improve gradually, and Japanese HD patients in particular have the lowest mortality rates in the world [1]. With these improving mortality rates, the health-related quality of life (HRQOL) is gaining increasing importance as a relevant outcome [2]. Among elderly HD patients, HRQOL is often prioritized over long-term survival. The dialysis session length in elderly patients may be shortened not with respect to mortality but based on other determinants, such as HRQOL, provided the dialysis efficiency was sufficient. Health-related quality of life (HRQOL) is often prioritized over long-term survival in elderly patients. A longer dialysis session length (DSL) has been shown to reduce mortality, its effects on improving the HRQOL are unknown

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