SUN-242 QUALITY OF LIFE ON NOCTURNAL HAEMODIALYSIS VS QUALITY OF LIFE ON DIURNAL HAEMODIALYSIS

Abstract

End stage renal disease (ESRD) occurs once 90 % of the kidney function is lost. Patients with ESRD must either undergo medical treatments, like haemodialysis, that substitute the function of the kidney, or they must have a kidney transplant. In the 1970s, haemodialysis treatment took 8 to 12 hours, three times per week. As technology advanced, dialyzers were able to handle more dialysate and higher blood flow rates hence treatment times were shortened to between three and five hours per treatment which has remained the norm until present day. One clinic in Tassin, France remained on the longer dialysis program and noticed advantages for patients who were on extended dialysis times. The main aim of this study was to determine if nocturnal dialysis resulted in improved dialysis clearance, better overall patient health and a better quality of life. The primary objective of this study was to compare the clearance of small molecules and large retention products and the secondary objective was to compare the quality of life and survival of patients on both nocturnal and daytime dialysis. Thirty patients with End Stage Renal Disease (ESRD) presenting to the dialysis centre for treatment, who met the inclusion criteria, were recruited to participate in this study. Blood samples were taken for each participant at a baseline, 3 month and 6 month interval. The Kidney Disease Quality of Life Survey Questionnaire (KDQOL: SF-36TM) was also given to each participant to complete. This survey consisted of three parts: 1) Physical Component Summary 2) Mental Component Summary and 3) Burden of Kidney Disease. This survey helped to predict the quality of life of the patients in each group. In this study, non-significant effects of treatment were found for all small solutes individually. This study showed that there was a statistically significant increase in both dialysis adequacy and the clearance of large molecules (Parathyroid Hormone and Beta-2-Microglobulin) in the nocturnal haemodialysis group. The results of the KDQOL: SF-36 survey showed that the nocturnal dialysis patients scored higher in both the Physical Component Summary and the Mental Component Summary which means that they felt they were in better physical and mental health. The survey also showed that the nocturnal dialysis patients felt the burden of kidney disease less than those patients dialyzing during the day. Although non-significant effects of treatment were found for all small solutes individually, dialysis adequacy as defined by Kt/V, increased in the nocturnal group while it levelled off in the diurnal group.