Van Eps Carolyn L, Jeffries Janine K, Johnson David W, Campbell Scott B, Isbel Nicole M, Mudge David W, Hawley Carmel M
Department of Nephrology, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland 4102, Australia.
Hemodial Int. 2010 Jan;14(1):29-38. doi: 10.1111/j.1542-4758.2009.00419.x.
Hemodialysis has been associated with reduced quality of life (QOL). Small cohort studies of quotidian hemodialysis regimens suggest general QOL and dialysis-related symptoms may improve compared with conventional regimens. An observational cohort study was conducted on 63 patients (age 51.7 +/- 12.9 years; 79.4% male; 33.3% diabetes; duration of renal replacement therapy 1.9 [0.7-6.4] years) converted from conventional home hemodialysis (3-5 sessions weekly, 3-6 h/session) to home nocturnal home hemodialysis (NHD) (3-5 sessions weekly, 6-10 h/session). Kidney Disease Quality of Life (KDQOL) and Assessment of Quality of Life instruments and 6-minute-walk tests were applied at baseline and 6 months. Baseline and 6 month surveys were returned by 70% of patients. On KDQOL, significant improvements in general health (P=0.02) and overall health ratings (P=0.0008), physical function (P=0.003), physical role (P=0.018), and energy and fatigue (P=0.027) were documented. There was a trend toward improvement in burden of kidney disease (P=0.05) and emotional role (P=0.066). There was a significant improvement in distance covered in the 6-minute-walk test from 513 m (420.5-576.4) to 536.5 m (459-609), P=0.007. On Assessment of Quality of Life, there was a trend toward improvement in overall utility score from 0.65 (0.39-0.81) to 0.73 (0.46-0.86), P=0.096. After 86.2 patient-years of observation, 23 patients have discontinued NHD (12 transplanted, 5 deceased, 4 psychosocial problems, 1 dialysis access problem, 1 medically unsuitable). Nocturnal home hemodialysis is a sustainable therapy. In addition to improving general QOL, alternate nightly NHD can significantly improve physical functioning as measured by KDQOL and 6-minute-walk tests.
血液透析与生活质量（QOL）下降有关。对每日血液透析方案的小型队列研究表明，与传统方案相比，总体生活质量和与透析相关的症状可能会有所改善。对63例患者（年龄51.7±12.9岁；79.4%为男性；33.3%患有糖尿病；肾脏替代治疗时间为1.9[0.7 - 6.4]年）进行了一项观察性队列研究，这些患者从传统家庭血液透析（每周3 - 5次，每次3 - 6小时）转换为家庭夜间血液透析（NHD）（每周3 - 5次，每次6 - 10小时）。在基线和6个月时应用了肾脏疾病生活质量（KDQOL）和生活质量评估工具以及6分钟步行试验。70%的患者返回了基线和6个月的调查问卷。在KDQOL方面，记录到总体健康状况（P = 0.02）、整体健康评分（P = 0.0008）、身体功能（P = 0.003）、身体角色（P = 0.018）以及精力和疲劳（P = 0.027）有显著改善。肾脏疾病负担（P = 0.05）和情感角色（P = 0.066）有改善趋势。6分钟步行试验中行走的距离从513米（420.5 - 576.4）显著增加到536.5米（459 - 609），P = 0.007。在生活质量评估方面，总体效用评分有从0.65（0.39 - 0.81）提高到0.73（0.46 - 0.86）的趋势，P = 0.096。经过86.2患者年的观察，23例患者停止了NHD（12例接受移植，5例死亡，4例存在心理社会问题，1例存在透析通路问题，1例因医学原因不适合）。夜间家庭血液透析是一种可持续的治疗方法。除了改善总体生活质量外，交替夜间NHD还可通过KDQOL和6分钟步行试验显著改善身体功能。
