National Centre for Sport and Exercise Medicine, Loughborough, UK.
Blood Purif. 2017;44(4):301-310. doi: 10.1159/000481248. Epub 2017 Oct 31.
Evidence suggests extended-hours haemodialysis (HD) may improve cardiovascular, medical and quality-of-life outcomes. In-centre nocturnal haemodialysis (INHD) is an established but underutilized method of providing extended-hours treatment. This 6-month, non-randomized controlled trial (ISRCTN16672784) recruited 13 INHD patients and 12 control patients on conventional HD. The effects of treatment on left ventricular (LV) structure, function and myocardial fibrosis were assessed using cardiac magnetic resonance imaging and native T1 mapping. Quality-of-life and clinical measures were also collected. INHD led to significant reductions in LV mass (-14.75 vs. +6.54 g; p = 0.02), global T1 (-30.62 vs. 0.4 ms; p = 0.05) and non-septal native T1 values (-30.93 vs. 8.96 ms; p = 0.02) over time. There were also significant improvements in serum phosphate (-0.39 vs. +0.02 mmol/L; p = 0.03) and reductions in ultrafiltration rates (-2.32 vs. +0.70 mL/h/kg p = 0.05) between INHD and controls. Six-months of INHD was associated with favourable LV remodelling and reduced myocardial fibrosis compared to patients on conventional haemodialysis.
证据表明，延长时间血液透析（HD）可能改善心血管、医疗和生活质量结果。中心夜间血液透析（INHD）是一种已确立但未充分利用的提供延长时间治疗的方法。这项为期 6 个月的非随机对照试验（ISRCTN16672784）招募了 13 名 INHD 患者和 12 名接受常规 HD 的对照患者。使用心脏磁共振成像和原生 T1 映射评估治疗对左心室（LV）结构、功能和心肌纤维化的影响。还收集了生活质量和临床措施。INHD 导致 LV 质量（-14.75 与 +6.54 g；p = 0.02）、整体 T1（-30.62 与 0.4 ms；p = 0.05）和非间隔原生 T1 值（-30.93 与 8.96 ms；p = 0.02）随时间的推移显著降低。血清磷酸盐（-0.39 与 +0.02 mmol/L；p = 0.03）也有显著改善，超滤率（-2.32 与 +0.70 mL/h/kg；p = 0.05）在 INHD 和对照组之间降低。与接受常规血液透析的患者相比，6 个月的 INHD 与有利的 LV 重塑和减少心肌纤维化相关。
