ABSTRACT
Objective To explore the causes of nocturnal hemodialysis (NHD) patient dropout and the risk factors for dropout. Methods We collected the clinical data of patients receiving NHD for more than 3 months, of whom 47 patients dropped out and 64 kept receiving NHD from Feb. 2009 to Nov. 2016 in Changzheng Hospital of Second Military Medical University. We investigated the general conditions; and we compared the differences of the blood parameters between the two groups when the patients received NHD for the first time and for the last time, including hemoglobin, platelet, albumin, ferritin, serum calcium, serum phosphorus and parathyroid hormone. We also analyzed the risk factors for NHD dropout or for death using Cox regression analysis model. Results Among 111 patients, 47 patients had withdrawn from NHD, with their average time for NHD being (31.55±20.30) months, and the causes for dropout included death, transferring to other hospitals, turning to conventional hemodialysis (CHD), renal transplantation and others. Univariate Cox regression analysis showed that hypertensive nephropathy (P=0.007, HR=2.913, 95%CI: 1.348-6.293) and diabetic nephropathy (P=0.047, HR=2.401, 95%CI: 1.014-5.685) were risk factors for NHD patient dropout, while chronic nephritis syndrome (P<0.001, HR=0.095, 95%CI 0.046-0.195) was a protective factor; blood albumin (P=0.007, HR=0.904, 95%CI:0.840-0.973) and age (P=0.027, HR=1.052, 95%CI:1.006-1.101) were risk factors for NHD patient dropout. Multivariate Cox regression analysis showed that albumin level (P=0.007, HR=0.911, 95%CI: 0.848-0.991) was an independent risk factor for death in NHD patients. Conclusion Hypertensive nephropathy and diabetic nephropathy are the risk factors for NHD patients dropout, while chronic nephritis syndrome was a protective factor. Low serum albumin level is an independent risk factor for death in NHD patients.
ABSTRACT
Objective To compare the differences of dialysis complications and tolerability between nocturnal hemodialysis (NHD) and conventional hemodialysis (CHD) patients. Methods Seventy-two NHD and 72 CHD patients from Changzheng Hospital of Second Military Medical University were enrolled in this study. The clinical data were collected and the postdialysis recovery time was recorded. The complications including intradialytic hypotension, postdialytic fatigue, itching, muscle spasms, dizziness, headache, loss of appetite, nausea, vomiting, and sleep disorders, and the mental pressure and daily life (fear of death, worrying about equipment failure, losing freedom, and failing to work) were all investigated using a questionnaire. Results Patients in the NHD group had significantly shortened postdialysis recovery time (P<0.01) and significantly less complications (intradialytic hypotension, postdialytic fatigue, itching, dizziness, headache, loss of appetite, nausea and vomiting) than those in the CHD group (P<0.05, P<0.01). The number of patients who lost freedom significantly was decreased (P<0.01), but the number of patients worrying about equipment failure was significantly increased (P<0.01). Conclusion The NHD patients have less complications associated with hemodialysis than CHD patients, and they also have improved tolerance to maintenance hemodialysis.
ABSTRACT
Objective To compare the differences of dialysis complications and tolerability between nocturnal hemodialysis (NHD) and conventional hemodialysis (CHD) patients.Methods Seventy-two NHD and 72 CHD patients from Changzheng Hospital of Second Military Medical University were enrolled in this study.The clinical data were collected and the postdialysis recovery time was recorded.The complications including intradialytic hypotension,postdialytic fatigue,itching,muscle spasms,dizziness,headache,loss of appetite,nausea,vomiting,and sleep disorders,and the mental pressure and daily life (fear of death,worrying about equipment failure,losing freedom,and failing to work) were all investigated using a questionnaire.Results Patients in the NHD group had significantly shortened postdialysis recovery time (P ＜ 0.01) and significantly less complications (intradialytic hypotension,postdialytic fatigue,itching,dizziness,headache,loss of appetite,nausea and vomiting) than those in the CHD group (P＜0.05,P＜0.01).The number of patients who lost freedom significantly was decreased (P＜0.01),but the number of patients worrying about equipment failure was significantly increased (P＜0.01).Conclusion The NHD patients have less complications associated with hemodialysis than CHD patients,and they also have improved tolerance to maintenance hemodialysis.
ABSTRACT
Objective To explore the causes of nocturnal hemodialysis (NHD) patient dropout and the risk factors for dropout.Methods We collected the clinical data of patients receiving NHD for more than 3 months,of whom 47 patients dropped out and 64 kept receiving NHD from Feb.2009 to Nov.2016 in Changzheng Hospital of Second Military Medical University.We investigated the general conditions;and we compared the differences of the blood parameters between the two groups when the patients received NHD for the first time and for the last time,including hemoglobin,platelet,albumin,ferritin,serum calcium,serum phosphorus and parathyroid hormone.We also analyzed the risk factors for NHD dropout or for death using Cox regression analysis model.Results Among 111 patients,47 patients had withdrawn from NHD,with their average time for NHD being (31.55±20.30) months,and the causes for dropout included death,transferring to other hospitals,turning to conventional hemodialysis (CHD),renal transplantation and others.Univariate Cox regression analysis showed that hypertensive nephropathy (P=0.007,HR=2.913,95％CI:1.348-6.293) and diabetic nephropathy (P=0.047,HR=2.401,95％CI:1.014-5.685) were risk factors for NHD patient dropout,while chronic nephritis syndrome (P＜0.001,HR=0.095,95％CI 0.046-0.195) was a protective factor;blood albumin (P=0.007,HR=0.904,95％CI:0.840-0.973) and age (P=0.027,HR=1.052,95％CI:1.006-1.101) were risk factors for NHD patient dropout.Multivariate Cox regression analysis showed that albumin level (P=0.007,HR=0.911,95％CI:0.848-0.991) was an independent risk factor for death in NHD patients.Conclusion Hypertensive nephropathy and diabetic nephropathy are the risk factors for NHD patients dropout,while chronic nephritis syndrome was a protective factor.Low serum albumin level is an independent risk faetor for death in NHD patients.