TY - JOUR
T1 - Physical intradialytic patient-reported outcome measures in haemodialysis and haemodiafiltration
T2 - A cross-over study
AU - Wijngaarden, Gertrude
AU - Rootjes, Paul A.
AU - Nubé, Menso J.
AU - de Roij van Zuijdewijn, Camiel L. M.
AU - Grooteman, Muriel P. C.
N1 - Funding Information: We are grateful to all patients who participated in this study. We would like to thank the medical and nursing staff of the dialysis centers Niercentrum aan de Amstel, Amstelveen, The Netherlands, St. Antonius hospital, Nieuwegein, Amsterdam UMC, location VU University medical center, Amsterdam, The Netherlands for support and participation. Publisher Copyright: © 2023 The Authors. Nephrology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Nephrology.
PY - 2023/5
Y1 - 2023/5
N2 - Aim: Standard haemodialysis (sHD) is associated with a poor survival and marked adverse intradialytic patient-reported outcome measures (ID-PROMs). Whereas physical ID-PROMs (PID-PROMs) are alleviated by cool dialysate (cHD), survival is prolonged by haemodiafiltration (HDF). So far, PID-PROMs are not prospectively compared between HD and HDF. Methods: To assess whether PID-PROMs and thermal perception differ between sHD, cHD, low volume HDF (lvHDF) and high volume HDF (hvHDF), 40 patients were cross-over randomized to each modality for 2 weeks. Dialysate temperature (T d) was 36.5°C, except in cHD (T d 35.5°C). Target convection volumes were 15 L in lvHDF and ≥ 23 L in hvHDF. PID-PROMs were evaluated with a modified Dialysis Symptom Index (mDSI) and thermal perception with the Visual Analogue Scale Thermal Perception (VAS-TP). T b and room temperature were measured as well. Results: Except for the item ‘feeling cold’ during cHD (p =.01), PID-PROMs did not differ between modalities, but varied markedly between patients (11/13 items, p <.05). T b increased in sHD, lvHDF, and hvHDF (+0.30, 0.35, 0.38°C, respectively, all p <.0005), but remained stable in cHD (+0.04°C, p =.43). Thermal perception remained unaltered in sHD and both HDF modalities, but shifted towards cold in cHD (p =.007). Conclusion: (1) PID-PROMs did not differ between modalities, but varied markedly between patients. Hence, PID-PROMs are largely patient-dependent. (2) While T b increased in sHD, lvHDF and hvHDF, thermal perception did not change. Yet, whereas T b remained unaltered in cHD, cold perception emerged. Hence, as for bothersome cold sensations, cHD should be avoided in perceptive individuals.
AB - Aim: Standard haemodialysis (sHD) is associated with a poor survival and marked adverse intradialytic patient-reported outcome measures (ID-PROMs). Whereas physical ID-PROMs (PID-PROMs) are alleviated by cool dialysate (cHD), survival is prolonged by haemodiafiltration (HDF). So far, PID-PROMs are not prospectively compared between HD and HDF. Methods: To assess whether PID-PROMs and thermal perception differ between sHD, cHD, low volume HDF (lvHDF) and high volume HDF (hvHDF), 40 patients were cross-over randomized to each modality for 2 weeks. Dialysate temperature (T d) was 36.5°C, except in cHD (T d 35.5°C). Target convection volumes were 15 L in lvHDF and ≥ 23 L in hvHDF. PID-PROMs were evaluated with a modified Dialysis Symptom Index (mDSI) and thermal perception with the Visual Analogue Scale Thermal Perception (VAS-TP). T b and room temperature were measured as well. Results: Except for the item ‘feeling cold’ during cHD (p =.01), PID-PROMs did not differ between modalities, but varied markedly between patients (11/13 items, p <.05). T b increased in sHD, lvHDF, and hvHDF (+0.30, 0.35, 0.38°C, respectively, all p <.0005), but remained stable in cHD (+0.04°C, p =.43). Thermal perception remained unaltered in sHD and both HDF modalities, but shifted towards cold in cHD (p =.007). Conclusion: (1) PID-PROMs did not differ between modalities, but varied markedly between patients. Hence, PID-PROMs are largely patient-dependent. (2) While T b increased in sHD, lvHDF and hvHDF, thermal perception did not change. Yet, whereas T b remained unaltered in cHD, cold perception emerged. Hence, as for bothersome cold sensations, cHD should be avoided in perceptive individuals.
KW - body temperature
KW - haemodiafiltration
KW - haemodialysis
KW - physical intradialytic patient- reported outcome measures
KW - thermal perception
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85150771189&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36861385
UR - http://www.scopus.com/inward/record.url?scp=85150771189&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/nep.14154
DO - https://doi.org/10.1111/nep.14154
M3 - Article
C2 - 36861385
SN - 1320-5358
VL - 28
SP - 261
EP - 271
JO - Nephrology (Carlton, Vic.)
JF - Nephrology (Carlton, Vic.)
IS - 5
ER -