Effects of Six versus Three Times per Week Hemodialysis on Physical Performance, Health, and Functioning: Frequent Hemodialysis Network (FHN) Randomized Trials

被引:84
作者
Hall, Yoshio N. [1 ]
Larive, Brett [2 ]
Painter, Patricia [3 ]
Kaysen, George A. [4 ]
Lindsay, Robert M. [5 ,6 ]
Nissenson, Allen R. [7 ]
Unruh, Mark L. [8 ]
Rocco, Michael V. [9 ]
Chertow, Glenn M.
机构
[1] Univ Washington, Kidney Res Inst, Seattle, WA 98108 USA
[2] Cleveland Clin Fdn, Dept Quantitat Hlth Sci, Cleveland, OH 44195 USA
[3] Univ Utah, Sch Phys Therapy, Salt Lake City, UT USA
[4] Univ Calif Davis, Div Nephrol, Davis, CA 95616 USA
[5] Univ Western Ontario, Div Nephrol, London, ON, Canada
[6] London Hlth Sci Ctr, London, ON, Canada
[7] DaVita Inc, Los Angeles, CA USA
[8] Univ Pittsburgh, Renal Electrolyte Div, Pittsburgh, PA USA
[9] Wake Forest Univ, Bowman Gray Sch Med, Nephrol Sect, Winston Salem, NC USA
来源
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2012年 / 7卷 / 05期
基金
美国国家卫生研究院;
关键词
QUALITY-OF-LIFE; STAGE RENAL-DISEASE; NOCTURNAL HOME HEMODIALYSIS; LOWER-EXTREMITY FUNCTION; NUTRITIONAL-STATUS; IMPROVES STRENGTH; BODY-COMPOSITION; MUSCLE ATROPHY; BASE-LINE; TRANSPLANTATION;
D O I
10.2215/CJN.10601011
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background and objectives Relatively little is known about the effects of hemodialysis frequency on the disability of patients with ESRD. Design, setting, participants, & measurements This study examined changes in physical performance and self-reported physical health and functioning among subjects randomized to frequent (six times per week) compared with conventional (three times per week) hemodialysis in both the Frequent Hemodialysis Network daily (n=245) and nocturnal (n=87) trials. The main outcome measures were adjusted change in scores over 12 months on the short physical performance battery (SPPB), RAND 36-item health survey physical health composite (PHC), and physical functioning subscale (PF) based on the intention to treat principle. Results Overall scores for SPPB, PHC, and PF were poor relative to population norms and in line with other studies in ESRD. In the Daily Trial, subjects randomized to frequent compared with conventional in-center hemodialysis experienced no significant change in SPPB (adjusted mean change of -0.20 +/- 0.19 versus -0.41 +/- 0.21, P=0.45) but experienced significant improvement in PHC (3.4 +/- 0.8 versus 0.4 +/- 0.8, P=0.009) and a relatively large change in PF that did not reach statistical significance. In the Nocturnal Trial, there were no significant differences among subjects randomized to frequent compared with conventional hemodialysis in SPPB (adjusted mean change of -0.92 +/- 0.44 versus -0.41 +/- 0.43, P=0.41), PHC (2.7 +/- 1.4 versus 2.1 +/- 1.5, P=0.75), or PF (-3.1 +/- 3.5 versus 1.1 +/- 3.6, P=0.40). Conclusions Frequent in-center hemodialysis compared with conventional in-center hemodialysis improved self-reported physical health and functioning but had no significant effect on objective physical performance. There were no significant effects of frequent nocturnal hemodialysis on the same physical metrics. Clin J Am Soc Nephrol 7: 782-794, 2012. doi: 10.2215/CJN.10601011
引用
收藏
页码:782 / 794
页数:13
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