title: At-home short daily hemodialysis improves the long-term health-related quality of life.
abstract: Patients with chronic kidney disease treated by in-center conventional hemodialysis (3 times per week) have significant impairments in health-related quality of life measures, which have been associated with increased morbidity and mortality. FREEDOM is an ongoing prospective cohort study measuring the potential benefits of at-home short daily (6 times per week) hemodialysis. In this interim report we examine the long-term effect of short daily hemodialysis on health-related quality of life, as measured by the SF-36 health survey. This was administered at baseline, 4 and 12 months after initiation of short daily hemodialysis to 291 participants (total cohort), of which 154 completed the 12-month follow-up (as-treated cohort). At the time of analysis, the mean age was 53 years, 66% were men, 58% had an AV fistula, 90% transitioned from in-center hemodialysis, and 45% had diabetes mellitus. In the total cohort analysis, both the physical- and mental-component summary scores improved over the 12-month period, as did all 8 individual domains of the SF-36. The as-treated cohort analysis showed similar improvements with the exception of the role-emotional domain. Significantly, in the as-treated cohort, the percentage of patients achieving a physical-component summary score at least equivalent to the general population more than doubled. Hence, at-home short daily hemodialysis is associated with long-term improvements in various physical and mental health-related quality of life measures.
authors.affiliation: Yale University School of Medicine, New Haven, CT, USA. fof@comcast.net
authors.forename: Fredric O
authors.initials: FO
authors.lastname: Finkelstein
authors.forename: Brigitte
authors.initials: B
authors.lastname: Schiller
authors.forename: Rachid
authors.initials: R
authors.lastname: Daoui
authors.forename: Todd W
authors.initials: TW
authors.lastname: Gehr
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kraus
authors.forename: Janice
authors.initials: J
authors.lastname: Lea
authors.forename: Yoojin
authors.initials: Y
authors.lastname: Lee
authors.forename: Brent W
authors.initials: BW
authors.lastname: Miller
authors.forename: Marvin
authors.initials: M
authors.lastname: Sinsakul
authors.forename: Bertrand L
authors.initials: BL
authors.lastname: Jaber
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical; D016009:Chi-Square Distribution; D015897:Comorbidity; D004644:Emotions; D005260:Female; D006304:Health Status; D006437:Hemodialysis, Home / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology