title: Can dialysis modality influence quality of life in chronic hemodialysis patients? Low-flux hemodialysis versus high-flux hemodiafiltration: a cross-over study.
abstract: BACKGROUND
  Hemodiafiltration with online preparation of the substitution [online high-flux hemodiafiltration (OHDF)] and hemodiafiltration with prepared bags of substitution (HDF) are important, recently widely used renal replacement therapies in patients with end-stage renal disease. However, there is little information on the comparative impacts of these modalities versus conventional low-flux hemodialysis (HD) on the quality of life (QoL) of HD patients. This study investigates the effect of dialysis modality on QoL in chronic HD patients.
  
  
  METHODS
  In this prospective, randomized, cross-over, open label study, 24 patients were enrolled. Their age were 62 ± 13.34 years (mean ± SD), with the duration of dialysis of 31 ± 23.28 months (mean ± SD). Five of the patients were women. QoL was measured by the Short-Form Health Survey with 36 questions (SF-36) and subscale scores were calculated. Each patient received HD, OHDF, and HDF for 3 months, with the dialysis modality subsequently being altered. They completed the questionnaire of QoL at the end of each period.
  
  
  RESULTS
  There were statistical significant differences in QoL for the total SF-36 [36.1 (26.7-45.7) and 40.7 (30.2-62.8)], for classic low-flux HD and high-flux hemodiafiltration, for bodily pain [45 (26.9-66.9) and 55 (35.6-87.5)], and for role limitations due to emotional functioning [0 (0-33.3) and 33.3 (0-100)], respectively. The scores did not differ significantly between the two types of hemodiafiltration.
  
  
  CONCLUSIONS
  Our study indicates that QoL differs significantly among patients receiving low-flux HD and high-flux hemodiafiltration, on total SF-36, bodily pain, and role limitations due to emotional functioning. Convective modalities may offer better QoL than diffusive HD.
authors.affiliation: Department of Nephrology, Democritus University of Thrace, Alexandroupolis, Greece. polych@med.duth.gr
authors.forename: Konstantia
authors.initials: K
authors.lastname: Kantartzi
authors.forename: Stelios
authors.initials: S
authors.lastname: Panagoutsos
authors.forename: Efthemia
authors.initials: E
authors.lastname: Mourvati
authors.forename: Athanasios
authors.initials: A
authors.lastname: Roumeliotis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Leivaditis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Devetzis
authors.forename: Ploumis
authors.initials: P
authors.lastname: Passadakis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Vargemezis
mesh_terms: D000223:Adaptation, Psychological; D000367:Age Factors; D000368:Aged; D018592:Cross-Over Studies; D005260:Female; D017583:Hemodiafiltration / Q000379:methods / Q000523:psychology; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012016:Reference Values; D006435:Renal Dialysis / Q000379:methods* / Q000523:psychology; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000628:therapy*; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome