title: Quality of life of hemodialysis patients in Central and Southern Italy: cross-sectional comparison between Hemodiafiltration with endogenous reinfusion (HFR) and Bicarbonate Hemodialysis.
abstract: BACKGROUND
  in hemodialysis (HD) patients, poor health-related quality of life (HR-QoL) is prevalent and associated with adverse outcomes. HR-QoL is strictly linked to nutritional status of HD patients. Hemodiafiltration with endogenous reinfusion (HFR) is an alternative dialysis technique that combines diffusion, convection and absorption. It reduces burden of inflammation and malnutrition and this effect may cause beneficial effect on HR-QoL. However no data on HR-QoL in HFR is currently available.
  
  
  METHODS
  we designed a cross-sectional multicentre study in order to compare the HR-QoL in patients treated with HFR versus Bicarbonate HD (BHD). We enrolled adult patients HFR treated for at least 6 months, with life expectancy greater than six months and without overt cognitive deficit. The recruited patients in HFR were matched for age, gender, dialytic vintage and performance in activities of daily living (Barthel index) with BHD treated patients. SF-36 questionnaire for the assessment of HR-QoL was administered.
  
  
  RESULTS
  one hundred fourteen patients (57 HFR vs 57 BHD) were enrolled (age 65.413.5 years; dialysis vintage 5.4 (3.3-10.3) years; 53% males) from 18 dialysis non-profit centres in central and southern Italy. As result of matching, no difference in age, gender, dialytic age and Barthel index was found between HFR and BHD patients. In HFR patients we observed better values of physical component score (PCS) of SF-36 than BHD patients (P=0.048), whereas no significant difference emerged in the mental component score (P=0.698). In particular HFR patients were associated with higher Physical Functioning (P=0.045) and Role Physical (P=0.027).
  
  
  CONCLUSIONS
  HFR is associated with better physical component of HR-QoL than BHD, independently of age, gender, dialysis vintage and invalidity score. Whether these findings translate into a survival benefit must be investigated by longitudinal studies.
authors.forename: Silvio
authors.initials: S
authors.lastname: Borrelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Minutolo
authors.forename: Luca
authors.initials: L
authors.lastname: De Nicola
authors.forename: Walter
authors.initials: W
authors.lastname: De Simone
authors.forename: Emanuele
authors.initials: E
authors.lastname: De Simone
authors.forename: Bruno
authors.initials: B
authors.lastname: Zito
authors.forename: Biagio Raffaele
authors.initials: BR
authors.lastname: Di Iorio
authors.forename: Lucia
authors.initials: L
authors.lastname: Di Micco
authors.forename: Luigi
authors.initials: L
authors.lastname: Leone
authors.forename: Antonio
authors.initials: A
authors.lastname: Bassi
authors.forename: Angelo
authors.initials: A
authors.lastname: Romano
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Porcu
authors.forename: Riziero
authors.initials: R
authors.lastname: Fini
authors.forename: Edward
authors.initials: E
authors.lastname: Vezza
authors.forename: Caterina
authors.initials: C
authors.lastname: Saviano
authors.forename: Ludovica
authors.initials: L
authors.lastname: D'Apice
authors.forename: Roberto
authors.initials: R
authors.lastname: Simonelli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bellizzi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Palladino
authors.forename: Olga
authors.initials: O
authors.lastname: Credendino
authors.forename: Raffaele
authors.initials: R
authors.lastname: Genualdo
authors.forename: Maria
authors.initials: M
authors.lastname: Capuano
authors.forename: Pasquale
authors.initials: P
authors.lastname: Guastaferro
authors.forename: Filippo
authors.initials: F
authors.lastname: Nigro
authors.forename: Vittorio
authors.initials: V
authors.lastname: Stranges
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Iuianiello
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Russo
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Auricchio
authors.forename: Antonio
authors.initials: A
authors.lastname: Treglia
authors.forename: Patrizia
authors.initials: P
authors.lastname: Palombo
authors.forename: Nunzio
authors.initials: N
authors.lastname: Rifici
authors.forename: Remo
authors.initials: R
authors.lastname: Nacca
authors.forename: Alberto
authors.initials: A
authors.lastname: Caliendo
authors.forename: Stefania
authors.initials: S
authors.lastname: Brancaccio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Conte
mesh_terms: D000368:Aged; D001639:Bicarbonates / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D005260:Female; D017583:Hemodiafiltration / Q000379:methods; D006801:Humans; D007558:Italy; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D011788:Quality of Life; D006435:Renal Dialysis
chemical_list: D001639:Bicarbonates