A novel study on the quality of life index in canine chronic kidney disease treated with incremental intermittent hemodialysis

Abstract

Background and Aim: In veterinary medicine, health-related quality-of-life index (QOLi) measurements are becoming increasingly important because they are a multifaceted concept that represents not only patients’ physical well-being but also clients’ emotional health. This study assessed QOLi in dogs receiving incremental intermittent hemodialysis (i-IHD) with high- and low-flux dialyzers. Materials and Methods: Thirty dogs diagnosed with chronic kidney disease (CKD) Stage IV were randomly divided into two groups of 15 dogs each. A high-flux dialyzer was used in Group I, whereas a low-flux dialyzer was used in Group II. i-IHD was performed on days 0, 2, 4, 19, and 34, whereas QOLi evaluation was performed on days 0, 15, 30, and 45. Results: Both groups exhibited considerable decreases in post-dialysis creatinine, blood urea nitrogen, and phosphorus levels, while Group I experienced notable reductions in post-dialysis triglyceride and cholesterol levels. Dialysis adequacy did not show any significant difference between the clearance rates of high- and low-flux dialyzers. The QOLi assessment showed better post-dialysis scores in all categories except for water balance in Group I, while Group II demonstrated a worsening trend in scores for mental status, appetite, mobility, general health, and pain. Conclusion: In the first three sessions of i-IHD, dogs with CKD should be treated every other day, and the schedule can be extended by 15 days after that. A high-flux membrane, which effectively decreases triglyceride and cholesterol levels more than a low-flux membrane, warrants consideration for dogs with cardiovascular complications undergoing dialysis. The dialysis-related QOLi aids in clinical decision-making and encourages client engagement. Keywords: chronic kidney disease, dialysis adequacy, incremental intermittent hemodialysis, quality of life index.