Time to recovery from haemodialysis : location, intensity and beyond

Jayanti, Anuradha; Foden, Philip; Morris, Julie; Brenchley, Paul; Mitra, Sandip

doi:10.1111/nep.12692

Cited by 15 publications

(20 citation statements)

References 17 publications

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“…This finding is in disagreement with that of previous studies that have demonstrated a significant association between a longer recovery time and the female sex [4][5]9].…”

Section: Discussioncontrasting

confidence: 57%

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Recovery Time after Hemodialysis Is Inversely Associated with the Ultrafiltration Rate

Bossola¹,

Stasio

Monteburini³

et al. 2018

Blood Purif

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Introduction: The present study aimed to determine the variables that are associated with a longer dialysis recovery time (DRT) and to define the relationship that exists between DRT and the ultrafiltration rate (UFR) in prevalent chronic hemodialysis (CHD) patients. Methods: We studied 210 prevalent CHD of 5 hemodialysis units in Central Italy. Patients were invited to answer to the question: “How long does it take you to recover from a dialysis session?” Answers to this question were subsequently converted into minutes. Demographic, clinical and laboratory parameters were recorded for each patient as well as the UFR (mL/kg/h), the dialysate sodium concentration and temperature. Results: Median DRT was 180 min (60–420). Ninety five (45%) patients had a DRT ≥ the median value. Mean UFR was 9.2 ± 3.0 mL/kg/h. Patients with a lower DRT had a less prevalent disability in the instrumental activities daily living, had a higher UFR, and a lower dialysate temperature, as compared with subjects with higher DRT. According to the logistic regression model, UFR was associated with a DRT below the median (i.e., 180) in the unadjusted model (OR 1.12; 95% CI 1.02–1.23; p = 0.019), after adjusting for age and sex (OR 1.11; 95% CI 1.01–1.22; p = 0.025), and in the fully adjusted model (OR 1.11; 95% CI 1.04–1.22; p = 0.040). UFR increase was associated with increasing probability of DRT below the median (p for trend = 0.035). The highest tertile of DRT was associated with UFR below the mean value (i.e., 9.2 mL/kg/h) in multinomial logistic regression having the lowest DRT tertile as reference. DRT was significantly lower in patients with UFR > 13 mL/kg/h than in patients with UFR 10–13 or < 10 mL/kg/h. Conclusion: DRT is inversely associated with UFR in CHD patients. Whether a high UFR should be recommended to reduce the DRT needs to be elucidated through an adequate prospective randomized study.

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“…This finding is in disagreement with that of previous studies that have demonstrated a significant association between a longer recovery time and the female sex [4][5]9].…”

Section: Discussioncontrasting

confidence: 57%

“…Little is known about the determinants of recovery time [5][6][7]. Recently, we have demonstrated that recovery time is significantly associated with post-dialysis fatigue and that the severity of post-dialysis fatigue was negatively and weakly associated with the ultrafiltration rate (UFR) [8].…”

Section: Introductionmentioning

confidence: 99%

Recovery Time after Hemodialysis Is Inversely Associated with the Ultrafiltration Rate

Bossola¹,

Stasio

Monteburini³

et al. 2018

Blood Purif

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“…Modalities such as frequent HD and hemodiafiltration (HDF) can achieve a high adequacy and more fluid removal while maintaining hemodynamic stability, which may lead to better DRT (5,(12)(13)(14). The Frequent Hemodialysis Network (FHN) trial and observational studies have demonstrated frequent HD leads to lower DRT compared to thrice weekly HD (5,12).…”

Section: Discussionmentioning

confidence: 99%

“…DRT has been shown to be a reliable and valid marker of health-related quality of life (HRQOL) (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Prior studies indicated that >65% of prevalent HD patients report DRT ≥2 hours (9,15).…”

Section: Introductionmentioning

confidence: 99%

Impacts of Dialysis Adequacy and Intradialytic Hypotension on Changes in Dialysis Recovery Time

Guedes

Pécoits-Filho

Leme

et al. 2020

Preprint

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Background: Patient reported long dialysis recovery time (DRT) is common and associated with higher hospitalization and mortality. The goal of our study was to test the hypothesis that hemodialysis (HD) dose and intradialytic hypotension (IDH) rates are associated with dialysis recovery time (DRT). Methods: We analyzed data from adult HD patients who responded to DRT survey ≤180 days from first date of dialysis (FDD) during 2014 to 2017. DRT survey was administered with annual KDQOL survey. DRT survey asks: “How long does it take you to be able to return to your normal activities after your dialysis treatment?” Answers are: <0.5, 0.5-to-1, 1-to-2, 2-to-4, or >4 hours. An adjusted logistic regression model computed odds ratio for increased/maintained longer DRT (increase above DRT >2 hours) in reference to decreased/maintained shorter DRT (decrease below DRT <2 hours, or from DRT >4 hours). Changes in DRT were calculated from incident (≤180 days FDD) to first prevalent (>365-to-≤545 days FDD) and second prevalent (>730-to-≤910 days FDD) years. Results: Among 98616 incident HD patients (age 62.6±14.4 years, 57.8% male) who responded to DRT survey, a higher spKt/V in the incident period was associated with 13.5% (OR=0.865; 95%CI 0.801-to-0.935) lower risk of longer DRT in the first-prevalent year. A higher number of HD treatments with IDH episodes/month in the incident period was associated with a 0.8% (OR=1.008; 95%CI 1.001-to-1.015) and 1.6% (OR=1.016; 95%CI 1.006-to-1.027) higher probability of a longer DRT in the first- and second-prevalent years, respectively. Consistently, an increased in incidence of IDH episodes/months was associated to longer DRT over time. Conclusions: Incident patients who had higher spKt/V and less sessions with IDH episodes had a lower likelihood of longer DRT in first year of HD. Dose optimization strategies with cardiac stability in fluid removal should be tested.

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“…The patient-reported experience on both LDNHD and SDHD has been positive in terms of physical, psychological and lifestyle aspects [68]. There is also an associated faster recovery time with home haemodialysis [69]. Once again, it is fair to say once again that the jury is still with regard to whether these treatments truly impact on quality of life.…”

Section: Quality-of-life Measures and Carer Burdenmentioning

confidence: 99%

Home Haemodialysis and Haemodiafiltration

Mitra

Kharbanda

2016

Advances in Hemodiafiltration

Self Cite

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There has been a resurgence in home haemodialysis over the last decade and interest in online haemodiafiltration in gaining momentum with advances in technology and the results of recent clinical trials. "oth increasing haemodialysis frequency and treatment time have a number of potential benefits in improving dialysis efficiency and are ideally placed in the home setting. This chapter describes the rationale behind dialysis treatments, which go beyond conventional haemodialysis CHD and future avenues for home dialysis, which may involve combining convective therapy with more frequent treatment.

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Time to recovery from haemodialysis : location, intensity and beyond

Abstract: Home-based HD and higher residual urine volumes are significantly associated with shorter RT. This home advantage for RT may be sustained by preserving residual renal function (in early stages) and increasing HD intensity (in later stages) of dialysis therapy.

Cited by 15 publications

References 17 publications

Recovery Time after Hemodialysis Is Inversely Associated with the Ultrafiltration Rate

Recovery Time after Hemodialysis Is Inversely Associated with the Ultrafiltration Rate

Impacts of Dialysis Adequacy and Intradialytic Hypotension on Changes in Dialysis Recovery Time

Home Haemodialysis and Haemodiafiltration

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