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  1. Daily home haemodialysis in The Netherlands : effects on metabolic control, haemodynamics, and quality of life.

    Article - En anglais

    Background

    More frequent dialysis has been claimed to improve clinical outcome and quality of life.

    Methods

    Clinical status was optimized in 13 haemodialysis patients during a run-in period of 2 2 months with three dialysis sessions a week.

    Thereafter, daily home haemodialysis (DHHD, 6 sessions per week) was initiated.

    The total weekly dialysis dose (Kt/V) was kept constant.

    Results

    Weekly Kt/V was 3.2±0.13 (M±SEM) before, and 3.2±0.15 after 6 months of DHHD (NS), time-averaged concentration of urea (TACu) was 21.2±1.6 mmol/l and 20.1±0.9 mmol/l (NS).

    Urea reduction was 0.56±0.05 before DHHD, and 0.41±0.06 during DHHD (P<0.0001).

    Serum K remained unchanged, but significantly less exchange resins were used (P<0.02).

    Also, the dose of phosphate-binding agents could be decreased.

    Values for Na, K, Cl, bicarbonate, Ca, PTH, albumin, and Hb remained unchanged.

    Iron deficiency developed in some patients

    Twenty-four-hour blood pressure monitoring showed a decrease of systolic blood pressure (141. 1 ± 17.2 mmHg before, and 130.9 ± 19.2 mmHg during DHHD, P<0.001).

    Diastolic blood pressure remained constant (82.8±7.2 and 76.9±10.1 mmHg, NS).

    Mean arterial pressure decreased from 102.2± 9.5 to 94.9±1.4 mmHg (P<0.02).

    Blood pressure decreased mainly in previously hypertensive patients.

    Mean target weight increased 0.8 kg.

    The amount of antihypertensive drugs used decreased from 1.88±0.35 to 0.75±0.17 (P<0.005, n=7). (...)

    Mots-clés Pascal : Insuffisance rénale, Chronique, Hémodialyse, A domicile, Quotidien, Métabolisme, Hémodynamique, Qualité vie, Pays Bas, Europe, Traitement, Technique, Homme, Appareil urinaire pathologie, Rein pathologie, Epuration extrarénale

    Mots-clés Pascal anglais : Renal failure, Chronic, Hemodialysis, At home, Daily, Metabolism, Hemodynamics, Quality of life, Netherlands, Europe, Treatment, Technique, Human, Urinary system disease, Kidney disease, Extrarenal dialysis

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0044214

    Code Inist : 002B27B03. Création : 31/05/1999.