Effects of Daily Home Hemodialysis on Circulation, Mental Functions, and Quality of Life
This study was designed to discover mechanisms responsible for the decrease in (high) blood pressure after starting daily hemodialysis, as has been observed by various investigators. We hypothesized that better control of body water and sodium content and a decline in the autonomic (sympathetic) nervous system activity, increased in chronic renal failure patients, would contribute to improved blood pressure regulation.
Moreover, we studied the effects of daily hemodialysis on mental functions, like information processing and memory, in relation to the previously reported improvement in quality of life, and the effects on nutrition. We hypothesized that all would improve.
|Study Design:||Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Study Into the Effects of Daily Home Hemodialysis on Hemodynamics, Neurocognitive Functions, and Quality of Life|
- Blood pressure at 6 months
- Cardiac output at 6 months
- Extracellular fluid volume at 6 months
- Plasma renin activity at 6 months
- Muscle sympathetic nerve activity (MSNA) at 6 months
- Electroencephalogram (EEG) at 6 months
- Neurocognitive functioning at 6 months
- Quality of life at 6 months
- Nutritional status at 6 months
|Study Start Date:||April 1999|
|Estimated Study Completion Date:||January 2002|
Although conventional hemodialysis has faced many technical improvements in recent years, a great deal of end-stage renal disease patients, treated with this modality, have suboptimal or high blood pressure, and suffer poor quality of life. Daily hemodialysis has been reported to improve both, but the pathophysiological background is poorly understood.
Patients were studied before and after 6 months of daily (i.e.6 times a week) home hemodialysis, and again after two months of conventional (i.e. thrice weekly) hemodialysis.
We measured the effects of daily dialysis (compared with conventional dialysis) on blood pressure, cardiac output, extracellular fluid volume, plasma renin activity, sympathetic nervous system activity (through MSNA), the electroencephalogram (EEG), neurocognitive functioning (speed of information processing, memory, executive functioning, and attention), quality of life, and nutritional status
|UMC Utrecht, Department of Nephrology & Hypertension|
|Utrecht, Netherlands, 3584 CX|
|Principal Investigator:||Pieter F Vos, MD||UMC Utrecht, Department of Nephrology & Hypertension|