Extended hours in-centre nocturnal haemodialysis, a regional Australian perspective.

Abstract

Introduction: There is an increasing need for renal replacement therapy in regional and remote Australia. Research has highlighted the benefits of home based nocturnal haemodialysis compared to conventional haemodialysis. Unfortunately, home based therapies may not be possible due to patient or residential factors. We propose that there are potential benefits of extended hours nocturnal in-centre haemodialysis compared to conventional haemodialysis in a regional Australian population. Aim: To compare quality of life scores for patients whilst on conventional haemodialysis with the subsequent scores on extended hours in-centre nocturnal haemodialysis. Methods: We conducted a prospective longitudinal non-randomised study. Current patients on conventional haemodialysis in Ballarat, Victoria who elected to change to the nocturnal haemodialysis regime independently of this study were consented to participate (n=13). Data was collected pre and post the commencement of extended hours in-centre nocturnal haemodialysis. The primary outcome was quality of life measured by the validated Palliative Care Outcome Scale (POS). Secondary outcome measures included haemoglobin (Hb), phosphate, calcium, urea reduction ratio (URR), albumin, alkaline phosphatase (ALP) and dropout rate. Preliminary results: Interim analysis using paired t-tests demonstrated no difference in POS scores at 1 month (95% CI p=0.383) and a trend towards lower mean serum phosphate after 3 months, although this was not statistically significant (95%CI p=0.096). Conclusions: Initial data suggests that changing from conventional haemodialysis to extended hours in-centre nocturnal haemodialysis does not change the mean patient POS quality of life score after 1 month. However, there may be a difference in outcomes after a longer duration on the nocturnal haemodialysis regime. This study is ongoing to assess primary and secondary outcomes at 6 months.