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QUALITY OF LIFE IN HEMODIAFILTRATION WITH ENDOGENOUS REINFUSION (HFR) VERSUS BICARBONATE HEMODIALYSIS (BHD): CROSS-SECTIONAL MULTICENTRE STUDY IN ITALY .

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Razionale

In hemodialysis (HD) patients, poor health-related quality of life (HRQoL) is frequent and is associated with adverse outcome. It is well known that HRQoL and nutritional status are strictly linked.  HFR is an alternative dialysis technique that reduces inflammation burden and malnutrition but it has never been evaluated the effect on HRQoL.

Casistica e Metodi

We designed a cross-sectional multicentre study in order to compare the HRQoL in patients treated with HFR versus BHD. We enrolled patients treated for at least 6 months HFR, with life expectancy greater than six months and without remarkable cognitive deficit. The recruited patients in HFR were matched for age, gender, dialytic vintage and performance in activities of daily living (Barthel index) with BHD treated patients. Demographic, clinical, laboratory and treatment data were collected and SF-36 questionnaire for the assessment of QoL was administered. 

Risultati

One hundred-fourteen patients were enrolled (age 65.4±13.5 years; dialysis vintage 5.4 (3.3-10.3) years; 53%males) from 18 dialysis non-profit centres in central and southern Italy. As result of matching,  no difference in age, gender, dialytic age and Barthel index was found between HFR and BHD patients. KTV, hemoglobin and serum albumin were similar between the two treatment groups. In HFR patients we observed higher values of SF-36 physical component score than BHD patients, whereas no significant difference emerged in the mental component score. The following table illustrates the SF-36 results:

 

HFR (n=57)

BHD (n=57)

P

Physical Component

56±20

48±23

0.048

Mental Component

57±21

55±19

0.698

 

 

 

 

Physical Functioning

61±26

51±30

0.045

Role Physical

66±47

45±46

0.027

Bodily Pain

63±25

58±31

0.346

General health

40±17

39±19

0.676

Vitality

51±22

48±21

0.492

Social Functioning

64±25

69±20

0.290

Role Emotional

64±40

60±43

0.595

Mental Health

64±24

60±22

0.437

Conclusioni

HFR is associated with a better physical component of HRQoL than BHD, independently of age, gender, dialysis vintage and invalidity score. 

Borrelli S1, Minutolo R1, De Nicola L1, De Simone W2, De Simone E2, Zito B2, Di Iorio BR3, Leone L4, Bassi A4, Treglia A5, Trombetta M6, Bartolomucci M6, Ferazzoli F6, Saviano C7, D’Apice L7, Palombo P8, Bellizzi V9, Credendino O10, Simonelli R11, Guastaferro P12, Nigro F12, Vezza E13, Simeoni P14, Porcu MC14, Di Silva A15, Nacca R16, Caliendo A16, Russo F17, Auricchio MR17, Iulianiello G18, Conte G1
(1Second University of Naples; 2Hospital of Avellino; 3Hospital of Solofra (AV); 4Hospital of Nocera (SA); 5Hospital of Formia (LT); 6Hospital of Frosinone; 7Hospital of Caserta; 8Hospital of Latina; 9Hospital of Salerno ; 10“Cardarelli” Hospital of Naples; 11Hospital of Pontecorvo (FR); 12Hospital of Sant’Angelo dei Lombardi (AV); 13Hospital of Alatri (FR); 14Hospital of Anagni (FR); 15Hospital of Terracina (LT); 16Hospital of Cassino (FR); 17Hospital of Castellammare di Stabia (NA); 18Hospital of San Felice a Cancello (CE).)
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