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Long-term clinical parameters after switching to nocturnal haemodialysis: A Dutch propensity-score-matched cohort study comparing patients on nocturnal haemodialysis with patients on three-times-a week haemodialysis/haemodiafiltration

Jansz, T. T., Ozyilmaz, A., Grooteman, M. P. C., Hoekstra, T., Romijn, M., Blankestijn, P. J., Bots, M. L. & van Jaarsveld, B. C., Mar-2018, In : BMJ Open. 8, 3, 10 p., 019900.

Research output: Contribution to journalArticleAcademicpeer-review

  • Thijs Thomas Jansz
  • Akin Ozyilmaz
  • Muriel P. C. Grooteman
  • Tiny Hoekstra
  • Marieke Romijn
  • Peter J. Blankestijn
  • Michael L. Bots
  • Brigit C. van Jaarsveld

Objectives Nocturnal haemodialysis (NHD), characterised by 8-hour sessions >= 3 times a week, is known to improve clinical parameters in the short term compared with conventional-schedule haemodialysis (HD), generally 3x3.5-4 hours a week. We studied long-term effects of NHD and used patients on conventional HD/haemodiafiltration (HDF) as controls.

Design Four-year prospective follow-up of patients who switched to NHD; we compared patients with patients on HD/HDF using propensity score matching.

Setting 28 Dutch dialysis centres.

Participants We included 159 patients starting with NHD any time since 2004, aged 56.7 +/- 12.9 years, with median dialysis vintage 2.3 (0.9-5.1) years. We propensity-score matched 100 patients on NHD to 100 on HD/HDF.

Primary and secondary outcome measures Control of hypertension (predialysis blood pressure, number of antihypertensives), phosphate (phosphate, number of phosphate binders), nutritional status and inflammation (albumin, C reactive protein and postdialysis weight) and anaemia (erythropoiesis-stimulating agent (ESA) resistance).

Results Switching to NHD was associated with a nonsignificant reduction of antihypertensives compared with HD/HDE (OR

Conclusions After switching to NHD, the lower need for antihypertensives, phosphate binders and ESA persists for at least 4 years. These sustained improvements in NHD contrast significantly with the course of these parameters during continued treatment with conventional-schedule HD and HOE. NHD provides an optimal form of dialysis, also suitable for patients expected to have a long waiting time for transplantation or those convicted to indefinite dialysis.

Original languageEnglish
Article number019900
Number of pages10
JournalBMJ Open
Volume8
Issue number3
Publication statusPublished - Mar-2018

    Keywords

  • CHRONIC KIDNEY-DISEASE, RANDOMIZED CONTROLLED-TRIAL, STAGE RENAL-DISEASE, QUALITY-OF-LIFE, CONVENTIONAL HEMODIALYSIS, ONLINE HEMODIAFILTRATION, ALL-CAUSE, CARDIOVASCULAR MORTALITY, OUTCOMES, CALCIFICATION

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