Nocturnal Home Hemodialysis: Patient's Perspective
Several studies have showed that nocturnal home hemodialysis (NHD, 6 times weekly 6–8 h) results in a better outcome. How do patients and their partners experience this very intensive treatment that has a great impact on daily life? Methods:
We followed a cohort of 12 patients (11 male, 1 female, mean age 46.8 ± 9.4 years, time for renal replacement 11.3 ± 9.4 years) and their partners during a year after starting NHD, using questionnaires and interviews and the SF-36. Results:
Both the physical and the mental components of the SF-36 showed an improvement in all aspects (p < 0.05), even in this small group. All couples considered NHD a tremendous improvement over routine thrice weekly dialysis. The drawbacks (such as daily routine and the intrusion of the treatment in bed) are outweighed by the advantages (such as better clinical condition, less fatigue, less uremic symptoms, better quality of life, more time, and free diet). Following are a few comments on NHD: “NHD is a difference of day and night,”“NHD gave me independence,”“Since I do NHD, I do aerobics,”“I am becoming too fat now!,”“My husband now is much faster than I am when we walk or ride the bicycle,”“There is no reason now why I won't live long,”“I got an excellent, but demanding new job, which is possible thanks to NHD,”“Being a good team is a prerequisite for success,”“Don't expect too much. You will remain a chronic patient,”“Become confident with ‘conventional’ home hemodialysis first before you start NHD.” Conclusion:
NHD results in a tremendous improvement of quality of life. However, patients and partners need active support.
Document Type: Research Article
Affiliations: Dianet Dialysis Centres, Utrecht, The Netherlands.
Publication date: 2004-01-01