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NDT Advance Access published online on May 23, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl256
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received November 6, 2005
Accepted April 12, 2006

Original Article

Effect of short daily home haemodialysis on quality of life, cognitive functioning and the electroencephalogram

Pieter F. Vos 1 *, Oliver Zilch 1, Aag Jennekens-Schinkel 2, Miriam Salden 3, Jasper Nuyen 3, Menno P. Kooistra M 4, Alexander C. van Huffelen 5, and Margriet M. Sitskoorn 3

1 Dianet Dialysis Centres, University Medical Centre Utrecht, Utrecht, The Netherlands; UMCU: Department of Nephrology and Hypertension, University Medical Centre, Utrecht, The Netherlands
2 UMCU: Department of Neuropsychology (WKZ), University Medical Centre, Utrecht, The Netherlands; UMCU: Department of Psychiatry, Rudolph Magnus Institute of Neuroscience, University Medical Centre, Utrecht, The Netherlands
3 UMCU: Department of Psychiatry, Rudolph Magnus Institute of Neuroscience, University Medical Centre, Utrecht, The Netherlands
4 Dianet Dialysis Centres, University Medical Centre Utrecht, Utrecht, The Netherlands
5 UMCU: Department of Neurophysiology, University Medical Centre, Utrecht, The Netherlands

* To whom correspondence should be addressed.
Pieter F. Vos, E-mail: p.vos{at}dianet.nl



  Abstract

Background. End-stage renal disease patients have a poor quality of life (QoL), suffer from impaired cognitive functioning, and their electroencephalogram (EEG) shows abnormalities. Conventional haemodialysis (CHD) only partially restores these disorders. Short daily haemodialysis (SDHD) has been reported to improve QoL, but effects on cognitive functioning and EEG have yet to be described.

Methods. Of the 13 patients (11 male, 2 female, age 45.5 ± 8.1 years), 11 completed the Kidney Disease Quality of Life and Affect Balance Scale questionnaires, 10 underwent neuropsychological testing, and all 13 underwent EEG examination. For the neuropsychological assessments, nine patients (six male, three female, age 45.4 ± 12.6) who remained on the CHD schedule, served as controls. The dialysis schedule of thrice-a-week for 4 h was changed in the experimental group to six times a week for 2 h (SDHD) over a period of 6 months and back to thrice a week for 4 h.

Results. When on SDHD, patients rated several dimensions of health-related QoL as being improved. After resuming CHD, one of these dimensions again decreased and several others worsened even lower than baseline. Cognitive functioning did not change when compared with control data. On the EEG, alpha peak frequency increased slightly when on SDHD but decreased significantly after resuming CHD.

Conclusions. SDHD improves health-related QoL, but has no clear effects on cognitive functioning and EEG. Resumption of CHD after SDHD decreases aspects of QoL and EEG alpha peak frequency but has no effect on cognitive functioning.

Keywords: cognitive functioning; electroencephalogram; end-stage renal disease; quality of life; short daily haemodialysis.
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