End-Stage Renal Disease Clinical Trial
Official title:
Study Into the Effects of Daily Home Hemodialysis on Hemodynamics, Neurocognitive Functions, and Quality of Life
This study was designed to discover mechanisms responsible for the decrease in (high) blood
pressure after starting daily hemodialysis, as has been observed by various investigators.
We hypothesized that better control of body water and sodium content and a decline in the
autonomic (sympathetic) nervous system activity, increased in chronic renal failure
patients, would contribute to improved blood pressure regulation.
Moreover, we studied the effects of daily hemodialysis on mental functions, like information
processing and memory, in relation to the previously reported improvement in quality of
life, and the effects on nutrition. We hypothesized that all would improve.
Although conventional hemodialysis has faced many technical improvements in recent years, a
great deal of end-stage renal disease patients, treated with this modality, have suboptimal
or high blood pressure, and suffer poor quality of life. Daily hemodialysis has been
reported to improve both, but the pathophysiological background is poorly understood.
Patients were studied before and after 6 months of daily (i.e.6 times a week) home
hemodialysis, and again after two months of conventional (i.e. thrice weekly) hemodialysis.
We measured the effects of daily dialysis (compared with conventional dialysis) on blood
pressure, cardiac output, extracellular fluid volume, plasma renin activity, sympathetic
nervous system activity (through MSNA), the electroencephalogram (EEG), neurocognitive
functioning (speed of information processing, memory, executive functioning, and attention),
quality of life, and nutritional status
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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