Effectiveness of haemodialysis modalities on QOL in clients with ESRD

Abstract

Conventional haemodialysis (CHD) is a life-saving treatment in patients with end-stage renal disease (ESRD). Several complications have been associated with CHD such as hypotension and a poor quality of life (QOL) (Punal et al., 2008; Suri et al., 2006). Thus, the effect of Short daily haemodialysis (SDHD), an alternative haemodialysis modality to CHD, on patients' QOL, was reviewed. The research question was "Is shorter daily haemodialysis more effective than conventional intervention regime in improving ESRD patients' quality of life?". Daily haemodialysis sessions, lasting not more than 3 hours, known as SDHD, were compared with thrice-weekly haemodialysis sessions lasting 4 hours every session, known as CHD. Patients with ESRD were the participants in this study with their QOL being the main outcome. A variety of keywords and databases were used to retrieve relevant studies. Only retrieved studies that satisfied the inclusion and exclusion criteria were analysed in this research project. In the studies retrieved, SDHD was performed either at home or at in-centres, with the duration of every SDHD session lasting not more than three hours. Furthermore, studies had to be published in English between 1990 and 2011 with a sample size of not less than 10 participants. Any discrimination in the selection of participants was not permitted and participants in every study had to have a follow period of at least eight weeks on SDHD. Eleven studies were retrieved excluding opinion or editorial article. Critical Appraisal Skills Programme tools (CASP) were used to appraise these studies. SDHD was reported to be more effective in improving patients' QOL when compared to CHD. However, further local and international research is required to support these findings. In addition, cost effectiveness of SDHD needs also to be estimated in future research.