Insomnia, muscular cramps and pruritus have low intensity in hemodialysis patients with good dialysis efficiency, low inflammation and arteriovenous fistula
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Insomnia, muscular cramps, pruritus and postdialysis recovery time (RT) are quality-of-life parameters that affect hemodialysis (HD) patients physically and mentally.
We included 171 end-stage renal disease patients: 115 on high-flux HD and 56 on online hemodiafiltration (HDF). Patients were asked “How long does it take you to recover from a dialysis session?” and they evaluated intensity (absent, mild, medium and severe) of insomnia, muscular cramps and pruritus in the past 4 weeks. We sought associations of RT, insomnia, muscular cramps and pruritus with themselves and age, dialysis vintage, sex, body mass index, hemoglobin, albumin, C-reactive protein (CRP), Daugirdas single-pool Kt/V (Kt/V), ultrafiltration volume, blood processed volume and vascular access type.
Insomnia absence correlated with muscular cramps absence (p = 0.01), arteriovenous fistula (AVF) presence (p = 0.02) and lower CRP (p = 0.003). Muscular cramps absence associated pruritus absence (p = 0.007) and AVF (p = 0.001). Absent pruritus patients were younger (p = 0.04), had higher Kt/V (p = 0.01) and more AVF (p = 0.02). Men insomnia was more severe in HD than HDF and albumin related (p = 0.007), while CRP was lower in absent pruritus. Women insomnia associated with muscular cramps (p = 0.04) and vascular access (p = 0.03), as was pruritus (p = 0.03). RT had no relations with any parameter.
HD patients with AVF have less insomnia, muscular cramps and pruritus. Insomnia is associated with muscular cramps and inflammation. Pruritus is worse in older patients, is diminished with increased dialysis efficiency and is associated with higher CRP in men. There is no difference between HD and HDF patients, except more severe insomnia for HD in men.
KeywordsInsomnia Muscular cramps Pruritus Posthemodialysis recovery time Hemodialysis
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Fukuhara S, Lopes AA, Bragg-Gresham JL, Kurokawa K, Mapes DL, Akizawa T, Bommer J, Canaud BJ, Port FK, Held PJ, Worldwide Dialysis Outcomes and Practice Patterns Study (2003) Health-related quality of life among dialysis patients on three continents: the Dialysis Outcomes and Practice Patterns Study. Kidney Int 64(5):1903–1910CrossRefPubMedGoogle Scholar
- 2.Mapes DL, Lopes AA, Satayathum S, McCullough KP, Goodkin DA, Locatelli F, Fukuhara S, Young EW, Kurokawa K, Saito A, Bommer J, Wolfe RA, Held PJ, Port FK (2003) Health-related quality of life as a predictor of mortality and hospitalization: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney Int 64(1):339–349CrossRefPubMedGoogle Scholar
- 3.Hayashino Y, Fukuhara S, Akiba T, Akizawa T, Asano Y, Saito S, Kurokawa K (2009) Low health-related quality of life is associated with all-cause mortality in patients with diabetes on haemodialysis: the Japan Dialysis Outcomes and Practice Patterns Study. Diabet Med 26(9):921–927. doi: 10.1111/j.1464-5491.2009.02800.x CrossRefPubMedGoogle Scholar
- 5.Rayner HC, Zepel L, Fuller DS, Morgenstern H, Karaboyas A, Culleton BF, Mapes DL, Lopes AA, Gillespie BW, Hasegawa T, Saran R, Tentori F, Hecking M, Pisoni RL, Robinson BM (2014) Recovery time, quality of life, and mortality in hemaodialysis patients: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 64(1):86–94. doi: 10.1053/j.ajkd.2014.01.014 CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Moura A, Madureira J, Alija P, Fernandes JC, Oliveira JG, Lopez M, Filgueiras M, Arnado L, Sameiro-Faria M, Miranda V, Vieira M, Santos-Silva A, Costa E (2014) Type of vascular access and location in online hemodiafiltration and its association with patient’s perception of health-related quality of life. J Vasc Access 15(3):175–182. doi: 10.5301/jva.5000182 CrossRefPubMedGoogle Scholar
- 14.Orasan RA, Patiu IM, Anghel D, Bejan C, Iosub L, Totolici C, Pop M, Turcea C, Teodoru C, Orasan OH, Kacso IM, Gherman Caprioara M (2013) Variation of clinical and laboratory features in chronic dialysis patients treated with high-flux hemodialysis after switching to online hemodiafiltration. Int Urol Nephrol 45(5):1415–1422. doi: 10.1007/s11255-012-0341-7 CrossRefPubMedGoogle Scholar
- 18.Ko MJ, Wu HY, Chen HY, Chiu YL, Hsu SP, Pai MF, Ju-Yehyang Lai CF, Lu HM, Huang SC, Yang SY, Wen SY, Chiu HC, Hu FC, Peng YS, Jee SH (2013) Uremic pruritus, dialysis adequacy, and metabolic profiles in hemodialysis patients: a prospective 5-year cohort study. PLoS ONE 8(8):e71404. doi: 10.1371/journal.pone.0071404 CrossRefPubMedPubMedCentralGoogle Scholar