BACKGROUND AND OBJECTIVES:Patients receiving hemodialysis often perceive their caregivers are overburdened. We hypothesize that increasing hemodialysis frequency would result in higher patient perceptions of burden on their unpaid caregivers. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In two separate trials, 245 patients were randomized to receive in-center daily hemodialysis (6 days/week) or conventional hemodialysis (3 days/week) while 87 patients were randomized to receive home nocturnal hemodialysis (6 nights/week) or home conventional hemodialysis for 12 months. Changes in overall mean scores over time in the 10-question Cousineau perceived burden scale were compared. RESULTS: In total, 173 of 245 (70%) and 80 of 87 (92%) randomized patients in the Daily and Nocturnal Trials, respectively, reported having an unpaid caregiver at baseline or during follow-up. Relative to in-center conventional dialysis, the 12-month change in mean perceived burden score with in-center daily hemodialysis was -2.1 (95% confidence interval, -9.4 to +5.3; P=0.58). Relative to home conventional dialysis, the 12-month change in mean perceived burden score with home nocturnal dialysis was +6.1 (95% confidence interval, -0.8 to +13.1; P=0.08). After multiple imputation for missing data in the Nocturnal Trial, the relative difference between home nocturnal and home conventional hemodialysis was +9.4 (95% confidence interval, +0.55 to +18.3; P=0.04). In the Nocturnal Trial, changes in perceived burden were inversely correlated with adherence to dialysis treatments (Pearson r=-0.35; P=0.02). CONCLUSION: Relative to conventional hemodialysis, in-center daily hemodialysis did not result in higher perceptions of caregiver burden. There was a trend to higher perceived caregiver burden among patients randomized to home nocturnal hemodialysis. These findings may have implications for the adoption of and adherence to frequent nocturnal hemodialysis.
RCT Entities:
BACKGROUND AND OBJECTIVES:Patients receiving hemodialysis often perceive their caregivers are overburdened. We hypothesize that increasing hemodialysis frequency would result in higher patient perceptions of burden on their unpaid caregivers. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In two separate trials, 245 patients were randomized to receive in-center daily hemodialysis (6 days/week) or conventional hemodialysis (3 days/week) while 87 patients were randomized to receive home nocturnal hemodialysis (6 nights/week) or home conventional hemodialysis for 12 months. Changes in overall mean scores over time in the 10-question Cousineau perceived burden scale were compared. RESULTS: In total, 173 of 245 (70%) and 80 of 87 (92%) randomized patients in the Daily and Nocturnal Trials, respectively, reported having an unpaid caregiver at baseline or during follow-up. Relative to in-center conventional dialysis, the 12-month change in mean perceived burden score with in-center daily hemodialysis was -2.1 (95% confidence interval, -9.4 to +5.3; P=0.58). Relative to home conventional dialysis, the 12-month change in mean perceived burden score with home nocturnal dialysis was +6.1 (95% confidence interval, -0.8 to +13.1; P=0.08). After multiple imputation for missing data in the Nocturnal Trial, the relative difference between home nocturnal and home conventional hemodialysis was +9.4 (95% confidence interval, +0.55 to +18.3; P=0.04). In the Nocturnal Trial, changes in perceived burden were inversely correlated with adherence to dialysis treatments (Pearson r=-0.35; P=0.02). CONCLUSION: Relative to conventional hemodialysis, in-center daily hemodialysis did not result in higher perceptions of caregiver burden. There was a trend to higher perceived caregiver burden among patients randomized to home nocturnal hemodialysis. These findings may have implications for the adoption of and adherence to frequent nocturnal hemodialysis.
Authors: Rita S Suri; Gihad E Nesrallah; Rahul Mainra; Amit X Garg; Robert M Lindsay; Tom Greene; John T Daugirdas Journal: Clin J Am Soc Nephrol Date: 2005-11-16 Impact factor: 8.237
Authors: R S Suri; A X Garg; G M Chertow; N W Levin; M V Rocco; T Greene; G J Beck; J J Gassman; P W Eggers; R A Star; D B Ornt; A S Kliger Journal: Kidney Int Date: 2006-12-13 Impact factor: 10.612
Authors: Joseph A Cafazzo; Kevin Leonard; Anthony C Easty; Peter G Rossos; Christopher T Chan Journal: Clin J Am Soc Nephrol Date: 2009-04-01 Impact factor: 8.237
Authors: Damien Ashby; Natalie Borman; James Burton; Richard Corbett; Andrew Davenport; Ken Farrington; Katey Flowers; James Fotheringham; R N Andrea Fox; Gail Franklin; Claire Gardiner; R N Martin Gerrish; Sharlene Greenwood; Daljit Hothi; Abdul Khares; Pelagia Koufaki; Jeremy Levy; Elizabeth Lindley; Jamie Macdonald; Bruno Mafrici; Andrew Mooney; James Tattersall; Kay Tyerman; Enric Villar; Martin Wilkie Journal: BMC Nephrol Date: 2019-10-17 Impact factor: 2.388
Authors: Paulo Roberto Santos; Ítala Mônica de Sales Santos; João Laerte Alves de Freitas Filho; Carlos Wellington Macha; Priscila Garcia Câmara Cabral Tavares; Ana Cláudia de Oliveira Portela; Ana Mayara Barros Campos; Ana Raquel Ferreira de Azevedo; Catarine Cavalcante Ary; Felipe Peixoto Nobre; Jamille Fernandes Carneiro; Yandra Maria Gomes Pontes Journal: Int Urol Nephrol Date: 2017-05-18 Impact factor: 2.370
Authors: Kelly Chong; Samuel A Silver; Jin Long; Yuanchao Zheng; V Shane Pankratz; Mark L Unruh; Glenn M Chertow Journal: Clin J Am Soc Nephrol Date: 2017-10-17 Impact factor: 8.237
Authors: Suma Prakash; Anna McGrail; Steven A Lewis; Jesse Schold; Mary Ellen Lawless; Ashwini R Sehgal; Adam T Perzynski Journal: Clin J Am Soc Nephrol Date: 2015-01-15 Impact factor: 8.237
Authors: Melissa Nataatmadja; Rathika Krishnasamy; Li Zuo; Daqing Hong; Brendan Smyth; Min Jun; Janak R de Zoysa; Kirsten Howard; Jing Wang; Chunlai Lu; Zhangsuo Liu; Christopher T Chan; Alan Cass; Vlado Perkovic; Meg Jardine; Nicholas A Gray Journal: Kidney Int Rep Date: 2021-02-01