Yan Hong Gu1, Xiu Hong Yang1, Li Hua Pan1, Xiao Li Zhan1, Li Li Guo2, Hui Min Jin1. 1. 1 Division of Nephrology, Shanghai Pudong Hospital, Fudan University, Pudong Medical Center, Shanghai, China. 2. 2 Hemodialysis Center, Bao Shan Branch of No.1 People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Abstract
INTRODUCTION: Patients with maintenance hemodialysis have experienced long-standing sleep disturbance. In this study, we attempted to explore whether long-term hemoperfusion could improve sleep and increase the overall survival in hemodialysis patients. METHODS: A total of 158 patients, who underwent routine hemodialysis, were assessed in this study. These patients were computer-matched into two groups, with one group including 80 patients with absolute hemodialysis and the other consisting of 78 cases with hemodialysis in combination with hemoperfusion. Hemoperfusion was performed 1-2 times biweekly, with each session lasting 2 h. Self-reported sleep disturbance was evaluated before and after the observational time (2-year period); sleep quality was measured using the Pittsburgh Sleep Quality Index. FINDINGS: Using multivariate regression analyses, we found sleep duration was associated with age, diabetes, low income, pruritus, hyperphosphatemia, hypercalcemia, high parathyroid hormone, and hemoglobin (P < 0.001). The overall survival rate of the hemodialysis in combination with hemoperfusion group was significantly higher than that of the absolute hemodialysis group (P < 0.05) after adjusting for sex, age, and diabetes. A 2-year hemoperfusion therapy was associated with improved sleep disturbance and sleep efficiency; this was accompanied by an increase in nocturnal melatonin levels. Furthermore, there was a significant difference in the first hospitalization between the hemodialysis and hemodialysis in combination with hemoperfusion groups (P < 0.01). DISCUSSION: Our results indicated that hemoperfusion in combination with hemodialysis is associated with an increase in the overall survival and improved sleep disorders in hemodialysis patients.
INTRODUCTION: Patients with maintenance hemodialysis have experienced long-standing sleep disturbance. In this study, we attempted to explore whether long-term hemoperfusion could improve sleep and increase the overall survival in hemodialysis patients. METHODS: A total of 158 patients, who underwent routine hemodialysis, were assessed in this study. These patients were computer-matched into two groups, with one group including 80 patients with absolute hemodialysis and the other consisting of 78 cases with hemodialysis in combination with hemoperfusion. Hemoperfusion was performed 1-2 times biweekly, with each session lasting 2 h. Self-reported sleep disturbance was evaluated before and after the observational time (2-year period); sleep quality was measured using the Pittsburgh Sleep Quality Index. FINDINGS: Using multivariate regression analyses, we found sleep duration was associated with age, diabetes, low income, pruritus, hyperphosphatemia, hypercalcemia, high parathyroid hormone, and hemoglobin (P < 0.001). The overall survival rate of the hemodialysis in combination with hemoperfusion group was significantly higher than that of the absolute hemodialysis group (P < 0.05) after adjusting for sex, age, and diabetes. A 2-year hemoperfusion therapy was associated with improved sleep disturbance and sleep efficiency; this was accompanied by an increase in nocturnal melatonin levels. Furthermore, there was a significant difference in the first hospitalization between the hemodialysis and hemodialysis in combination with hemoperfusion groups (P < 0.01). DISCUSSION: Our results indicated that hemoperfusion in combination with hemodialysis is associated with an increase in the overall survival and improved sleep disorders in hemodialysis patients.