Authors (including presenting author) :
Chan WH, Hui CF, Ho WY, Wong KC, Wong PK, Tsang WY, Wong YH, Wong SHS
Affiliation :
Renal Unit, Department of Medicine & Geriatrics, United Christian Hospital
Introduction :
The expansion of home hemodialysis (HHD) services in Hong Kong was marked by the initiation of a pilot program in 2021, utilizing a novel HHD machine (NxStage System One; Fresenius Medical Care, Tijuana, Mexico). Despite known benefits, such as reduced training time and space requirements, the impact on patients’ Health-Related Quality of Life (HRQoL) has not been thoroughly investigated in the local context. This study aims to bridge the gap by comparing HRQoL outcomes between patients receiving HHD using the novel HHD machine and those receiving in-center hemodialysis (ICHD).
Objectives :
1. To evaluate HRQoL of patients before and after participating in the HHD program.
2. To compare HRQoL between HHD patients and ICHD patients, both of which are HD modalities with a duration of approximately 2 years.
Methodology :
HRQoL was assessed using the Kidney Disease Quality of Life Instrument (KDQOL™-36), which is a self-reported questionnaire. Data were collected from November 2021 to November 2023. The KDQOL™-36 questionnaire comprised five domains: physical health, mental health, burden of chronic renal disease, symptoms/problems, and the impact of chronic renal disease on daily life. Higher scores indicated better HRQoL.
The questionnaires were collected once before the HHD training, then after six months of training, and subsequently once every year.
For ICHD patients, the questionnaires were collected after 2 to 4 years of ICHD treatment.
Result & Outcome :
Total 19 patients participated in the study: 10 undergoing ICHD and 9 enrolled in HHD initially. 2 patients later dropped out from the HHD program due to death and experiencing seizures. Transitioning to HHD was associated with a significant improvement in HRQoL (p = 0.018). Compared to ICHD patients, patients on HHD showed a significantly higher HRQoL scores (p = 0.015)
Conclusions
Patients undergoing HHD experience an improvement in quality of life, and also showed a significantly higher score compared with ICHD patients, suggesting that HHD may be a preferable alternative to ICHD for those patients who are suitable for HHD. These preliminary results advocate for further research into the life quality determinants in the HD population to enhance patient outcomes.
