Intradialytic symptoms common, linked to longer recovery time and shortened treatments
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Published findings indicated that 87% of patients on hemodialysis experienced intradialytic symptoms. These symptoms were associated with longer recovery time, as well as shortened or skipped treatments.
“The quality of care of the patient receiving dialysis is largely defined, in current practice, by the achievement of quantifiable laboratory-based tests, including those related to urea kinetics, anemia and bone and mineral metabolism, as well as mortality rates and hospitalizations,” Luis Alvarez, MD, PhD, of Palo Alto Medical Foundation in California, and colleagues wrote. “While reflective of the dialysis procedure and outcomes, these metrics are generally unrelated or minimally related to how a patient feels and functions.”
The researchers added that it is important to understand how intradialytic symptoms may impact patients’ quality-of-life — in some cases causing them to skip dialysis altogether, resulting in increased risk for hospitalization and death — to improve patient-centered care. To this end, they sent an online questionnaire to 10,000 patients who had been receiving in-center hemodialysis three times per week for at least 3 months (359 responded; 37% with diabetes; 70% with hypertension). The questionnaire consisted of 12 items that addressed the type and severity of symptoms, how long it took for patients to return to normal activities after dialysis and whether they stopped dialysis or skipped a treatment due to symptoms.
Researchers found that 87% of patients had symptoms during hemodialysis in the previous week, with the most common being fatigue, cramps and low blood pressure. The median recovery time was 3 hours (range 0 to 24; 40% with recovery time of 4 hours or longer).
Further, researchers found that 33% of patients reported stopping dialysis due to symptoms (most commonly for cramps and low blood pressure), while 6% reported skipping dialysis.
“This study highlights that the burden of symptoms during dialysis itself should be considered an important outcome to measure and should be a target for further innovation,” the researchers wrote. “As improvements in dialysis technology are introduced, a measurement of success can reasonably be expected to include an improvement in intradialytic syndrome.” – by Melissa J. Webb
Disclosures: Alvarez reports being an employee of Outset Medical. Please see full study for all other authors’ relevant financial disclosures.
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