At-home short daily hemodialysis improves the long-term health-related quality of life

Kidney Int. 2012 Sep;82(5):561-9. doi: 10.1038/ki.2012.168. Epub 2012 May 23.


Patients with chronic kidney disease treated by in-center conventional hemodialysis (3 times per week) have significant impairments in health-related quality of life measures, which have been associated with increased morbidity and mortality. FREEDOM is an ongoing prospective cohort study measuring the potential benefits of at-home short daily (6 times per week) hemodialysis. In this interim report we examine the long-term effect of short daily hemodialysis on health-related quality of life, as measured by the SF-36 health survey. This was administered at baseline, 4 and 12 months after initiation of short daily hemodialysis to 291 participants (total cohort), of which 154 completed the 12-month follow-up (as-treated cohort). At the time of analysis, the mean age was 53 years, 66% were men, 58% had an AV fistula, 90% transitioned from in-center hemodialysis, and 45% had diabetes mellitus. In the total cohort analysis, both the physical- and mental-component summary scores improved over the 12-month period, as did all 8 individual domains of the SF-36. The as-treated cohort analysis showed similar improvements with the exception of the role-emotional domain. Significantly, in the as-treated cohort, the percentage of patients achieving a physical-component summary score at least equivalent to the general population more than doubled. Hence, at-home short daily hemodialysis is associated with long-term improvements in various physical and mental health-related quality of life measures.

Trial registration: NCT00288613.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arteriovenous Shunt, Surgical
  • Chi-Square Distribution
  • Comorbidity
  • Emotions
  • Female
  • Health Status*
  • Hemodialysis, Home / adverse effects
  • Hemodialysis, Home / methods*
  • Hemodialysis, Home / psychology
  • Humans
  • Kidney Failure, Chronic / ethnology
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / psychology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Pain / epidemiology
  • Pain / psychology
  • Pain Measurement
  • Prospective Studies
  • Quality of Life*
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology

Associated data