Table 3.

Summary of outcomes data from DHD programs with five or more patients and ≥3 months of follow-up, 1998 to 2004a

CategoryOutcomePositive Findings (P < 0.05)Nonsignificant Trends/No Change
Health-related quality of lifeSF-36 PCS scoreIncrease by 9 points (17)Increase (trend) (9)
SF-36 MCS scoreIncrease by 4 to 9 points (9,17)
SF-36 subscales scoresNo change in 6/8 subscales (27)
KDQOL-SF subscales scoresIncrease by 7 to 19 points in 11/19 subscales (14)No change in 10/11 subscales reported (31)
Nottingham Health Profile scoresNo change in 5/6 subscales (27)
Dialysis and/or uremic symptomsDecrease or disappearance (16,17,27,29,31)No change (23)
Minutes to recovery after HDDecrease from 327 ± 203 to 30 ± 44 min (9)
UtilityIncrease by 0.14 in Time Trade-Off (9)No change in Health Utilities Index (9)
Cardiovascular diseaseSystolic BPDecrease by 7 to 23 mmHg (14,16,2224,27,31)Decrease (trend) (19)
Diastolic BPDecrease by 4 to 12 mmHg (16,2224,31)Decrease (trend) (19,27); no change (14)
Mean arterial pressureDecrease by 3 to 12 mmHg (10,17,22,23,27,29)
BP medicationDecrease by 20 to 70% (10,14,16,27)Decrease (trend) (10,17,23,29,31)
Left ventricular hypertrophyDecrease in LVMI by 29 to 38 g/m2 (17,23); decrease in other measures (19,22,23)
ErythropoiesisHemoglobinIncrease by 1 to 1.5 g/dl (22,24)Increase (trend) (19); no change (13,17,23)
HematocritIncrease by 1.2 to 5% (16,22,29,31)Increase (trend) (14); no change (23)
Erythropoietin doseDecrease by 32 to 47% (14,17,31)Decrease (trend) (13,16,23,24,26)
NutritionProtein intakeIncrease by 25% (18)
Dry body weightIncrease by 1.7 to 2.0 kg (16,18,29)Increase (trend) (19,27,31); no change (14,22,23)
Interdialytic weight gain/UF volumeIncrease by 0.6 to 3.9 kg/wk (14,18)Increase (trend) (10,23,27,29); no change (31)
Serum albuminIncrease by 0.2 to 0.6 g/dl (11,16,18,22,29)Increase (trend) (19); no change (14,23,24,26)
nPNAIncrease by 0.1 g/kg per d (18)No change (11,23,26)
Serum cholesterolIncrease by 31 mg/dl (26)No change (16,19,22)
Mineral metabolism/bone diseasePhosphateDecrease by 1.2 mmol/L (30)Decrease (trend) (24,26); no change (12,14,16,17)
Phosphate binder doseDecrease by 38% (17)Decreased (12); no change (14,16,27)
Aplastic bone diseaseDecrease (trend) (30)
HospitalizationsHospital admission rateDecrease (relative risk = 0.6 to 0.7b) (trend) (14)
Mean length of stayDecrease by 26 to 40%b (trend) (14)
  • a PCS, Physical Components Summary score; MCS, Mental Components Summary score; KDQOL-SF, Kidney Disease Quality of Life Short Form Questionnaire; LVMI, left ventricular mass index; HD, hemodialysis; UF, ultrafiltration. Details on individual studies are provided in Table 2. All outcomes above are described at 3 to 24 mo of follow-up (majority at 12 mo). All studies with statistically significant findings are described in column 3, and all studies that evaluated the outcome but did not have statistically significant results are presented in column 4.

  • b This study reports statistically significant decreases in hospital admission rate and length of stay at 6 yr of follow-up; here 1 yr data is described due to potential informative censoring after 1 yr (see text).