Cihan Uysal, Murat Altunok, Hamiyet Ozkan, Ismail Kocyigit
{"title":"Does Ultrafiltration Rate Influence Sleep Quality Among Hemodialysis Patients.","authors":"Cihan Uysal, Murat Altunok, Hamiyet Ozkan, Ismail Kocyigit","doi":"10.1159/000548767","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Sleep disturbances are common in hemodialysis (HD) patients. We examined the excessive ultrafiltration rate (UFR), which is associated with poor outcomes, for its possible impact on sleep quality.</p><p><strong>Methods: </strong>Only oligo-anuric patients with a three-times-weekly HD schedule were included in the study. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and a score> 5 indicated poor sleepers. Ultrafiltration values refer to the month preceding the PSQI survey. Patients were divided into three categories: optimal UFR group (<10 mL/kg/h), borderline UFR group (10-13 mL/kg/h), and high UFR group (≥13 mL/kg/h).</p><p><strong>Results: </strong>A total of 102 patients were included, with a median age of 60(46-67) years. Median time of undergoing dialysis was 44.5(22-77) months. Average interdialytic weight gain (IDWG) percentage was 4.7(3.7-5.7) and UFR was 11.6±3.5 mL/kg/h. 37 patients (36.3%) had optimal UFR, 29 patients (28.4%) had borderline UFR, 36 patients (35,3%) had high UFR. Average PSQI score was 7 points (4-10) and 61 patients (59.8%) was identified as poor sleepers. Mean UFR was 11.7±3.4 mL/kg/h in poor sleepers and 11.5±3.7 mL/kg/h in non-poor sleepers (p=0. 819). PSQI score and poor sleeper prevalence were not significantly different between UFR groups. There was no significant correlation between PSQI and UFR (p=0.325). In multivariate regression analysis, UFR was not an independent predictor of sleep quality. Additionally, younger age and a long history of HD were independent predictors of high UFR.</p><p><strong>Conclusion: </strong>Excessive and rapid fluid removal does not constitute a risk for poor sleep quality. Also, current findings underscore the increased frequency and complexity of sleep disorders in dialysis patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-17"},"PeriodicalIF":1.8000,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Purification","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000548767","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Sleep disturbances are common in hemodialysis (HD) patients. We examined the excessive ultrafiltration rate (UFR), which is associated with poor outcomes, for its possible impact on sleep quality.
Methods: Only oligo-anuric patients with a three-times-weekly HD schedule were included in the study. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and a score> 5 indicated poor sleepers. Ultrafiltration values refer to the month preceding the PSQI survey. Patients were divided into three categories: optimal UFR group (<10 mL/kg/h), borderline UFR group (10-13 mL/kg/h), and high UFR group (≥13 mL/kg/h).
Results: A total of 102 patients were included, with a median age of 60(46-67) years. Median time of undergoing dialysis was 44.5(22-77) months. Average interdialytic weight gain (IDWG) percentage was 4.7(3.7-5.7) and UFR was 11.6±3.5 mL/kg/h. 37 patients (36.3%) had optimal UFR, 29 patients (28.4%) had borderline UFR, 36 patients (35,3%) had high UFR. Average PSQI score was 7 points (4-10) and 61 patients (59.8%) was identified as poor sleepers. Mean UFR was 11.7±3.4 mL/kg/h in poor sleepers and 11.5±3.7 mL/kg/h in non-poor sleepers (p=0. 819). PSQI score and poor sleeper prevalence were not significantly different between UFR groups. There was no significant correlation between PSQI and UFR (p=0.325). In multivariate regression analysis, UFR was not an independent predictor of sleep quality. Additionally, younger age and a long history of HD were independent predictors of high UFR.
Conclusion: Excessive and rapid fluid removal does not constitute a risk for poor sleep quality. Also, current findings underscore the increased frequency and complexity of sleep disorders in dialysis patients.
期刊介绍：
Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.
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