Influence of dialysis modality and membrane flux on insomnia severity in haemodialysis patients

Abstract

Aim Insomnia is an important problem in dialysis patients. A greater prevalence of insomnia in chronic kidney disease compared with non-renal patients suggests a role for uraemic toxins in contributing to insomnia. The aim of this study was to examine if dialysis modality and membrane permeability is associated with the frequency and severity of insomnia in haemodialysis patients. Methods In our cross-sectional study, we evaluated 122 patients who were divided into three groups: on-line haemodiafiltration, high flux haemodialysis and low flux haemodialysis. The frequency and severity of insomnia was evaluated with the Insomnia Severity Index. Results Insomnia was present in 47.5% of all patients. The majority of patients who reported insomnia were receiving low flux haemodialysis (80%), followed by patients on high flux haemodialysis (43.6%) and haemodiafiltration (20.9%). Patients using low flux membranes, had a significantly higher Insomnia Severity Index (11.9 ± 6.6) compared with patients receiving high flux haemodialysis (6.8 ± 6.3) and haemodiafiltration (5.2 ± 7.0). The insomnia severity index did not differ between patients receiving high flux haemodialysis compared with on-line haemodiafiltration. Conclusion This study indicates that different haemodialysis modalities are associated with insomnia and suggests a potential benefit of using high flux membranes. Summary at a Glance This study evaluates the relationship of haemodialysis and the use of convective and diffusion based treatments on the reported incidence of insomnia. Patients receiving haemodiafiltration or high flux haemodialysis had the lowest reported prevalence of insomnia. © 2013 Asian Pacific Society of Nephrology.