Comparison of peritoneal dialysis and hemodialysis on sleep and life quality in patients with refractory congestive heart failure

Objective To investigate the effect of peritoneal dialysis(PD)and hemodialysis(HD)on sleep and life quality in patients with refractory congestive heart failure(RCHF).Methods The clinical data and follow-up material of PD patients(31)or HD ones(17)in Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from January 1,2010 to December 31,2017,were analyzed retrospectively.Clinical and laboratory examination data before and 6 months after dialysis,the MOS item short from health survey(SF-36)results,and Pittsburgh sleep quality index( PSQI)were collected for analysis.Through self-contrast of the indices before and after treatment,effects of the two treatment ways on life quality in these patients were compared.Results After six months treatment,both PD and HD effectively improved NYHA classification and B-type natriuretic peptide levels(both P<0.01)with no significant difference between the two treatment ways(P>0.05).Neither PD nor HD significantly improved left ventricular ejection fraction after 6-month dialysis(P>0.05).Except hypnotic drugs and daytime dysfunction,other sleep quality indices were improved significantly the HD patients(P<0.05).In the PD patients,except hypnotic drugs,other 6 sleep quality indices were improved significantly(P<0.05).Total PSQI scores were increased for both HD and PD ways(P<0.05)with no difference between HD and PD(P>0.05).Other 7 life quality indices except emotional function were significantly improved in the HD patients(P<0.01),while all the eight life quality indices were improved in the PD patients(P<0.01).After treatment of 6 months,except physical function other life quality indices for the PD patients were better than those for the HD patients(all P<0.05).Logistic regression analysis showed that PD was associated with better emotional function and physical function than HD(P<0.05).Conclusions Both PD and HD can both improve clinical symptoms and sleep quality in RCHF patients as assessed by NYHA classification and B-type natriuretic peptide levels.However,improvement of life quality for PD was better than that for HD.