Scoping Literature Review Incorporating Critical Appraisal of Research

Scoping Literature Review Incorporating Critical Appraisal of
Research
Intro not done yet:
The research question is In patients with chronic renal failure that
requires hemodialysis (P), what is the impact on patient outcomes (O) of
short daily hemodialysis (C) compared to conventional hemodialysis?
Themes in Support of Analysis, Along With Assessment and Synthesis
Based on findings
Dialysis patients confront a high mortality and morbidity rate. Studies are being
carried out on the impact of hemodialysis frequency on patients with end-stage
renal disease (ESRD) since they are not much evident. The crossover study
based on the short daily hemodialysis is significant. The study conducted by
Goldfarb-Rumyantzev
et al. (2005) with the observation study is taken into
account (Goldfarb-Rumyantzev
et al. 2005). The rigorous models bring about the
theme of care being observed. Although the studies have been performed by
researchers earlier, the studies taken into account throw light on the crucial
findings. The study encompasses the A-B-A design which is in sync with the
theme of conducting a study with phases and these were organized in sequence
(Goldfarb-Rumyantzev
et al. 2005). For the majority of ESRD patients,
conventional thrice-weekly hemodialysis (CHD) is considered to be the standard
frequency of dialysis (Goldfarb-Rumyantzev
et al. 2005). Even though the
process sustains life, it is of not much help in restoring health.
Daily hemodialysis is proven to be more advantageous than thrice-weekly HD as
the increase in frequency ensures effective discharge of uraemic toxins and
depletes variations in the volume of extracellular fluid (Hall
et al. 2012). Hall et
al. (2012) have the effect studied for the Short daily and the impact on

performance and functioning ascertained too (Hall
et al. 2012). This was in-
center hemodialysis (HD) also enables a decline in left ventricular mass and
biochemical variables with control of anemia and blood pressure, and
enhancement in hematocrit and physical function(Goldfarb-Rumyantzev
et al.
2005). However, no remarkable progress in mood, body composition, nutritional
status, or objectively measured physical and cognitive performance was
observed. Daily HD was found to have a better outcome on patients suffering
from acute renal failure than those who underwent dialysis three times a week.
The theme associated with serving the community is crucial. Short daily HD, both
home as well as in-center, is economically and logistically challenging. Daily HD
is still widely used as attention is being given to alter treatment frequency rather
than raising the dialysis dose per session.
Extended-hours nocturnal hemodialysis provides longer treatment times with
enhanced fluid and electrolyte control (Goldfarb-Rumyantzev
et al. 2005). It aids
metabolic variables, left ventricular mass, and hypertension. The treatment is
associated with nearly one-third lower risk of death which is in sharp contrast to
conventional hemodialysis (Sirich
et al. 2017). A rise in albumin, hemoglobin,
and calcium along with a decline in predialysis systolic blood pressure and
phosphorus level were observed after the therapy (Sirich
et al. 2017). The shift
from conventional HD to nocturnal HD consumes dialysis time but accompanies
medication changes to reduce blood and dialysate flow and utilize smaller
dialyzer area.
The increase in dialysis time showed an improvement in patients’ dialysis
efficacy which is directly associated with longevity. Stable serum albumin, stable
interdialytic weight gain, and post-dialysis weight signify an advanced nutritional

level. The rate of urea generation is less during night time than day time. Though
the clearance may not be much different than CHD, the process drastically
improves the clearance of small solute but the ideal measurement needs to be
established. The clearance of middle and large molecules can be done through
long time treatment. NHD controls blood pressure and reduces left ventricular
mass with the assistance of a nominal amount of antihypertensive drugs.
The patients’ quality of life is threatened when they undergo chronic
hemodialysis. Several distressing symptoms they suffer can impair their health.
The sleep quality of patients treated with hemodialysis is observed to be
significantly diminished (Lorenzen
et al. 2012). This could be related to anxiety,
depression, frequent hospitalizations, chronic health conditions, and mortality.
The lack of proper sleep has a direct impact on the physical as well as the mental
well-being of the patients. Unruh
et al. 2016 have brought out in the study, the
frequency pertaining to hemodialysis and the impact being studied from sleep
quality too (Unruh
et al. 2016). Sleep apnea, restless legs while sleeping, and
dozing off during daytime indicate mortality in ESRD patients (Unruh
et al. 2016).
A better discharge of uremia by employing more frequent HD may assist them to
attain improved sleep quality. NHD cures sleep apnea but does not have much
impact on day time sleepiness or occasional limb movements.
Insight into the Previous Research Linked To Research
Impairment of physical health and functioning is relatively high in kidney failure
than in other chronic diseases. Studies by Frequent Hemodialysis Network were
conducted to evaluate self-reported physical health and functioning in patients
who were subjected to dialysis with a frequency of six times per week and three

times per week (Grove
et al. 2015; Creswell 2014; Finlay & Ballinger 2006;
Schneider
et al. 2016). Data was collected on the basis of demographics, clinical
features, nutritional pointers, laboratory variables, and physical parameters and
composition. Conventional HD does not support ESRD patients with fertility
problems whereas nocturnal HD boosts fertility and reduces complications. The
decline in prolactin levels in women may re-establish the menstrual cycle and
heighten testosterone levels in men. The quality of life in NHD patients is seen to
evolve with developing physical constituent and lower hospitalization rates,
though there is no notable progress in the mental component. However, the
overall quality and perception of life are way better than CHD patients.
The group also comprised people who underwent kidney transplantation.
Patients subjected to frequent in-center stated notable progress in self-reported
physical health irrespective of demographics characteristics or prior kidney or
heart dysfunctions. Cardiovascular and strengthening interventions were
reported to create positive transformations in muscle strength and composition.
Appetite was developed through increased frequency of HD as it controlled
uremia (Grove
et al. 2015; Creswell 2014; Finlay & Ballinger 2006; Schneider
et
al. 2016). Consistent physical activities resulted in a hike in physical
performance. Advancement in mobility with low fatigue was observed due to an
increase in the removal of extracellular fluid. Frequent in-center hemodialysis
had a positive effect on self-reported physical health and functioning but not on
physical performance when compared to conventional in-center HD. A study
performed at Kuratorium fu ̈r Dialyse und Nierentransplantation for 12 months
moved its participants from conventional thrice-weekly HD to short daily home
HD. An increase in dialysis dose reported a hike in dialysis efficacy with an
improvement in blood pressure, hemoglobin level, and nutritional status. It also