الفهرس 
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Abstract
Internal medicine
End stage renal disease (ESRD) is a devastating problem both at the personal and national level and has become a worldwide public health problem.Chronic kidney diseases represent the 12th leading cause of death and 17th leading cause of disability and the majority of patients with ESRD are treated with hemodialysis.The global number of people being treated for end-stage renal disease (ESRD) was estimated to be 2,786,000 by the end of 2011. and continues to rise at an alarmingly fast rate. Around 2,618,000 people were on maintenance dialysis (hemodialysis or peritoneal dialysis) and 622,000 people underwent kidney transplants, according to the US Renal Data System. Hemodialysis remained the most frequent treatment modality at the end of 2011, with roughly 1,929,000 patients (89 percent of all dialysis patients) and around 235,000 individuals having peritoneal dialysis (11 percent of all dialysis patients). By 2030, this number will have more than doubled to 5439 million, with Asia and Africa seeing the most rise. The goal of this study is to assess hemodialysis patients’ quality of life and determine whether there is a difference in quality of life between morning and evening dialysis shifts.This study compares morning hemodialysis to night hemodialysis in terms of (1) blood pressure, (2) HRQOL, (3) anaemia, (4) mineral metabolism, and (5) quality of life. (5)Sleep quality (6)hemodialysis adequacy.This cross-sectional study was conducted on 60 patients both male and female who attending dialysis units at Minia university hospital at both morning dialysis shift at (8am :12pm) and evening shift (5pm:9pm) in the period between December 2020 to February 2021.
The main results of the study revealed that:
The mean (± SD) URR, KT/V and HR were 64.6±3.6 %, 1.3±0.1 and 86.6±15.8 respectively. The mean (± SD) systolic blood pressure measured predialysis, intradialysis and postdialysis was 150.5±21.3, 139.5±19.3 and 134±18.6 mm/Hg respectively. The mean (± SD) diastolic blood pressure measured predialysis, intradialysis and postdialysis was 89.8±10.2, 85.3±8.9 and 83.2±8.7 mm/Hg respectively. The mean (± SD) weight measured predialysis and postdialysis was 74.3±17.4 and 71.8±17.1 kg respectively.
The mean (±SD) Hb was 10.1±2.3 gm/dl while the median levels of TLC and platelets were 6.2 and 217.5 respectively. Regarding kidney functions, the mean (± SD) of creatinine and urea levels were 6.7±0.5 mg/dl, 136.4±3.9 mg/dl respectively. As regards electrolytes, the mean Na and K+ levels were 137.4±6.6 mEq/L and 4.3±0.5 mEq/L respectively while the mean total & ionized calcium and phosphorus were8.3±0.9 mg/dL, 1±0.1 mg/dL and 4.2±1.4 mg/dL respectively. The mean PTH and albumin levels were 358±326.6 pg/mL and 4±0.9 gm/dl respectively, while the median CRP was 0.
The median response to Sexual function, Sleep and Social support was 100, 87.5 and 83.3. The median response to Dialysis staff encouragement, Patient satisfaction, Physical functioning and Role physical was 75, 50, 80 and 100 respectively. The median response to Pain, General health and Emotional wellbeing was 77.5, 60 and 84. The median response to Role emotional, social function and Energy/Fatigue was 100, 87.5 and 80 respectively.
There was significant increase number of sessions per week in patients with morning shift compared to night hemodialysis (p= 0.014). The night hemodialysis was significantly higher in patients living in urban areas (p< 0.001). Prevalence of diabetes was significantly higher in patients with night shift compared to morning hemodialysis (p= 0.028).
There were no differences between patients with morning and night hemodialysis with respect to age, sex, cardiac problems and Cause of Kidney disease. Also, there was no significant differences between the two groups regarding education, marriage, working and health insurance.Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.