LUMIDIAL:光疗在血液透析中的可行性、试点研究和实际经验

Benoit Franko, Marianne Jund, Cécile Herlet, Violaine Delsante, Lucas Pires, Anne-Laure Claudel, Tristan Delory
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摘要

简介:睡眠和情绪障碍是血液透析患者的常见病,但光疗对这一人群的影响仍然未知:睡眠和情绪障碍在血液透析患者中很常见,但光疗对这一人群的影响仍然未知:我们进行了一项随机、对照、开放标签试验,比较了每周三次每次 30 分钟的光疗或不进行光疗的两个组别。主要终点是光疗五周后睡眠质量(PSQI)的变化,情绪变化(DASS-21)是次要终点。我们在一项前瞻性、非随机、真实的试验后队列中增加了相同标准的描述:研究结果:我们在试点研究中纳入了 28 名可分析的患者。光疗对降低 PSQI 没有明显效果(p = 0.496)。抑郁症有减轻趋势(-6.2 [95% CI, -12.5 to -0.05],p = 0.058)。在实际队列中,27 名患者中有 12 人的抑郁评分显著降低(≥ 6 分):讨论:每周三次在血液透析中进行光疗似乎对睡眠质量没有影响,但可以减轻抑郁状态。该技术易于实施、耐受性好且成本低廉。要验证其对抑郁症的疗效,还需要进行多中心随机试验,与假装置进行对比。
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LUMIDIAL: feasibility of light therapy in hemodialysis, pilot study and real-life experience

Introduction: Sleep and mood disorders are common in hemodialysis, but the effect of light therapy remains unknown in this population.

Methods: We conducted a randomized, controlled, open-label pilot trial comparing two group of either 30 minutes of light therapy three times a week, or no exposure. The primary endpoint was change in sleep quality (PSQI) after five weeks of light therapy, with change in mood (DASS-21) as a secondary endpoint. We added the description of the same criteria in a prospective, non-randomized, real-life post-trial cohort.

Study results: We included 28 analyzable patients in the pilot study. Light therapy had no significant effect on PSQI reduction (p = 0.496). There was a trend towards a reduction in depression (-6.2 [95% CI, -12.5 to -0.05], p = 0.058). In the real-life cohort, out of 27 patients, 12 had a significant reduction in depression score (≥ 6 points).

Discussion: Light therapy performed in hemodialysis three times a week appears to have no effect on sleep quality, but could reduce depressive states. The technique is easy to implement, well tolerated and inexpensive. A multicenter randomized trial against the sham device will be needed to validate its effect on depression.

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