Personalized virtual reality in hemodialysis patients: a multicenter pilot study

Patients undergoing hemodialysis frequently experience stress, physical discomfort, depressive symptoms and prolonged immobility during lengthy treatment sessions. Immersive virtual reality (VR) has shown promise as a non-pharmacological intervention to improve wellbeing in various clinical settings. However, no multicenter study has examined personalized immersive VR in dialysis patients. This study therefore aimed to assess the tolerability and effects of a single personalized VR session on wellbeing, pain and physiological parameters in patients undergoing hemodialysis.

In this pre-post single group pilot study, 148 participants from 12 dialysis centers (10 outpatient, 2 in-hospital) were enrolled. Each patient completed one personalized 20-min VR session, selecting from 20 immersive 360° options. Emotional wellbeing and pain were assessed before and after VR exposure, while treatment tolerance, perceived quality and feasibility were assessed post-session. Physiological parameters (blood pressure, heart rate, oxygen saturation) were recorded before, during and after exposure.

Of the 148 enrolled participants, 143 completed the intervention (mean age 62.2 ± 14.5 years; 64.9% male and 35.1% female). Wellbeing improved significantly; among participants reporting pain, scores decreased by ∼50%. Systolic blood pressure declined from 135 to 128 mmHg and diastolic from 72 to 69 mmHg during VR exposure, with heart rate decreasing from a mean of 72 to 67 bpm (P < .0001 for all); values returned toward baseline afterwards. No serious adverse events were reported.

Personalized VR was well tolerated and produced measurable psychological and physiological benefits in dialysis patients, supporting its potential as a feasible non-pharmacological adjunct to routine care.