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Almeida ARF, Grincenkov FRS, Colugnati FAB, Medina-Pestana JO, De Geest S, Sanders-Pinheiro H. Quality of life of patients after kidney transplant: ADHERE Brazil multicenter cross-sectional study. Appl Nurs Res 2024; 78:151815. [PMID: 39053995 DOI: 10.1016/j.apnr.2024.151815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/16/2023] [Accepted: 06/25/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Quality of life (QoL) is a measure to evaluate kidney transplant (KT) results. AIM To describe the QoL profile in a larger sample of Brazilian patients who underwent KT according to age, sex, and access to KT. METHODS We conducted a secondary data analysis of the ADHERE BRAZIL multicenter cross-sectional study including 1105 patients from 20 centers, considering KT access region and transplant activity. QoL was assessed by the WHOQOL-BREF. Data was compared using Generalized Estimating Equations. RESULTS Overall, 58.5 % of the patients were men, mean age of 47.6 ± 12.6 years. The general QoL score was 81 ± 15.1, 58.6 ± 11.6 for physical, 65.5 ± 11.4 for psychological, 68.3 ± 17.1 for social relationships, and 64.2 ± 13.3 for environmental domain. Higher QoL scores were observed in men compared to women in three WHOQOL-BREF domains: psychological (OR:2.62; CI, 1.29 ̶ 3.95, p < 0.0001), social relationships (OR:3.21; CI, 1.2 ̶ 5.23, p = 0.002) and environmental (OR:3.79; CI:2.23 ̶ 5.35, p < 0.0001). Younger patients (18-44 years) had higher scores in the psychological (OR:-2.69; CI, -4.13 ̶ -1.25; p < 0.001; OR:-3.52; CI, -5.39 ̶ -1.66; p < 0.001) and social (OR:-3.46; CI, -5.64 ̶ -1.27; p = 0.002; OR:-7.17; CI, -10 ̶ -4.35; p < 0.0001) domains than older ones (45-59 and > 60 years, respectively). Patients from higher KT access region had higher scores in environmental domain (OR:3.53; CI, 0.28 ̶ 6.78; p = 0.033). CONCLUSIONS Featuring the results of KT under patient view, the physical and social relationships domains were the most and least affected, respectively. Lower QoL subgroups (females and age > 45 years) should be targeted in future multi-professional interventions.
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Affiliation(s)
- Aline R F Almeida
- Renal Transplantation Unit, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil; Interdisciplinary Center for Studies and Research in Nephrology (NIEPEN), Faculty of Medicine, Federal University of Juiz de Fora. Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil.
| | - Fabiane R S Grincenkov
- Faculty of Psychology, Federal University of Juiz de Fora, Rua José Lourenço Kelmer, S/N, São Pedro, Juiz de Fora, MG CEP: 36036-900, Brazil.
| | - Fernando A B Colugnati
- Renal Transplantation Unit, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil; Interdisciplinary Center for Studies and Research in Nephrology (NIEPEN), Faculty of Medicine, Federal University of Juiz de Fora. Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil.
| | - José O Medina-Pestana
- Hospital do Rim e Hipertensão, Oswaldo Ramos Foundation, Nephrology Discipline, Federal University of São Paulo, Rua Borges Lagoa, 960, Vila Clementino, São Paulo, SP CEP: 04038-002, Brazil.
| | - Sabina De Geest
- Institute of Nursing Science, Department Public Health, University of Basel, Peterspl. 1, 4001 Basel, Switzerland; Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Oude Markt 13, 3000 Leuven, Belgium.
| | - Helady Sanders-Pinheiro
- Renal Transplantation Unit, University Hospital, Federal University of Juiz de Fora, Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil; Interdisciplinary Center for Studies and Research in Nephrology (NIEPEN), Faculty of Medicine, Federal University of Juiz de Fora. Avenida Eugênio do Nascimento, S/N, Dom Bosco, Juiz de Fora, MG CEP: 36038-330, Brazil.
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İlter SM, Tülüce D. The Level of Knowledge of Organ Transplantation and Attitudes Toward Organ Donation of Carers of Patients Receiving Hemodialysis. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231212739. [PMID: 37947406 DOI: 10.1177/00302228231212739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Purpose: Renal transplantation is the most effective treatment method for chronic renal failure and helps improve the quality of life of patients and caregivers.In the present study, the purpose was to determine the knowledge level of the primary caregivers of patients receiving hemodialysis treatment about organ transplantation and their attitudes toward organ donation.Method: The study was conducted in a descriptive fashion with the relatives of 71 patients who were receiving treatment in the hemodialysis unit for the end-stage renal failure of a state hospital between 01.08.2022 and 15.10.2022. The data of the study were collected face to face with a questionnaire form, Organ Donation Attitude Scale, and Organ Tissue Donation and Transplantation Information Scale. The SPSS 24 package program was used in the analysis of the data. Descriptive statistics, numbers, percentages, and mean values were used in the analysis of the data. The One-Sample Kolmogorov-Smirnov Test was used to evaluate the homogeneity of the data. The Studentt test, the One-Way Analysis of Variance, the Kruskal-Wallis Test, and the Tukey Post-Hoc Test were used for the analysis between the groups. Statistical significance was taken as p < .05.Results: The benevolence and moral values/beliefs sub-dimension score average of the participants was found to be 98.44 ± 14.61, the fear of medical neglect was 32.10 ± 10.09, and the mean bodily injury sub-dimension score was 30.45 ± 11.28. It was also found that the mean score of the Organ-Tissue Donation and Transplant Information Scale was 11.41 ± 2.59. A statistically significant and negative relationship was detected between the participants' medical neglect and bodily injury attitudes and the Organ-Tissue Donation and Transplant Information Scale score averages (p < .05).Conclusion and Suggestions: As a result, it was found that the positive attitudes of the caregivers of individuals receiving hemodialysis treatment about organ donation were at a good level, and as the level of organ transplantation knowledge increased, negative attitudes towards organ donation decreased. In this context, it can be suggested that healthcare professionals provide training on organ transplantation and donation to the relatives of patients receiving hemodialysis treatment.
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Affiliation(s)
- Sümeyra Mihrap İlter
- Department of Gerontology, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Derya Tülüce
- Department of Nursing, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
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Fidan C, Ağırbaş İ. The effect of renal replacement therapy on health-related quality of life in end-stage renal disease: a meta-analysis. Clin Exp Nephrol 2023; 27:829-846. [PMID: 37466815 DOI: 10.1007/s10157-023-02377-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND End-stage renal disease (ESRD) patients judge health-related quality of life (HRQoL) as an essential outcome. In meta-analysis studies, there is ongoing debate regarding the impact of renal replacement therapy (RRT) methods on HRQoL in ESRD patients. Hence, the main objective of this study was to examine the influence of RRT method utilization on HRQoL in individuals with ESRD. Additionally, the secondary objective was to explore the impact of RRT method use on HRQoL, considering various moderator variables. METHODS RRT methods called hemodialysis (HD), peritoneal dialysis (PD), home dialysis (HoD), and kidney transplantation (KT) are used to treat ESRD. HD was defined as in-center HD (ICHD) and home HD (HHD). HoD was defined as HHD and PD. The estimated Hedges' g were conducted by random effect meta-analysis. RESULTS A total of 111 publications, including 50.151 patients, were included. KT was better at improving patients' HRQoL than other methods. PD was better at improving patients' HRQoL than HD. HoD was better at improving patients' HRQoL than ICHD. Sensitivity analyses yielded similar results. Publication bias was not tested. The subgroup and meta-regression analyses showed that the moderating variables had a statistically significant effect on the HRQoL of patients with ESRD. CONCLUSION For the treatment of ESRD, either KT, PD, or HoD can be used in terms of HRQoL. We need to improve the factors affecting the HRQoL of ESRD patients undergoing HD and ICHD. Healthcare professionals should consider the factors that influence HRQoL and choose an RTT method for each ESRD patient.
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Affiliation(s)
- Cuma Fidan
- Department of Healthcare Management, Health Sciences Faculty, Mus Alparslan University, 49250, Mus, Turkey.
| | - İsmail Ağırbaş
- Department of Healthcare Management, Ankara University, Ankara, Turkey
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Dumaine CS, Fox DE, Ravani P, Santana MJ, MacRae JM. Health related quality of life during dialysis modality transitions: a qualitative study. BMC Nephrol 2023; 24:282. [PMID: 37740177 PMCID: PMC10517513 DOI: 10.1186/s12882-023-03330-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/11/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Modality transitions represent a period of significant change that can impact health related quality of life (HRQoL). We explored the HRQoL of adults transitioning to new or different dialysis modalities. METHODS We recruited eligible adults (≥ 18) transitioning to dialysis from pre-dialysis or undertaking a dialysis modality change between July and September 2017. Nineteen participants (9 incident and 10 prevalent dialysis patients) completed the KDQOL-36 survey at time of transition and three months later. Fifteen participants undertook a semi-structured interview at three months. Qualitative data were thematically analyzed. RESULTS Four themes and five sub-themes were identified: adapting to new circumstances (tackling change, accepting change), adjusting together, trading off, and challenges of chronicity (the impact of dialysis, living with a complex disease, planning with uncertainty). From the first day of dialysis treatment to the third month on a new dialysis therapy, all five HRQoL domains from the KDQOL-36 (symptoms, effects, burden, overall PCS, and overall MCS) improved in our sample (i.e., those who remained on the modality). CONCLUSIONS Dialysis transitions negatively impact the HRQoL of people with kidney disease in various ways. Future work should focus on how to best support people during this time.
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Affiliation(s)
- Chance S Dumaine
- Division of Nephrology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Danielle E Fox
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Pietro Ravani
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Division of Nephrology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Maria J Santana
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Pediatrics, University of Calgary, Calgary, Canada
| | - Jennifer M MacRae
- Division of Nephrology, Cumming School of Medicine, University of Calgary, Calgary, Canada.
- Department of Cardiac Sciences, University of Calgary, Calgary, Canada.
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Sitjar-Suñer M, Suñer-Soler R, Bertran-Noguer C, Masià-Plana A, Romero-Marull N, Reig-Garcia G, Alòs F, Patiño-Masó J. Mortality and Quality of Life with Chronic Kidney Disease: A Five-Year Cohort Study with a Sample Initially Receiving Peritoneal Dialysis. Healthcare (Basel) 2022; 10:healthcare10112144. [PMID: 36360484 PMCID: PMC9690964 DOI: 10.3390/healthcare10112144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/17/2022] [Accepted: 10/22/2022] [Indexed: 11/29/2022] Open
Abstract
The quality of life, morbidity and mortality of people receiving renal replacement therapy is affected both by the renal disease itself and its treatment. The therapy that best improves renal function and quality of life is transplantation. Objectives: To study the quality of life, morbidity and mortality of people receiving renal replacement therapy over a five-year period. Design: A longitudinal multicentre study of a cohort of people with chronic kidney disease. Methods: Patients from the Girona health area receiving peritoneal dialysis were studied, gathering data on sociodemographic and clinical variables through an ad hoc questionnaire, quality of life using the SF-36 questionnaire, and social support with the MOS scale. Results: Mortality was 47.2%. Physical functioning was the variable that worsened most in comparison with the first measurement (p = 0.035). Those receiving peritoneal dialysis (p = 0.068) and transplant recipients (p = 0.083) had a better general health perception. The social functioning of transplant recipients improved (p = 0.008). Conclusions: People with chronic kidney disease had a high level of mortality. The dimension of physical functioning worsens over the years. Haemodialysis is the therapy that most negatively effects general health perception. Kidney transplantation has a positive effect on the dimensions of energy/vitality, social functioning and general health perception.
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Affiliation(s)
- Miquel Sitjar-Suñer
- Primary Health Centre, Institut Català de la Salut, 17800 Olot, Spain
- Nursing Department, University of Girona, 17003 Girona, Spain
| | - Rosa Suñer-Soler
- Nursing Department, University of Girona, 17003 Girona, Spain
- Health and Health Care Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain
- Correspondence:
| | - Carme Bertran-Noguer
- Nursing Department, University of Girona, 17003 Girona, Spain
- Health and Health Care Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain
| | - Afra Masià-Plana
- Nursing Department, University of Girona, 17003 Girona, Spain
- Health and Health Care Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain
| | | | - Glòria Reig-Garcia
- Nursing Department, University of Girona, 17003 Girona, Spain
- Health and Health Care Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain
| | - Francesc Alòs
- Primary Health Centre, Passeig de Sant Joan, Institut Català de la Salut, 08010 Barcelona, Spain
| | - Josefina Patiño-Masó
- Nursing Department, University of Girona, 17003 Girona, Spain
- Quality of Life Research Institute, University of Girona, 17003 Girona, Spain
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Quality of Life, Depression, and Anxiety in Patients Undergoing Renal Replacement Therapies in Saudi Arabia. ScientificWorldJournal 2022; 2022:7756586. [PMID: 35392177 PMCID: PMC8983209 DOI: 10.1155/2022/7756586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 02/22/2022] [Accepted: 03/19/2022] [Indexed: 12/27/2022] Open
Abstract
Despite improvements in renal replacement therapy (RRT) for end-stage renal disease (ESRD), it continues to have serious negative impacts on quality of life (QOL) and emotional status. This study determines the association between demographic characteristics and the negative emotional states of depression, anxiety, and stress in Saudi Arabia. A comparative cross-sectional study was conducted in the Eastern Region of Saudi Arabia. Convenience sampling was used to recruit participants comprising hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (Tx) patients. They completed the Short Form-36 Survey and the Depression, Anxiety, Stress Scale (DASS). The physical component summary (PCS) score was similar for HD (41.7) and PD (41.5), but higher among Tx (45.2). The mental component summary (MCS) score was similar between HD (48.0) and Tx (48.8), but lower in PD (42.3). The majority of patients in all groups had normal levels of depression, anxiety, and stress. Overall, the study found that PCS was higher among Tx patients compared to HD and PD, while MCS was higher among HD and Tx patients than PD patients. Most patients' levels of depression, anxiety, and stress were within the normal range. Those findings will provide policymakers and health managers with the significant factors which can affect the QOL of dialysis and Tx patients.
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de Souza Rezende P, Porcher Andrade F, Ferraro Dos Santos Borba C, Eidt Rovedder PM. Pulmonary function, muscle strength, and quality of life have differed between chronic kidney disease patients and healthy individuals. Ther Apher Dial 2021; 26:337-344. [PMID: 34328280 DOI: 10.1111/1744-9987.13714] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 11/27/2022]
Abstract
Chronic kidney disease (CKD) patients have lower pulmonary function, respiratory and peripheral muscle strength values when compared to the general population, which reflects negatively in the quality of life (QoL). The aim of this study was to compare the pulmonary function, respiratory and peripheral muscle strength, and QoL between CKD patients and healthy individuals. Cross-sectional study with a consecutive sample of 39 individuals separated into three groups: nondialysis-dependent CKD in stage 5 (CKD-5), HD group (CKD-HD), and healthy individuals. The tests performed were spirometry, manovacuometry, handgrip strength (HGS), and Medical Outcomes Short-Form Health Survey (SF-36). A significant difference between groups was observed in forced expiratory volume in 1 second (FEV1 ) and its predicted value (p = 0.004 and p < 0.001, respectively), forced vital capacity (FVC), and its predicted value (p = 0.008 and p < 0.001, respectively), peak expiratory flow (PEF) and its predicted value (p = 0.004 and p < 0.001, respectively), maximal inspiratory pressure (MIP) and its predicted value (p = 0.022), maximal expiratory pressure (MEP) and its predicted value (p = 0.030 and p = 0.009, respectively) in which CKD-5 presented the worst values, followed by CKD-HD and healthy group. The CKD-5 had worse pulmonary function, respiratory muscle strength, and QoL. Moreover, CKD-HD also showed some impairment in pulmonary function and QoL when compared with healthy individuals. Even with the peripheral muscle strength preserved, its decrease is proportional to the pulmonary impairment in the evaluated CKD patients.
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Affiliation(s)
- Patrícia de Souza Rezende
- Physiotherapy School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Francini Porcher Andrade
- Ciências Pneumológicas Post Graduation Program, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Paula Maria Eidt Rovedder
- Physiotherapy School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.,Ciências Pneumológicas Post Graduation Program, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.,Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Jeong HW, Song CE, An M. Feasibility and preliminary effects of a theory-based self-management program for kidney transplant recipients: A pilot study. PLoS One 2021; 16:e0248947. [PMID: 34191808 PMCID: PMC8244880 DOI: 10.1371/journal.pone.0248947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 03/08/2021] [Indexed: 11/19/2022] Open
Abstract
Self-care activities are important to prevent transplant-related side effects and complications among kidney transplant recipients. Therefore, we developed a theory-based self-management program for kidney transplant recipients hospitalized after surgery. This study aimed to examine the feasibility of the program and to identify its preliminary effects on autonomy, competence, and self-care agency. We assessed feasibility using quantitative data collected based on a single group repeated-measures design, along with qualitative data such as patients' feedback on satisfaction during patient counseling. The program comprised video education and individual counseling by nurses. Thirty patients completed this program. Outcome variables were measured thrice: before education, immediately following the first week of video education, and after two consecutive weeks of counseling. A repeated measures ANOVA showed a statistically significant increase in autonomy (F = 5.03, p = .038), competence (F = 17.59, p < .001), and self-care agency (F = 24.19, p < .001). Our pilot study provided preliminary evidence supporting the feasibility for implementation of the theory-based self-management program, and suggesting its preliminary effects in improving autonomy, competence, and self-care agency among kidney transplant recipients. Further research is needed to examine the short- and long-term effects of this program in a longitudinal, randomized control study with a larger sample.
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Affiliation(s)
- Hye Won Jeong
- Department of Nursing, Chonnam National University Hospital, Gwangju, South Korea
| | - Chi Eun Song
- Department of Nursing, Nambu University, Gwangju, South Korea
| | - Minjeong An
- Interdisciplinary Program of Arts & Design Technology, College of Nursing, Chonnam National University, Gwangju, South Korea
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Sarhan AL, Jarareh RH, Shraim M. Quality of life for kidney transplant recipients and hemodialysis patients in Palestine: a cross-sectional study. BMC Nephrol 2021; 22:210. [PMID: 34082724 PMCID: PMC8173862 DOI: 10.1186/s12882-021-02412-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/20/2021] [Indexed: 12/18/2022] Open
Abstract
Background Health related quality of life (HRQOL) is an important indicator of medical treatment and is a strong predictor of disability and mortality. The literature has shown mixed evidence about whether kidney transplantation improves HRQOL compared with other renal replacement modalities. The aim of this study was to compare the HRQOL in kidney transplant recipients (KTRs) and hemodialysis (HD) patients. Methods A cross-sectional study of 100 KTRs and 272 HD patients from two central kidney units in the West Bank, Palestine. The HRQOL was assessed using the Short Form-36 Health Survey. Multivariable linear regression was used to estimate differences in mean HRQOL scores between KTRs and HD patients. Results As compared to HD patients, KTRs had higher clinically important HRQOL in main domains and subscales of the SF-36 including physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, ranging between 15.5 for social functioning (95% Confidence Interval (CI) 10.1, 20.7) to 32.6 for general health (95% CI 24.0, 41.1). Conclusions We found that KTRs have better HRQOL than HD patients in physical and mental components of the SF-36 scale including physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Further longitudinal research comparing HRQOL among KTRs and the general population may identify key modifiable factors associated with lower HRQOL among KTRs that are amenable to intervention.
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Affiliation(s)
- Adnan Lutfi Sarhan
- Department of Public Health, Faculty of Medicine and Health Sciences, An-Najah National University, Ramallah, Palestine
| | - Raya H Jarareh
- Palestine Medical Complex, Ministry of Health, Ramallah, Palestine
| | - Mujahed Shraim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, PO Box. 2713, Doha, Qatar.
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Brito DCSD, Machado EL, Reis IA, Cherchiglia ML. Impact of clinical, sociodemographic and quality of life factors on dialysis patient survival: a nine-year follow-up cohort study. CAD SAUDE PUBLICA 2020; 36:e00007320. [PMID: 33331548 DOI: 10.1590/0102-311x00007320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/15/2020] [Indexed: 11/22/2022] Open
Abstract
Although renal replacement therapy has contributed to the survival of chronic kidney failure (CKF) patients, mortality remains a major concern. This study aimed to identify the factors associated with mortality in a prospective cohort of CKF patients. Sociodemographic, clinical, nutritional, lifestyle and quality of life data were collected from 712 patients. The instruments used were the Short-Form Health Survey (SF-36), Global Subjective Assessment (GSA) and Charlson Comorbidity Index (CCI) questionnaires. A total of 444 patients died during the study. After five years of follow-up, factors such as not being married (hazard ratio - HR = 1.289, 95%CI: 1.001; 1.660), a low frequency of leisure activities (HR = 1.321; 95%CI: 1.010; 1.727) and not being transplanted (HR = 7.246; 95%CI: 3.359; 15.630) remained independently associated with the risk of mortality. At the end of the follow-up period, factors such as not being married (HR = 1.337, 95%CI: 1.019; 1.756), not being transplanted (HR = 7.341, 95%CI: 3.829; 14.075) and having a worse nutritional status (HR = 1.363, 95%CI: 1.002; 1.853) remained independently associated with an increased risk of mortality, whereas a high schooling level (10 to 12 years, HR = 0.578, 95%CI: 0.344; 0.972; and over 12 years, HR = 0.561, 95%CI: 0.329; 0.956) and a better SF-36 physical functioning score (HR = 0.992, 95%CI: 0.987; 0.998) were protective factors associated with survival. The survival of patients with CKF is associated with factors not restricted to the clinical spectrum. The following factors were associated with high mortality: not being married, low schooling level, a limited social routine, a longer time on dialysis, worse nutritional status, and worse physical functioning.
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Yoshinaga K, Araki M, Wada K, Maruyama Y, Mitsui Y, Sadahira T, Kubota R, Nishimura S, Kobayashi Y, Takeuchi H, Tanabe K, Kitagawa M, Morinaga H, Uchida HA, Kitamura S, Sugiyama H, Wada J, Watanabe M, Watanabe T, Nasu Y. Low-dose rituximab induction therapy is effective in immunological high-risk renal transplantation without increasing cytomegalovirus infection. Int J Urol 2020; 27:1136-1142. [PMID: 33012030 DOI: 10.1111/iju.14382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/17/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To analyze the effect and impact of low-dose rituximab induction therapy on cytomegalovirus infection in living-donor renal transplantation. METHODS A total of 92 recipients undergoing living-donor renal transplantation at Okayama University Hospital from May 2009 to August 2018 were evaluated retrospectively. Indications for preoperative rituximab (200 mg/body) were the following: (i) ABO major mismatch; (ii) ABO minor mismatch; (iii) donor-specific anti-human leukocyte antigen antibody-positive; and (iv) focal segmental glomerulosclerosis. We excluded four recipients who were followed <3 months, five who received >200 mg/body rituximab and seven who received prophylactic therapy for cytomegalovirus. RESULTS There were 59 patients in the rituximab group and 17 in the non-rituximab group. Groups differed significantly in age (median age 53 vs 37 years, respectively; P = 0.04), but not in sex (male 64% vs 65%, P = 1.00), focal segmental glomerulosclerosis (3% vs 0%, P = 1.00) or percentage of cytomegalovirus-seronegative recipients of renal allografts from cytomegalovirus-seropositive donors (12% vs 18%, P = 0.68). The estimated glomerular filtration rate did not differ significantly between groups until 24 months after transplantation. Cytomegalovirus clinical symptoms (10% vs 24%, P = 0.22), including fever ≥38°C (5% vs 12%, P = 0.31) and gastrointestinal symptoms (5% vs 12%, P = 0.31), and the 5-year survival rates of death-censored graft loss (90% vs 83%, P = 0.43) did not differ significantly between groups. CONCLUSIONS Low-dose rituximab induction therapy is effective in immunological high-risk recipients without increasing cytomegalovirus infection in the absence of valganciclovir prophylaxis.
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Affiliation(s)
- Kasumi Yoshinaga
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Motoo Araki
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Koichiro Wada
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Yuki Maruyama
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Yosuke Mitsui
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Takuya Sadahira
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Risa Kubota
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Shingo Nishimura
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Yasuyuki Kobayashi
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Hidemi Takeuchi
- Department of, Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Katsuyuki Tanabe
- Department of, Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Masashi Kitagawa
- Department of, Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Hiroshi Morinaga
- Department of, Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Haruhito Adam Uchida
- Department of, Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Shinji Kitamura
- Department of, Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Hitoshi Sugiyama
- Department of, Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Jun Wada
- Department of, Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Masami Watanabe
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Toyohiko Watanabe
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Yasutomo Nasu
- Departments of, Department of, Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
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Sitjar-Suñer M, Suñer-Soler R, Masià-Plana A, Chirveches-Pérez E, Bertran-Noguer C, Fuentes-Pumarola C. Quality of Life and Social Support of People on Peritoneal Dialysis: Mixed Methods Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4240. [PMID: 32545857 PMCID: PMC7345330 DOI: 10.3390/ijerph17124240] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023]
Abstract
Although some study has been made into quality of life in patients with peritoneal dialysis, little is known about how this relates to social support. The aim of this paper was to study health-related quality of life, perceived social support and the experiences of people receiving peritoneal dialysis. A cross-sectional study was conducted using quantitative and qualitative methodologies, between June 2015 and March 2017. Fifty-five patients receiving peritoneal dialysis were studied. The most affected quality of life dimensions were the effects of the disease, the burden of the disease, occupational status, sleep and satisfaction. The physical component of the quality of life questionnaire was negatively associated with the number of hospital admissions over the previous year (p = 0.027) and positively associated with social support (p = 0.002). With regard to the mental component, age (p = 0.010) and social support (p = 0.041) were associated with a better quality of life. Peritoneal dialysis, while not a panacea, is experienced as being less aggressive than hemodialysis, allowing greater autonomy and improved perceived health. Greater symptomology corresponded to worse quality of life and to perceiving the disease as a burden. Patients had to adapt to the new situation despite their expectations. Social support was observed to be a key factor in perceived quality of life.
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Affiliation(s)
- Miquel Sitjar-Suñer
- University Hospital Dr. Josep Trueta, Nephrology Service, 17007 Girona, Spain;
- UVic-UCC, Barcelona, 08500 Vic, Spain
| | - Rosa Suñer-Soler
- Department of Nursing, University of Girona, 17003 Girona, Spain; (A.M.-P.); (C.B.-N.); (C.F.-P.)
- Health and Health Care Research Group, University of Girona, 17003 Girona, Spain
| | - Afra Masià-Plana
- Department of Nursing, University of Girona, 17003 Girona, Spain; (A.M.-P.); (C.B.-N.); (C.F.-P.)
| | - Emilia Chirveches-Pérez
- Department of Nursing, UVic-UCC, 08500 Vic, Spain;
- Research Group on Methodology, Methods, Models of Health and Social Outcome, UVic-UCC, 08500 Vic, Spain
| | - Carme Bertran-Noguer
- Department of Nursing, University of Girona, 17003 Girona, Spain; (A.M.-P.); (C.B.-N.); (C.F.-P.)
- Health and Health Care Research Group, University of Girona, 17003 Girona, Spain
| | - Concepció Fuentes-Pumarola
- Department of Nursing, University of Girona, 17003 Girona, Spain; (A.M.-P.); (C.B.-N.); (C.F.-P.)
- Health and Health Care Research Group, University of Girona, 17003 Girona, Spain
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Ramírez-Perdomo CA, Perdomo-Romero AY, Rodriguez-Vélez ME. El sistema de salud: barreras para los usuarios con insuficiencia renal crónica. AVANCES EN ENFERMERÍA 2020. [DOI: 10.15446/av.enferm.v38n2.83555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: comprender la experiencia vivida por un grupo de personas con insuficiencia renal crónica que recibieron un trasplante de órgano frente a los servicios de salud y lossignificados del cuidado de la salud realizados por enfermeras y familiares.Materiales y métodos: estudio cualitativo con enfoque fenomenológico-hermenéutico. La muestra se compone de 11 personas con insuficiencia renal crónica trasplantadas, cincocuidadores y cinco enfermeras. Entrevistas recolectadas y grabadas entre diciembre de 2015 y enero de 2017. Para el análisis se empleó el método propuesto por Van Manen.Resultados: uno de los temas que emerge es la experiencia de encontrarse y vivir con insuficiencia renal crónica, del cual se extrae el subtema relacionado con la vivencia en elsistema de salud por parte de las personas enfermas, sus cuidadores y los profesionales de enfermería.Conclusiones: la insuficiencia renal crónica asume un significado complejo y multidimensional para la persona con la enfermedad, sus cuidadores familiares y las enfermeras que asumen el cuidado de este grupo de personas, que los lleva a experimentar el sistema de salud con un efecto adverso que deshumaniza el cuidado de las personas.
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Oduncuoğlu BF, Alaaddinoğlu EE, Çolak T, Akdur A, Haberal M. Effects of Renal Transplantation and Hemodialysis on Patient's General Health Perception and Oral Health-Related Quality of Life: A Single-Center Cross-Sectional Study. Transplant Proc 2020; 52:785-792. [PMID: 32113695 DOI: 10.1016/j.transproceed.2020.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/27/2019] [Accepted: 01/20/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients with end-stage renal disease have a lower quality of life compared to the general population. Oral health-related quality of life (OHRQoL) is of particular interest as good oral health could influence general health. This study aimed to compare dental and periodontal health status, OHRQoL, and general health perception of renal transplant (TX) and hemodialysis patients (HD) with that of healthy controls. METHODS The study included 64 TX, 63 HD, and 61 healthy patients. TX patients were also grouped according to the time elapsed after transplantation and currently use of immunosuppressive agents. The numbers of decayed, missing, and filled teeth were recorded as DMFT, and periodontal health status was evaluated. Patients' general health perceptions and OHRQoL were assessed using Short Form-36, Oral Health Impact Profile-14, and OHRQoL-United Kingdom questionnaires. RESULTS The HD groups presented significantly higher DMFT scores and periodontal scores than TX and control groups. OHRQoL-United Kingdom total scores of TX and HD groups were lower than controls (P < .05). Oral Health Impact Profile-14 total scores revealed that HD groups' OHRQoL was significantly lower than TX and control groups (P < .05). Perceptions of general health of TX patients were higher than in the HD group. CONCLUSIONS Renal transplantation has shown to increase quality of life and OHRQoL compared to hemodialysis therapy. Neither the immunosuppressive agent nor the time elapsed after transplantation were observed to be significant factors affecting OHRQoL.
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Affiliation(s)
| | | | - Turan Çolak
- Department of Nephrology, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Aydıncan Akdur
- Department of General Surgery Division of Transplantation, Başkent University, Ankara, Turkey
| | - Mehmet Haberal
- Department of General Surgery Division of Transplantation, Başkent University, Ankara, Turkey.
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