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Yamamoto S, Tanaka T, Omori K, Ei I, Kikuchi K, Konagai A, Goto S, Kitamura N, Narita I. Pruritus and protein-bound uremic toxins in patients undergoing hemodialysis: a cross-sectional study. Clin Kidney J 2024; 17:sfae007. [PMID: 38283986 PMCID: PMC10818225 DOI: 10.1093/ckj/sfae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Indexed: 01/30/2024] Open
Abstract
Background Patients undergoing hemodialysis frequently experience pruritus; its severity is associated with poor quality of life and mortality. Recent progress in hemodialysis treatment has improved the removal of small- and middle-molecular-weight molecules; however, the removal of protein-bound uremic toxins (PBUTs) remains difficult. It is possible that pruritus is associated with serum PBUTs in patients undergoing hemodialysis. Methods We conducted a multicenter cross-sectional study in patients undergoing hemodialysis (n = 135). The severity of pruritus was assessed using the 5D-itch scale and medication use. Serum PBUTs, including indoxyl sulfate, p-cresyl sulfate, indole acetic acid, phenyl sulfate, and hippuric acid, were measured using mass spectrometry; the PBUT score was calculated from these toxins using principal component analysis. Univariate and multiple regression analyses were performed to examine independent predictors of pruritus. Results Pruritus was reported by 62.2%, 21.5%, and 13.3%, 1.5% and 0.7% as 5 (not at all), 6-10, 11-15, 16-20, and 21-25 points, respectively. The PBUT score was higher in patients undergoing dialysis having pruritus than those without pruritus (0.201 [-0.021 to 0.424] vs -0.120 [-0.326 to 0.087]; P = 0.046). The PBUT score was shown to have an association with the presence of pruritus (coefficient 0.498[Formula: see text]0.225, odds ratio: 1.65 [1.06-2.56]; P = 0.027). Conclusion Uremic pruritus was frequently found and associated with the PBUT score in patients undergoing hemodialysis. Further studies are required to clarify the impact of PBUTs on uremic pruritus and to explore therapeutic strategies in patients undergoing hemodialysis.
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Affiliation(s)
- Suguru Yamamoto
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takahiro Tanaka
- Clinical and Translational Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | | | - Isei Ei
- Santo-Second Clinic, Niigata, Japan
| | - Kaori Kikuchi
- Research and Development Division, Kureha Corporation, Tokyo, Japan
| | - Ayano Konagai
- Research and Development Division, Kureha Corporation, Tokyo, Japan
| | - Shin Goto
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Nobutaka Kitamura
- Clinical and Translational Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Tanemoto Y, Yamada U, Nakayama M, Takeuchi T, Tanemoto F, Ito Y, Kobayashi D, Ohta D, Hashizume M. Association of illness perception and alexithymia with fatigue in hemodialysis recipients: a single-center, cross-sectional study. Sci Rep 2023; 13:16592. [PMID: 37789052 PMCID: PMC10547682 DOI: 10.1038/s41598-023-43935-9] [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: 04/19/2023] [Accepted: 09/30/2023] [Indexed: 10/05/2023] Open
Abstract
Fatigue in hemodialysis recipients interferes with daily activities and renal rehabilitation, and its underlying causes and treatment remain unclear. Psychological factors, like illness perceptions and alexithymia, cause fatigue in other diseases; however, their contribution to hemodialysis-related fatigue is unknown. This cross-sectional study included 53 hemodialysis recipients. To assess participants' fatigue, we used a self-administered patient-reported outcome questionnaire whose items have shown correlation with those of established scales, such as the Profile of Mood States and Visual Analogue Scales. The associations among the scores of the revised Illness Perceptions Questionnaire (IPQ-R), Toronto Alexithymia Scale (TAS-20), and Hospital Anxiety and Depression Scale and fatigue were analyzed using bivariable and multivariable analyses. Patients with fatigue had significantly higher median scores for the IPQ-R subscales "Identity" and "Negative emotional representation about illness" than those without fatigue, suggesting the association of specific illness perception with fatigue. Median scores for the TAS-20 subscale "Difficulty identifying feelings" were also significantly higher among fatigued patients, suggesting the association of alexithymia with fatigue. Depression was not associated with fatigue. Multivariable logistic regression revealed the association of a high "Identity" score with the risk of fatigue (adjusted odds ratio, 1.32; 95% confidence interval, 1.00-1.73; P = 0.04), while there were no significant association between a high "Difficulty identifying feelings" score and the risk of fatigue (adjusted odds ratio, 1.09; 95% confidence interval, 0.95-1.24). Specific illness perception and alexithymia were slightly associated with hemodialysis-related fatigue. Cognitive-behavioral therapy for these conditions could reduce fatigue and promote renal rehabilitation.
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Affiliation(s)
- Yoko Tanemoto
- Department of Psychosomatic Medicine, Toho University Graduate School of Medicine, Omori Nishi 5-21-16, Ota-Ku, Tokyo, 143-0015, Japan.
- Department of Psychosomatic Medicine, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan.
| | - Ui Yamada
- Department of Psychosomatic Medicine, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Masaaki Nakayama
- Department of Nephrology, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Takeaki Takeuchi
- Department of Psychosomatic Medicine, Toho University School of Medicine, Omori Nishi 5-21-16, Ota-Ku, Tokyo, 143-0015, Japan
| | - Fumiaki Tanemoto
- Department of Nephrology, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Yugo Ito
- Department of Nephrology, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Daiki Kobayashi
- Division of General Internal Medicine, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Amicho Chuo 3-20-1, Inashiki-Gun, Ibaraki, 300-0332, Japan
| | - Daisuke Ohta
- Department of Psychosomatic Medicine, St. Luke's International Hospital, Akashicho 9-1, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Masahiro Hashizume
- Department of Psychosomatic Medicine, Toho University Graduate School of Medicine, Omori Nishi 5-21-16, Ota-Ku, Tokyo, 143-0015, Japan
- Department of Psychosomatic Medicine, Toho University School of Medicine, Omori Nishi 5-21-16, Ota-Ku, Tokyo, 143-0015, Japan
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Hachisuka M, Hayashi H, Iwasaki YK, Ito N, Arai T, Kobayashi S, Mimuro R, Fujimoto Y, Oka E, Hagiwara K, Tsuboi I, Murata H, Yamamoto T, Ogano M, Yodogawa K, Hayashi M, Shimizu W. Improvement in Quality of Life via Catheter Ablation for Atrial Fibrillation in Patients Undergoing Hemodialysis Therapy. CJC Open 2022; 4:748-755. [PMID: 36148254 PMCID: PMC9486863 DOI: 10.1016/j.cjco.2022.05.009] [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: 05/10/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Masato Hachisuka
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiroshi Hayashi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
- Corresponding author: Dr Hiroshi Hayashi, Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. Tel.: 81-3-3822-2131 x24007; fax: 81-3-5685-0987.
| | - Yu-ki Iwasaki
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Nobuaki Ito
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Toshiki Arai
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Serina Kobayashi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Rei Mimuro
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Yuhi Fujimoto
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Eiichiro Oka
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Kanako Hagiwara
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Ippei Tsuboi
- Department of Cardiovascular Medicine, National Hospital Organization Shizuoka Medical Centre, Shizuoka, Japan
| | - Hiroshige Murata
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Teppei Yamamoto
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Michio Ogano
- Department of Cardiovascular Medicine, National Hospital Organization Shizuoka Medical Centre, Shizuoka, Japan
| | - Kenji Yodogawa
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Meiso Hayashi
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
- Mabori Medical Clinic, Yokosuka, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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Health-Related Quality of Life Sleep Score Predicts Transfer to Hemodialysis among Patients on Peritoneal Dialysis. Healthcare (Basel) 2022; 10:healthcare10061030. [PMID: 35742081 PMCID: PMC9222522 DOI: 10.3390/healthcare10061030] [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: 04/30/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 12/04/2022] Open
Abstract
Despite the superiority of peritoneal dialysis (PD) over hemodialysis (HD) regarding health-related quality of life (HRQOL), the specific HRQOL domain(s) that predict unplanned HD transfer remains uncertain. In this cohort study, we assessed the HRQOL of 50 outpatients undergoing PD using the Japanese version 1.3 Kidney Disease Quality of Life-Short Form from March 2017 to March 2018 and prospectively analyzed the association of each HRQOL component with HD transfer until June 2021. During the follow-up (41.5 (13.0–50.1) months), 21 patients were transferred to HD. In a multivariate Cox proportional hazards model adjusted for age, sex, PD vintage, urine output, Charlson comorbidity index, and incremental shuttle walking test, a higher sleep score was significantly associated with lower HD transfer rates (HR 0.70 per 10, p = 0.01). An adjusted subdistribution hazard model where elected transition to HD, death, and transplantation were considered competing events of unintended HD transfer that showed sleep score as an exclusive predictor of HD transfer (HR 0.70 per 10, p = 0.002). Our results suggest that sleep score among the HRQOL subscales is instrumental in predicting HD transfer in patients undergoing PD.
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Shimizu Y, Wakabayashi K, Nakata J, Io H, Hamada C, Tomino Y, Suzuki Y. The Influence of an Unexpected Switch of Hemodialysis Facilities on the Quality of Life (QOL) in Hemodialysis Patients. Int J Nephrol Renovasc Dis 2022; 15:151-160. [PMID: 35444454 PMCID: PMC9013676 DOI: 10.2147/ijnrd.s358915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Background Patients and Methods Results Conclusion
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Affiliation(s)
- Yoshio Shimizu
- Department of Nephrology, Juntendo University Shizuoka Hospital, Izunokuni-shi, 410-2211, Japan
- Shizuoka Medical Research Center for Disaster, Izunokuni-shi, 410-2211, Japan
- Correspondence: Yoshio Shimizu, Division of Nephrology, Department of Internal Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni-shi, Shizuoka, 410-2211, Japan, Tel +81-55-948-3111, Fax +81-55-946-0858, Email
| | - Keiichi Wakabayashi
- Department of Nephrology, Juntendo University Shizuoka Hospital, Izunokuni-shi, 410-2211, Japan
| | - Junichiro Nakata
- Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, 113-8421, Japan
| | - Hiroaki Io
- Division of Nephrology, Juntendo University Nerima Hospital, Tokyo, 117-8521, Japan
| | - Chieko Hamada
- Juntendo University Faculty of Health Sciences and Nursing, Mishima-shi, 411-8787, Japan
| | - Yasuhiko Tomino
- Asian Pacific Renal Research Promotion Office, Medical Corporation SHOWAKI, Tokyo, 160-0023, Japan
| | - Yusuke Suzuki
- Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, 113-8421, Japan
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Uchiyama K, Morimoto K, Washida N, Kusahana E, Nakayama T, Itoh T, Kasai T, Wakino S, Itoh H. Effects of a remote patient monitoring system for patients on automated peritoneal dialysis: a randomized crossover controlled trial. Int Urol Nephrol 2022; 54:2673-2681. [PMID: 35362819 PMCID: PMC8972739 DOI: 10.1007/s11255-022-03178-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 03/15/2022] [Indexed: 11/24/2022]
Abstract
Purpose Remote patient monitoring (RPM) has contributed to improved patient-centered outcomes and prognosis in patients with end-stage renal disease on automated peritoneal dialysis (APD). However, evidence from prospective trials is lacking. Methods The participants (n = 15; median age: 65 years; males: 10; peritoneal dialysis vintage: 6.4 ± 3.5 years) randomly received APD therapy using the Kaguya® APD system either with or without the connective use of the cloud-based RPM software Sharesource® for 12 weeks. The primary outcome was patient satisfaction assessed using a modified nine-item Treatment Satisfaction Questionnaire for Medication (TSQM-9) questionnaire. The secondary outcomes were healthcare resource consumption, the health-related quality of life (HRQOL) subscales assessed with the Kidney Disease Quality of Life-Short Form questionnaire, and clinical laboratory parameters. Results Significant improvements were observed in the TSQM-9 subscales of Effectiveness (64.4 ± 18.8 vs. 57.8 ± 18.8; P = 0.006) and Convenience (76.3 ± 15.4 vs. 63.3 ± 17.3; P < 0.001) in patients on Sharesource®. Moreover, Sharesource® reduced the total amount of healthcare resource consumption (0.80 ± 1.32 vs. 1.87 ± 2.39 times/12 weeks; P = 0.02) and consultation time during regular monthly visits (813 ± 269 vs. 1024 ± 292 s; P < 0.001). A significant increase in ultrafiltration volume was found associated with more frequent modification of APD prescription in patients with Sharesource®. Sharesource® also improved the HRQOL subscale of General Health and Vitality. Conclusion Sharesource® can improve patient-centered outcomes in patients on APD while reducing the treatment burden for both patients and medical staff. Trial registration: The study was registered in the Japan Registry of Clinical Trials (jRCT Number: jRCTs032190005). Supplementary Information The online version contains supplementary material available at 10.1007/s11255-022-03178-5.
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Affiliation(s)
- Kiyotaka Uchiyama
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Kohkichi Morimoto
- Apheresis and Dialysis Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
| | - Naoki Washida
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.,Department of Nephrology, International University of Health and Welfare School of Medicine, 4-3, Kozunomori, Narita, Chiba, 286-8686, Japan
| | - Ei Kusahana
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Takashin Nakayama
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Tomoaki Itoh
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Takahiro Kasai
- Department of Nephrology, International University of Health and Welfare School of Medicine, 4-3, Kozunomori, Narita, Chiba, 286-8686, Japan
| | - Shu Wakino
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
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7
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Shimizu S, Onishi Y, Kabaya K, Wang J, Fukuma S, Morinaga J, Hatakeyama S, Kobayashi S, Maeno K, Yamazaki H, Fukuhara S. Cohort profile: Alliance for Quality Assessment in Healthcare-Dialysis (AQuAH-D) prospective cohort study of patients on haemodialysis in Japan. BMJ Open 2022; 12:e054427. [PMID: 35078844 PMCID: PMC8796223 DOI: 10.1136/bmjopen-2021-054427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/09/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The global burden of kidney failure is increasing, but the treatment of kidney failure varies widely between patients, between dialysis facilities and over time. The Alliance for Quality Assessment in Healthcare-Dialysis (AQuAH-D) aims to conduct efficient and timely cohort studies on associations between those variations and clinical and patient-reported outcomes. PARTICIPANTS Included are outpatients aged 20 years old or older who are undergoing haemodialysis and have consented to participate. A total of 2895 patients were enrolled from 25 facilities in Japan between August 2018 and July 2020 and are to be followed until 31 December 2026. Chart review and annual questionnaires are used to collect data on patient characteristics and on outcomes including quality of life. Data on medications, haemodialysis prescriptions and blood tests are obtained from existing electronic records. Data are collected retrospectively from 1 January 2017 to patient enrolment, and prospectively from patient enrolment until the end of December 2026. FINDINGS TO DATE To date, the mean age is 68.3 (SD 12.2) years and 35.2% are female. The most common cause of kidney failure is diabetic nephropathy (37.4%). In January 2020, the facilities' median weekly doses of erythropoietin stimulating agent (ESA) and of intravenous vitamin D ranged from 1846 to 9692 IU (epoetin alfa equivalent) and 0.78 to 2.25 µg (calcitriol equivalent), respectively. The facilities' percentages of patients to whom calcimimetics are prescribed varied from 19% to 79%. During the retrospective period (averaging 1.85 years per participant), the incidence rates of any hospitalisation and of hospitalisation due to cardiovascular disease were 67.2 and 12.0 per 100 person-years, respectively. FUTURE PLANS AQuAH-D data will be updated every 6 months and will be available for studies addressing a wide range of research questions, using the advantages of granular data and quality-of-life measurement of ageing patients on haemodialysis.
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Affiliation(s)
- Sayaka Shimizu
- Department of Research, Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshihiro Onishi
- Department of Research, Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
| | - Koji Kabaya
- Department of Research, Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
| | - Jui Wang
- Department of Research, Institute for Health Outcomes & Process Evaluation Research, Kyoto, Japan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Shingo Fukuma
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jun Morinaga
- Department of Nephrology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University School of Medicine Graduate School of Medicine, Hirosaki, Japan
| | | | | | - Hajime Yamazaki
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shunichi Fukuhara
- Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of General Medicine, Shirakawa Satellite for Teaching and Research (STAR), Fukushima Medical University, Fukushima, Japan
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The effect of trichlormethiazide in autosomal dominant polycystic kidney disease patients receiving tolvaptan: a randomized crossover controlled trial. Sci Rep 2021; 11:17666. [PMID: 34480075 PMCID: PMC8417075 DOI: 10.1038/s41598-021-97113-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 08/17/2021] [Indexed: 12/11/2022] Open
Abstract
The vasopressin V2 receptor antagonist tolvaptan delays the progression of autosomal dominant polycystic kidney disease (ADPKD). However, some patients discontinue tolvaptan because of severe adverse aquaretic events. This open-label, randomized, controlled, counterbalanced, crossover trial investigated the effects of trichlormethiazide, a thiazide diuretic, in patients with ADPKD receiving tolvaptan (n = 10) who randomly received antihypertensive therapy with or without trichlormethiazide for 12 weeks. The primary and secondary outcomes included amount and osmolarity of 24-h urine and health-related quality-of-life (HRQOL) parameters assessed by the Kidney Disease Quality of Life-Short Form questionnaire, renal function slope, and plasma/urinary biomarkers associated with disease progression. There was a significant reduction in urine volume (3348 ± 584 vs. 4255 ± 739 mL; P < 0.001) and a significant increase in urinary osmolarity (182.5 ± 38.1 vs. 141.5 ± 38.1 mOsm; P = 0.001) in patients treated with trichlormethiazide. Moreover, trichlormethiazide improved the following HRQOL subscales: effects of kidney disease, sleep, emotional role functioning, social functioning, and role/social component summary. No significant differences were noted in renal function slope or plasma/urinary biomarkers between patients treated with and without trichlormethiazide. In patients with ADPKD treated with tolvaptan, trichlormethiazide may improve tolvaptan tolerability and HRQOL parameters.
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9
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Influence of unstable psychological condition on the quality of life of hemodialysis patients. RENAL REPLACEMENT THERAPY 2020. [DOI: 10.1186/s41100-020-00271-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Purpose
Hemodialysis patients tend to be in “unstable psychological conditions” because of complications and physical activity restriction. This study aimed to investigate unusual psychological factors and their influence on the quality of life (QOL) of hemodialysis patients.
Methods
This study targeted 55 patients who had experienced > 1 year of stable maintenance outpatient hemodialysis. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate unusual psychological conditions. The Kidney Disease Quality of Life Short Form (KDQOL-SF) was used to evaluate QOL. Participants were grouped into “unstable psychological conditions” if HADS indicated that “depression is suspected” or “suspected depression, anxiety stated” (“Anxiety/Depression group”); this group was then compared to the “Stable group”.
Results
A total of 18 participants (32.7%) were included in the “Anxiety/Depression group”, and all QOL scores in this group were lower than those in the “Stable group”. In particular, a significantly low value was shown in the respective criteria such as “effects of kidney disease,” “social support,” and “general health perceptions”.
Conclusions
A possibility was suggested that the major causes were the restrictions of social activity by hospital visits and treatment and unique psychological conditions.
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Kurita N, Wakita T, Ishibashi Y, Fujimoto S, Yazawa M, Suzuki T, Koitabashi K, Yanagi M, Kawarazaki H, Green J, Fukuhara S, Shibagaki Y. Association between health-related hope and adherence to prescribed treatment in CKD patients: multicenter cross-sectional study. BMC Nephrol 2020; 21:453. [PMID: 33129292 PMCID: PMC7603681 DOI: 10.1186/s12882-020-02120-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 10/22/2020] [Indexed: 02/07/2023] Open
Abstract
Background In chronic kidney disease (CKD), patients’ adherence to prescriptions for diet and for medications might depend on the degree to which they have hope that they will enjoy life, and that hope could vary with the stage of CKD. The aims of this study were to quantify both the association of CKD stage with health-related hope (HR-Hope), and the association of that hope with psychological and physiological manifestations of adherence. Methods This was a cross-sectional study involving 461 adult CKD patients, some of whom were receiving dialysis. The main exposure was HR-Hope, measured using a recently-developed 18-item scale. The outcomes were perceived burden of fluid restriction and of diet restriction, measured using the KDQOL, and physiological manifestations of adherence (systolic and diastolic blood pressure [BP], and serum phosphorus and potassium levels). General linear models and generalized ordered logit models were fit. Results Participants at non-dialysis stage 4 and those at stage 5 had lower HR-Hope scores than did those at stage 2 or 3 (combined). Those at non-dialysis stage 5 had the lowest scores. HR-Hope scores of participants at stage 5D were similar to those of participants at stage 4, but they were lower than the scores of participants at stage 2 or 3 (combined). Higher HR-Hope scores were associated with lower perceived burdens of fluid restriction and of diet restriction (adjusted ORs per ten-point difference were 0.82 and 0.84, respectively). Higher HR-Hope scores were associated with lower systolic BP (adjusted mean difference in systolic BP per ten-point difference in HR-Hope scores was − 1.87 mmHg). In contrast, HR-Hope scores were not associated with diastolic BP, serum phosphorus levels, or serum potassium levels. Conclusions Among CKD patients, HR-Hope is associated with disease stage, with psychological burden, and with some physiological manifestations of adherence. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12882-020-02120-0.
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Affiliation(s)
- Noriaki Kurita
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan. .,Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan. .,Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
| | | | | | - Shino Fujimoto
- Department of Nephrology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Masahiko Yazawa
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Tomo Suzuki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.,Department of Nephrology, Kameda Medical Center, Chiba, Japan
| | - Kenichiro Koitabashi
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Mai Yanagi
- Department of Nephrology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Hiroo Kawarazaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.,Department of Nephrology, Inagi Municipal Hospital, Tokyo, Japan
| | - Joseph Green
- Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunichi Fukuhara
- Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan.,Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Section of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
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11
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Yamamoto S, Matsuzawa R, Kamitani T, Hoshi K, Ishii D, Noguchi F, Hamazaki N, Nozaki K, Ichikawa T, Maekawa E, Matsunaga A, Yoshida K. Efficacy of Exercise Therapy Initiated in the Early Phase After Kidney Transplantation: A Pilot Study. J Ren Nutr 2020; 30:518-525. [PMID: 32507332 DOI: 10.1053/j.jrn.2019.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/23/2019] [Accepted: 11/24/2019] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE In patients with kidney transplant (KT), frailty is a predictor of adverse outcomes. Outcomes of exercise therapy in patients with KT, particularly the efficacy of early exercise after KT, have not been evaluated. We investigated the effect of exercise intervention beginning early after KT on physical performance, physical activity, quality of life, and kidney function in patients with KT. METHODS KT recipients who underwent surgery with usual care plus exercise training from a prospective cohort (exercise group; n = 10) and those with usual care alone from a historical cohort (control group; n = 14) were included in this study. Early exercise comprised supervised aerobic training and physical activity instruction from day 6 to 2 months after KT. The following outcomes were measured: 6-minute walking distance, isometric knee extensor strength, gait speed, physical activity, quality of life, and estimated glomerular filtration rate. RESULTS Analyses of covariance, adjusted for baseline values, revealed significant mean differences between exercise and control groups at 2 months after KT in 6-minute walking distance (+44.4 m, P = .03) and isometric knee extensor strength (+8.1%body weight, P = .03). No significant between-group differences were found in gait speed, physical activity, and quality of life. The analysis of variance for comparison of the area under the recovery curves of estimated glomerular filtration rate after KT revealed no significant difference between groups. CONCLUSION Supervised aerobic training and physical activity instruction initiated in the early phase after KT can improve physical performance without adversely affecting kidney function.
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Affiliation(s)
- Shohei Yamamoto
- Department of Rehabilitation Sciences, Kitasato University Graduate School of medical Sciences, Sagamihara, Japan
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Hyogo, Japan
| | - Tsukasa Kamitani
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keika Hoshi
- Center for Public Health Informatics, National Institute of Public Health, Wako, Japan; Department of Hygiene, Kitasato University School of Medicine, Sagamihara, Japan
| | - Daisuke Ishii
- Department of Urology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Fumino Noguchi
- Department of Transplant Support Center, Kitasato University Hospital, Sagamihara, Japan
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Takafumi Ichikawa
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Atsuhiko Matsunaga
- Department of Rehabilitation Sciences, Kitasato University Graduate School of medical Sciences, Sagamihara, Japan
| | - Kazunari Yoshida
- Department of Organ Transplant Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
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12
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Fujimoto K, Adachi H, Yamazaki K, Nomura K, Saito A, Matsumoto Y, Igarashi K, Uranishi H, Sakaguchi S, Matsuura T, Imura J, Okino K, Mukai K, Okushi Y, Kagaya Y, Tsuruyama Y, Okada K, Miyatake N, Haraguchi T, Iida Y, Yokoyama H. Comparison of the pain-reducing effects of EMLA cream and of lidocaine tape during arteriovenous fistula puncture in patients undergoing hemodialysis: A multi-center, open-label, randomized crossover trial. PLoS One 2020; 15:e0230372. [PMID: 32210455 PMCID: PMC7094835 DOI: 10.1371/journal.pone.0230372] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 02/26/2020] [Indexed: 11/18/2022] Open
Abstract
Arteriovenous fistula puncture pain is a serious problem for patients undergoing dialysis and a good indication for topical anesthetics. No previous study has compared lidocaine/prilocaine cream (EMLA) with lidocaine tape for pain relief during arteriovenous fistula puncture in patients undergoing maintenance hemodialysis. To this end, we conducted a multicenter randomized crossover study including 66 patients (mean age, 65.8 years; males, 57.6%) undergoing maintenance hemodialysis thrice/week. Subjects were assigned to Sequence EL (EMLA administration followed by lidocaine, with 1-week wash-out) or Sequence LE (reverse administration, first lidocaine then EMLA). All subjects completed the study. At each puncture site, 1 g EMLA (25 mg lidocaine + 25 mg prilocaine) or one sheet of lidocaine tape (18 mg lidocaine) was applied 1 h or 30 min prior to arteriovenous fistula puncture, respectively. The primary endpoint was puncture pain relief, which was measured using a 100-mm visual analog scale. The secondary endpoints included quality of life, which was measured by SF-36, and safety. EMLA produced a 10.1-mm greater visual analog scale improvement than lidocaine tape (P = 0.00001). However, there was no statistically significant difference in the quality of life between the two groups, and no significant carryover/period effect was observed in any analysis. Further, no drug-related adverse events were observed. Taken together, these results suggest that EMLA cream is superior to lidocaine tape for the relief of arteriovenous fistula puncture pain in patients undergoing maintenance hemodialysis. Trial registration: University Hospital Medical Information Network Clinical Trials Registry (UMIN000027885).
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Affiliation(s)
- Keiji Fujimoto
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
- * E-mail:
| | - Hiroki Adachi
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | | | - Kanae Nomura
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | - Atsushi Saito
- Kanazawa Medical University Himi Municipal Hospital, Toyama, Japan
| | | | | | | | | | - Toshikazu Matsuura
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | | | - Kazuaki Okino
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | - Kiyotaka Mukai
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | - Yuki Okushi
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | - Yu Kagaya
- Keiju Medical Center, Ishikawa, Japan
| | - Yuko Tsuruyama
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | - Keiichiro Okada
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | - Nobuhiko Miyatake
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
| | | | - Yasuo Iida
- Department of Mathematics, Kanazawa Medical University, Ishikawa Japan
| | - Hitoshi Yokoyama
- Department of Nephrology, Kanazawa Medical University School of Medicine, Ishikawa, Japan
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13
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Nakanishi Y, Naito K, Yamagata T, Takami T. Health-Related Quality of Life After Microscopic Total Removal of Spinal Intramedullary Ependymomas in a Single-Institute 3-Year Prospective Study. World Neurosurg 2020; 136:e614-e624. [PMID: 32001405 DOI: 10.1016/j.wneu.2020.01.126] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Health-related quality of life (HRQOL) after surgery for spinal intramedullary benign encapsulated tumors remains unclear. A single-institute, 3-year, prospective study was conducted to examine HRQOL after microscopic total removal of spinal intramedullary ependymomas using a safe and precise strategy. METHODS A cohort of 20 patients with a possible diagnosis of spinal intramedullary benign ependymomas was recruited. Patients who underwent microscopic total removal of the tumor and for whom the pathologic diagnosis was verified as World Health Organization grade II benign ependymoma were included. Sixteen patients (average age, 48.7 years) were eligible for study analysis. Careful assessment was performed for all patients before and 6-12 months after surgery. The 36-Item Short Form Health Survey was used to assess HRQOL, with the surveyor recording answers as reported by the individual patient. RESULTS Average total HRQOL score was 431.1 before surgery and was maintained at 434.2 at 6-12 months postoperatively. Patients with mild functional symptoms tended to demonstrate a higher total HRQOL score preoperatively compared with patients with moderate to severe functional symptoms. A strong correlation was noted between postoperative functional conditions and preservation of HRQOL. CONCLUSIONS This is the first study focusing on HRQOL after microscopic total removal of spinal intramedullary ependymomas. This study suggested that radical surgery using a safe and precise strategy appears justifiable and that preservation of neurologic function after surgery may lead to maintenance of postoperative HRQOL.
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Affiliation(s)
- Yuta Nakanishi
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kentaro Naito
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Toru Yamagata
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Toshihiro Takami
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
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14
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Tanaka M, Ishibashi Y, Hamasaki Y, Kamijo Y, Idei M, Kawahara T, Nishi T, Takeda M, Nonaka H, Nangaku M, Mise N. Health-related quality of life on combination therapy with peritoneal dialysis and hemodialysis in comparison with hemodialysis and peritoneal dialysis: A cross-sectional study. Perit Dial Int 2020; 40:462-469. [DOI: 10.1177/0896860819894066] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background:The health-related quality of life (HRQOL) of dialysis patients has not been well examined, especially in combination therapy with peritoneal dialysis and hemodialysis (PD+HD) patients. We compared the HRQOL of PD+HD patients with that of HD and PD patients.Methods:A multicenter, cross-sectional study was conducted on 36 PD+HD, 103 HD, and 90 PD patients in Japan who completed the Kidney Disease Quality of Life Short Form 36, version 1.3. HRQOL scores were summarized into physical- (PCS), mental- (MCS), role/social- (RCS), and kidney disease component summaries (KDCS).Results:Of the PD+HD patients, 31 (86%) transferred from PD and 5 (14%) transferred from HD. They had the longest dialysis vintage and the smallest urine volume. PCS, MCS, and KDCS HRQOL scores of PD+HD patients were comparable with those of HD and PD patients. However, the RCS score for PD+HD was significantly higher than that for HD ( p = 0.020) and comparable with that for PD. PD+HD and PD were associated with significantly higher RCS scores than HD after adjusting for age, gender, diabetic nephropathy, dialysis vintage, ischemic heart disease, and peripheral arterial disease.Conclusions:For RCS, HRQOL in PD+HD patients was better than that in HD and comparable with that in PD patients, whereas the PCS, MCS, and KDCS HRQOL scores of PD+HD patients were comparable with those of HD and PD patients.
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Affiliation(s)
- Mototsugu Tanaka
- Division of Nephrology and Endocrinology, The University of Tokyo School of Medicine, Japan
| | - Yoshitaka Ishibashi
- Division of Nephrology, Department of Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Yoshifumi Hamasaki
- Division of Nephrology and Endocrinology, The University of Tokyo School of Medicine, Japan
| | - Yuka Kamijo
- Division of Nephrology, Department of Medicine, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Mayumi Idei
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takuya Kawahara
- Clinical Research Support Center, The University of Tokyo Hospital, Japan
| | | | | | | | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo School of Medicine, Japan
| | - Naobumi Mise
- Division of Nephrology, Department of Medicine, Mitsui Memorial Hospital, Tokyo, Japan
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15
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Suzuki Y, Kamiya K, Tanaka S, Hoshi K, Watanabe T, Harada M, Matsuzawa R, Shimoda T, Yamamoto S, Matsunaga Y, Yoneki K, Yoshida A, Matsunaga A. Effects of electrical muscle stimulation in frail elderly patients during haemodialysis (DIAL): rationale and protocol for a crossover randomised controlled trial. BMJ Open 2019; 9:e025389. [PMID: 31122968 PMCID: PMC6537999 DOI: 10.1136/bmjopen-2018-025389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The phenomenon of population ageing is accompanied by increases in the number of elderly haemodialysis patients worldwide. The incidence of frailty is high in the haemodialysis population and is associated with poor clinical outcome. Although several interventions have been developed for use in general haemodialysis patients, the efficacy of such rehabilitation programmes in frail elderly patients on haemodialysis has not been elucidated. Here, we examined whether electrical muscle stimulation (EMS) would show beneficial effects in frail elderly patients on haemodialysis. METHODS AND ANALYSIS This is a randomised, two-period, controlled crossover trial, which will enrol 20 patients. Haemodialysis patients aged ≥65 years and defined as frail (ie, Short Physical Performance Battery score 4-9), will be randomly assigned to either group 1 (EMS intervention beginning in treatment period I, followed by reallocation as controls in treatment period II after a 5-week washout period) or group 2 (opposite schedule) in a 1:1 ratio. The two intervention periods will last 5 weeks each with an intervening washout period of 5 weeks. In the EMS intervention group, the treatment will be applied to the skeletal muscle of the entire lower extremity for 5 weeks, three times/week for 30-40 min during haemodialysis. The primary outcome of this study is the change in quadriceps isometric strength after the interventions. The secondary outcomes are the changes in physical function, physical activity, difficulty in activities of daily living, body composition, cognitive function, depressive symptoms, quality of life, blood test results and the clinical safety and feasibility of EMS therapy. ETHICS AND DISSEMINATION This study has been approved by the institutional review board/ethics committee of Kitasato University Allied Health Sciences. This study will be reported in peer reviewed publications and at conference presentations. TRIAL REGISTRATION NUMBER UMIN000032501.
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Affiliation(s)
- Yuta Suzuki
- Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Kentaro Kamiya
- Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Shinya Tanaka
- Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Keika Hoshi
- Department of Hygiene, Kitasato University School of Medicine, Kanagawa, Japan
| | - Takaaki Watanabe
- Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Manae Harada
- Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Ryota Matsuzawa
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Takahiro Shimoda
- Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Shohei Yamamoto
- Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Yusuke Matsunaga
- Sleep Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Kei Yoneki
- Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Atsushi Yoshida
- Haemodialysis Center, Sagami Circulatory Organ Clinic, Sagahihara, Japan
| | - Atsuhiko Matsunaga
- Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
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16
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Uchiyama K, Washida N, Morimoto K, Muraoka K, Kasai T, Yamaki K, Miyashita K, Wakino S, Itoh H. Home-based Aerobic Exercise and Resistance Training in Peritoneal Dialysis Patients: A Randomized Controlled Trial. Sci Rep 2019; 9:2632. [PMID: 30796338 PMCID: PMC6385506 DOI: 10.1038/s41598-019-39074-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 01/16/2019] [Indexed: 01/08/2023] Open
Abstract
Potential effects of aerobic and resistance training in peritoneal dialysis (PD) patients have been partially elucidated. We investigated effects of a home-based exercise program on physical functioning and health-related quality of life (HRQOL) in PD patients. Patients were randomly assigned to exercise (n = 24) and usual care (n = 23) groups. The exercise patients performed aerobic exercise thrice weekly and resistance training twice weekly at home for 12 weeks. The usual care patients received no specific intervention. The distance in incremental shuttle walking test significantly improved in the exercise group compared with the usual care group (P = 0.02). Among the HRQOL subscales assessed using the Kidney Disease Quality of Life-Short Form questionnaire, kidney disease component summary (P = 0.03), physical role functioning (P = 0.01), emotional role functioning (P < 0.01), and role/social component summary (P < 0.01) significantly improved in the exercise group. Moreover, serum albumin was significantly maintained in the exercise group (P = 0.03). There were no reported adverse events associated with the intervention. To our knowledge, this is the first randomized controlled trial to indicate the beneficial effects of a 12-week home-based exercise program exclusively in PD patients.
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Affiliation(s)
- Kiyotaka Uchiyama
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Naoki Washida
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Nephrology, International University of Health and Welfare School of Medicine, 4-3, Kozunomori, Narita, Chiba, 286-8686, Japan
| | - Kohkichi Morimoto
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kaori Muraoka
- Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takahiro Kasai
- Department of Nephrology, International University of Health and Welfare School of Medicine, 4-3, Kozunomori, Narita, Chiba, 286-8686, Japan
| | - Kentaro Yamaki
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazutoshi Miyashita
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shu Wakino
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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17
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Pilates exercises and quality of life of patients with chronic kidney disease. Complement Ther Clin Pract 2019; 34:35-40. [DOI: 10.1016/j.ctcp.2018.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/27/2018] [Accepted: 10/28/2018] [Indexed: 01/07/2023]
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18
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Uchiyama K, Washida N, Muraoka K, Morimoto K, Kasai T, Yamaki K, Miyashita K, Wakino S, Itoh H. Exercise Capacity and Association with Quality of Life in Peritoneal Dialysis Patients. Perit Dial Int 2018; 39:66-73. [PMID: 30478142 DOI: 10.3747/pdi.2018.00075] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 07/01/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Muscle wasting, common and progressive in uremic patients, is associated with a high probability for morbidity, lower health-related quality of life (HRQOL), and mortality. However, exercise tolerance in peritoneal dialysis (PD) patients has not been fully elucidated. The aim of this study was to evaluate exercise capacity, its determinants, and its association with HRQOL in PD patients. METHODS Outpatients treated with PD at Keio University Hospital from December 2016 to March 2018 were included in this single-center cross-sectional observational study. Exercise capacity was assessed by incremental shuttle walking test (ISWT) and handgrip and quadriceps strength. In addition to evaluation of PD-related parameters, HRQOL was assessed by the Kidney Disease Quality of Life-Short Form questionnaire. RESULTS Among the 50 recruited PD outpatients, age and PD vintage were 63.8 ± 9.6 and 3.8 ± 2.8 years, respectively. Physical examination revealed ISWT of 312.0 ± 138.2 m, handgrip strength of 27.5 ± 6.9 kg, and quadriceps strength of 23.3 ± 10.0 kg. Multivariate analysis showed that younger age and male sex were significantly associated with higher ISWT and handgrip and quadriceps strength. Skeletal mass index (SMI) remained a significant predictor of handgrip and quadriceps strength. Moreover, only ISWT was strongly correlated with higher HRQOL scores, including physical, mental, and kidney-specific domains, even after adjustment for age and sex. CONCLUSIONS Exercise tolerance in PD patients was partially determined by age, sex, and SMI. Moreover, this is the first study to demonstrate the strong relationship between aerobic capacity and HRQOL in PD patients.
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Affiliation(s)
- Kiyotaka Uchiyama
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Washida
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Nephrology, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Kaori Muraoka
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kohkichi Morimoto
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takahiro Kasai
- Department of Nephrology, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Kentaro Yamaki
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazutoshi Miyashita
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shu Wakino
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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19
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Nagasawa H, Sugita I, Tachi T, Esaki H, Yoshida A, Kanematsu Y, Noguchi Y, Kobayashi Y, Ichikawa E, Tsuchiya T, Teramachi H. The Relationship Between Dialysis Patients' Quality of Life and Caregivers' Quality of Life. Front Pharmacol 2018; 9:770. [PMID: 30061835 PMCID: PMC6054989 DOI: 10.3389/fphar.2018.00770] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 06/25/2018] [Indexed: 11/25/2022] Open
Abstract
Patients on dialysis require caregiving and assistance in their daily lives from family members and/or others for hospital visitation and supervised administration. This places a considerable burden on caregivers, which can in turn influence caregivers' quality of life (QOL). We recruited dialysis patients and their caregivers to elucidate how the QOL of patients relates to that of their caregivers'. Patients completed the EuroQol 5-Dimension scale (EQ-5D) and Kidney Disease Quality of Life-Short Form. Caregivers completed the EQ-5D and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). We calculated utility index values for the EQ-5D, and physical, mental (MCS), and role-social component summary scores for the SF-36. Compared to national norms, the caregivers of dialysis patients tended to have poor physical health-related QOL but normal mental health-related QOL, as also found with patients. The multivariate analysis revealed that ≥ median dialysis period and ≥ average burden of kidney disease were significantly related to caregiver MCS score (odds ratios; 6.79 and 9.89, respectively). Caregivers tended to have lower physical health-related QOL if their patients had high social QOL, and lower mental health-related QOL during the early stage of the patient's dialysis treatment, and when patients experienced low disease-targeted QOL.
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Affiliation(s)
- Hiroyuki Nagasawa
- Department of Pharmacy, Secomedic Hospital, Funabashi, Japan.,Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Ikuto Sugita
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Tomoya Tachi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Hiroki Esaki
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Aki Yoshida
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Yuta Kanematsu
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Yoshihiro Noguchi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Yukio Kobayashi
- Department of Pharmacy, Chiba Central Medical Center, Chiba, Japan
| | | | - Teruo Tsuchiya
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.,Community Health Support and Research Center, Gifu, Japan
| | - Hitomi Teramachi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.,Laboratory of Community Healthcare Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
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20
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Nagasawa H, Tachi T, Sugita I, Esaki H, Yoshida A, Kanematsu Y, Noguchi Y, Kobayashi Y, Ichikawa E, Tsuchiya T, Teramachi H. The Effect of Quality of Life on Medication Compliance Among Dialysis Patients. Front Pharmacol 2018; 9:488. [PMID: 29950988 PMCID: PMC6008555 DOI: 10.3389/fphar.2018.00488] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/24/2018] [Indexed: 01/13/2023] Open
Abstract
Dialysis treatment is known to lead to reduced quality of life (QOL) among patients. This decreased QOL is believed to influence medication compliance, although this effect has not yet been clarified. In this study, we investigated whether decreased QOL due to dialysis treatment does in fact influence medication compliance. Participants were 92 patients who self-managed their medication and were receiving dialysis treatment at Secomedic Hospital or Chiba Central Medical Center. We surveyed their age, sex, dialysis period, and medication management situation, and administered the EQ-5D and Kidney Disease Quality of Life Instrument-Short Form. A multiple logistic regression analysis with medication compliance as the dependent variable and QOL as the independent variable was conducted. The recovery rate and effective response rate were both 100%. The results indicated that patients with good sleep QOL (mean or above) had higher odds of medication compliance (odds ratio, 3.36; 95% confidence interval, 1.26-8.96; P = 0.016). Therefore, improving the quality of sleep of dialysis patients might help to improve their medication compliance.
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Affiliation(s)
- Hiroyuki Nagasawa
- Department of Pharmacy, Secomedic Hospital, Funabashi, Japan.,Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Tomoya Tachi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Ikuto Sugita
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Hiroki Esaki
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Aki Yoshida
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Yuta Kanematsu
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Yoshihiro Noguchi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Yukio Kobayashi
- Department of Pharmacy, Chiba Central Medical Center, Chiba, Japan
| | | | - Teruo Tsuchiya
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.,Community Health Support and Research Center, Gifu, Japan
| | - Hitomi Teramachi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Gifu, Japan.,Laboratory of Community Healthcare Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
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21
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Aiyegbusi OL, Kyte D, Cockwell P, Marshall T, Gheorghe A, Keeley T, Slade A, Calvert M. Measurement properties of patient-reported outcome measures (PROMs) used in adult patients with chronic kidney disease: A systematic review. PLoS One 2017. [PMID: 28636678 PMCID: PMC5479575 DOI: 10.1371/journal.pone.0179733] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Patient-reported outcome measures (PROMs) can provide valuable information which may assist with the care of patients with chronic kidney disease (CKD). However, given the large number of measures available, it is unclear which PROMs are suitable for use in research or clinical practice. To address this we comprehensively evaluated studies that assessed the measurement properties of PROMs in adults with CKD. Methods Four databases were searched; reference list and citation searching of included studies was also conducted. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to appraise the methodological quality of the included studies and to inform a best evidence synthesis for each PROM. Results The search strategy retrieved 3,702 titles/abstracts. After 288 duplicates were removed, 3,414 abstracts were screened and 71 full-text articles were retrieved for further review. Of these, 24 full-text articles were excluded as they did not meet the eligibility criteria. Following reference list and citation searching, 19 articles were retrieved bringing the total number of papers included in the final analysis to 66. There was strong evidence supporting internal consistency and moderate evidence supporting construct validity for the Kidney Disease Quality of Life-36 (KDQOL-36) in pre-dialysis patients. In the dialysis population, the KDQOL-Short Form (KDQOL-SF) had strong evidence for internal consistency and structural validity and moderate evidence for test-retest reliability and construct validity while the KDQOL-36 had moderate evidence of internal consistency, test-retest reliability and construct validity. The End Stage Renal Disease-Symptom Checklist Transplantation Module (ESRD-SCLTM) demonstrated strong evidence for internal consistency and moderate evidence for test-retest reliability, structural and construct validity in renal transplant recipients. Conclusions We suggest considering the KDQOL-36 for use in pre-dialysis patients; the KDQOL-SF or KDQOL-36 for dialysis patients and the ESRD-SCLTM for use in transplant recipients. However, further research is required to evaluate the measurement error, structural validity, responsiveness and patient acceptability of PROMs used in CKD.
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Affiliation(s)
- Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Derek Kyte
- Centre for Patient Reported Outcomes Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- * E-mail:
| | - Paul Cockwell
- Centre for Patient Reported Outcomes Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Department of Renal Medicine, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Tom Marshall
- Centre for Patient Reported Outcomes Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | | | | | - Anita Slade
- Centre for Patient Reported Outcomes Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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22
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Short-term outcome and quality of life in kidney transplant recipient with monoclonal gammopathy. CEN Case Rep 2017; 5:168-172. [PMID: 28508971 DOI: 10.1007/s13730-016-0218-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/14/2016] [Indexed: 10/22/2022] Open
Abstract
Monoclonal gammopathy of undetermined significance (MGUS) is the common pre-malignant B cell disorders with a general prevalence of 3-5 % at age over 50. Because of the potential malignant transformation and immune insufficiency, pre-transplant MGUS recipient should be carefully followed after allograft transplantation. The post-transplant prognosis and quality of life (QOL) in patient with MGUS have not yet been fully determined. The aim of this study is to evaluate function and pathology of the renal allograft and self-assessment QOL changes during 2 years after transplantation in our case of MGUS-bearing recipient. We here studied the clinical course and QOL improvement before and 20 months after transplant in a 56-year-old woman, who had pre-existing MGUS and underwent living donor kidney transplantation. After the renal allograft transplant, the patients maintained normal GFR and had neither acute rejections nor histologic evidence of renal injuries related to the monoclonal gammopathy on the protocol biopsy of 1 year post-transplant. During further 20 months follow-up, the pre-transplant MGUS remained uneventful without any hematologic abnormalities and other medical complications, i.e., infection. Evaluation of QOL using a self-assessment questionnaire showed significant improvement for physical and mental items on both 6 and 18 months post-transplant. The renal transplant thus successfully provided a greater satisfaction for the recipient on both physical and mental health aspects. Our observations suggest that renal transplantation is beneficial even in those who had pre-existing MGUS if managed and followed carefully, which ultimately could significantly improve the patient QOL.
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23
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Hayashi A, Yamaguchi S, Waki K, Fujiu K, Hanafusa N, Nishi T, Tomita H, Kobayashi H, Fujita H, Kadowaki T, Nangaku M, Ohe K. Testing the Feasibility and Usability of a Novel Smartphone-Based Self-Management Support System for Dialysis Patients: A Pilot Study. JMIR Res Protoc 2017; 6:e63. [PMID: 28428168 PMCID: PMC5418525 DOI: 10.2196/resprot.7105] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 02/28/2017] [Accepted: 02/28/2017] [Indexed: 12/11/2022] Open
Abstract
Background Diet and fluid restrictions that need continuous self-management are among the most difficult aspects of dialysis treatment. Smartphone applications may be useful for supporting self-management. Objective Our objective is to investigate the feasibility and usability of a novel smartphone-based self-management support system for dialysis patients. Methods We developed the Self-Management and Recording System for Dialysis (SMART-D), which supports self-monitoring of three mortality-related factors that can be modified by lifestyle: interdialytic weight gain and predialysis serum potassium and phosphorus concentrations. Data is displayed graphically, with all data evaluated automatically to determine whether they achieve the values suggested by the Japanese Society for Dialysis Therapy guidelines. In a pilot study, 9 dialysis patients used SMART-D system for 2 weeks. A total of 7 of them completed questionnaires rating their assessment of SMART-D’s usability and their satisfaction with the system. In addition, the Kidney Disease Quality of Life scale was compared before and after the study period. Results All 9 participants were able to use SMART-D with no major problems. Completion rates for body weight, pre- and postdialysis weight, and serum potassium and phosphorus concentrations were, respectively, 89% (SD 23), 95% (SD 7), and 78% (SD 44). Of the 7 participants who completed the usability survey, all were motivated by the sense of security derived from using the system, and 6 of the 7 (86%) reported that using SMART-D helped improve their lifestyle and self-management. Conclusions Using SMART-D was feasible, and the system was well regarded by patients. Further study with larger scale cohorts and longer study and follow-up periods is needed to evaluate the effects of SMART-D on clinical outcomes and quality of life.
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Affiliation(s)
- Aki Hayashi
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoko Yamaguchi
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kayo Waki
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuhito Fujiu
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norio Hanafusa
- Division of Total Renal Care Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Blood Purification, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
| | | | | | - Haruka Kobayashi
- Business Development of Healthcare Business Smart-Life Solutions Department, NTT DOCOMO, Inc, Tokyo, Japan
| | - Hideo Fujita
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kadowaki
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Ohe
- Department of Biomedical Informatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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24
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Development and validity of the questionnaire of patients' experiences in postacute outpatient physical therapy settings. Phys Ther 2015; 95:767-77. [PMID: 25413623 DOI: 10.2522/ptj.20140041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 11/12/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patient feedback surveys are increasingly seen as a key component of health care quality monitoring and improvement. OBJECTIVE The study objective was to describe the development and initial psychometric evaluation of a fixed-length questionnaire about the experiences of patients receiving physical therapist treatment in postacute outpatient settings. DESIGN This was an instrument development study with validity and reliability testing. METHODS A total of 465 participants attending 3 rehabilitation centers for musculoskeletal conditions completed the questionnaire. A cognitive pretest was applied to the draft version (n=94), and a revised version was evaluated for test-retest reliability (n=90). Analyses to evaluate variance and nonresponse rates for items, the factor structure of the questionnaire, and the metric properties of multi-item scales were conducted. RESULTS Exploratory factor analyses yielded evidence for a 7-factor structure of the questionnaire, with 3 factors that may be conceptually viewed as professionals' attitudes and behavior (providing information and education, sensitivity to patients' changes, and emotional support) and 4 factors that conceptually reflect organizational environment (duration of attendance, interruptions during care delivery, waiting times, and patient safety). Item-scale correlations ranged from .70 to .93. The percentage of scaling success was 100% for all of the scales. Cronbach alpha coefficients ranged from .70 to .87. Intraclass correlation coefficients ranged from .57 to .80 (median=.68). LIMITATIONS Generalization to other patients is not known. CONCLUSIONS The questionnaire has test-retest reliability, and the scales have internal consistency and convergent and discriminant validity. All of the scales are distinct and unidimensional.
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25
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Fukuda S, Koyama H, Kondo K, Fujii H, Hirayama Y, Tabata T, Okamura M, Yamakawa T, Okada S, Hirata S, Kiyama H, Kajimoto O, Watanabe Y, Inaba M, Nishizawa Y. Effects of nutritional supplementation on fatigue, and autonomic and immune dysfunction in patients with end-stage renal disease: a randomized, double-blind, placebo-controlled, multicenter trial. PLoS One 2015; 10:e0119578. [PMID: 25746727 PMCID: PMC4352065 DOI: 10.1371/journal.pone.0119578] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 01/30/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Fatigue is a predictor of cardiovascular events in patients with end-stage renal disease (ESRD) undergoing hemodialysis treatment. We hypothesized that multinutritional support would improve quality of life, fatigue symptoms, and potential quantitative measures including endocrine, immune and autonomic functions in patients with ESRD undergoing hemodialysis. METHODS Two hundred and two hemodialysis patients were randomly assigned to receive active treatment (containing vitamin B1, vitamin B2, niacin, vitamin B6, vitamin B12, folic acid, vitamin C, carnitine, coenzyme Q10, naïve galacto-oligosaccharide, and zinc) or placebo after each dialysis session for 12 weeks. The patients and attending physicians were blinded to the treatment, and 172 patients (86 in each group) completed the study. Fatigue was evaluated via fatigue questionnaire at 0, 4, and 12 weeks. To assess human herpes virus (HHV) 6 and 7 reactivation, numbers of viral DNA copies were determined in saliva by polymerase chain reaction at weeks 0 and 12. Autonomic function was determined via measurement of beat-to-beat variation by using acceleration plethysmography. RESULTS Clinical characteristics, changes in fatigue, quality of life score, endocrine functions, and laboratory data did not differ significantly between the two groups. Several parameters of heart rate variability significantly increased after nutritional treatment compared to placebo. Nutritional drink for 12 weeks significantly suppressed HHV7 DNA copy numbers. Similarly, HHV6 DNA copy numbers tended to be decreased by treatment but without reaching statistical significance. CONCLUSIONS Nutritional supplementation may modulate immune and autonomic dysfunction in ESRD patients undergoing hemodialysis.
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Affiliation(s)
- Sanae Fukuda
- University of Welfare Sciences, Kasiwara, Osaka, 582-0026, Japan; RIKEN Center for Life Science Technologies, Kobe, Hyogo, 650-0047, Japan; Department of Physiology, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
| | - Hidenori Koyama
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan; Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Kazuhiro Kondo
- Department of Virology, The Jikei University School of Medicine, Tokyo, 105-8461, Japan
| | - Hisako Fujii
- Department of Physiology, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan; Center for Drug & Food Clinical Evaluation, Osaka City University Hospital, Osaka, 540-0051, Japan
| | - Yoshinobu Hirayama
- College of Pharmaceutical Sciences, Ritsumeikan University, Kusatsu, 525-8577, Japan
| | | | | | | | | | - Sumio Hirata
- Kumamoto University School of Pharmacy, Kumamoto, 862-0973, Japan
| | - Hiroshi Kiyama
- Nagoya University School of Medicine, Nagoya, 466-8550, Japan
| | - Osami Kajimoto
- Department of Medical Science on Fatigue, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
| | - Yasuyoshi Watanabe
- RIKEN Center for Life Science Technologies, Kobe, Hyogo, 650-0047, Japan; Department of Physiology, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
| | - Masaaki Inaba
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
| | - Yoshiki Nishizawa
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan
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26
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Bouidida B, Rhou H, Ezaitouni F, Ouzeddoun N, Bayahia R, Elhajji K, Roudiès R, Sekkat FZ, Razine R, Abouqal R, Alghadi A, Azennoud A, Benamar L. Translation, cultural adaptation and validation of the kidney disease quality of life-short form 1.3 in an African country. Transplant Proc 2015; 46:1295-301. [PMID: 24935292 DOI: 10.1016/j.transproceed.2014.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 02/06/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND The impact of dialysis on patient quality of life has been recognized as an important outcome measure. The Dialysis Outcomes and Practice Patterns Study compared quality of life in 4 continents [1], but very scarce information is available about dialysis patients' quality of life in Africa. The objective of this study was to translate the Kidney Disease Quality of Life-Short Form (KDQOL-SF) into Moroccan and measure its psychometric properties. METHODS The questionnaire was first translated into Moroccan by 2 independent translators, and then 2 backward translations into English were performed after pretesting in 10 dialysis patients. The final questionnaire was then administered to 80 dialysis patients. Reliability was estimated by internal consistency and test-retest reliability. Validity was assessed using known group comparisons and correlations between overall health rating and scales scores. RESULTS Some activities were substituted since they were not common in Morocco. All subscales had a Cronbach α above the recommended value except for 3 scales. All of the items showed good test-retest reliability. Correlation of items within subscales was higher than that of items outside subscales in 87% of cases. Regarding construct validity, all KDQOL-SF scales had significant correlation with overall health rating except for sexual function and dialysis staff encouragement. Furthermore, the questionnaire could be used to discriminate between subgroups of the patients. CONCLUSIONS The psychometric properties of the KDQOL-SF resulting from this first-time administration of the instrument support the validity and reliability of the KDQOL-SF as a measure of quality of life of patients having hemodialysis in Morocco.
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Affiliation(s)
| | - H Rhou
- Department of Nephrology-Dialysis-Transplantation, Ibn Sina University Hospital, Rabat, Morocco
| | - F Ezaitouni
- Department of Nephrology-Dialysis-Transplantation, Ibn Sina University Hospital, Rabat, Morocco
| | - N Ouzeddoun
- Department of Nephrology-Dialysis-Transplantation, Ibn Sina University Hospital, Rabat, Morocco
| | - R Bayahia
- Department of Nephrology-Dialysis-Transplantation, Ibn Sina University Hospital, Rabat, Morocco
| | - K Elhajji
- Department of Psychiatry, Ibn Sina University Hospital, Rabat, Morocco
| | - R Roudiès
- Department of Psychiatry, Ibn Sina University Hospital, Rabat, Morocco
| | - F Z Sekkat
- Department of Psychiatry, Ibn Sina University Hospital, Rabat, Morocco
| | - R Razine
- Department of Epidemiology, Ibn Sina University Hospital, Rabat, Morocco
| | - R Abouqal
- Department of Epidemiology, Ibn Sina University Hospital, Rabat, Morocco
| | - A Alghadi
- Department of English, Faculty of letters and Humanities, Rabat, Morocco
| | | | - L Benamar
- Department of Nephrology-Dialysis-Transplantation, Ibn Sina University Hospital, Rabat, Morocco
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27
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Iseki K, Tsuruya K, Kanda E, Nomura T, Hirakata H. Effects of sleepiness on survival in Japanese hemodialysis patients: J-DOPPS study. Nephron Clin Pract 2015; 128:333-40. [PMID: 25572670 DOI: 10.1159/000366479] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 08/04/2014] [Indexed: 11/19/2022] Open
Abstract
Sleep disorder and poor sleep quality are common in chronic hemodialysis (HD) patients. They have been claimed as a cause of morbidity and mortality. The relationship between the degree of sleepiness and survival has not been studied. We studied the degree of sleepiness in 1,252 adult HD patients (age ≥20 years) recruited into the Dialysis Outcomes Practice Pattern Study in Japan (J-DOPPS III), using the Japanese version of the Epworth Sleepiness Scale (JESS) questionnaire. Demographic data were presented for three subgroups: low, intermediate, and high JESS score. Cox proportional hazard regression analysis was performed to estimate the independent effect of several variables on survival. The hazard ratio for mortality was 2.312 (95% CI 1.267-4.220; p = 0.006) for those with a high JESS score (vs. those with a low JESS score) after adjusting for age, vintage (length of time on HD), sex, diabetes, body mass index, cardiovascular disease, HD treatment regimen (time, frequency, and single-pool Kt/V), laboratory data (serum albumin, creatinine, and total cholesterol), and medication (antihypertensive drugs, erythropoietin, vitamin D, and phosphate binders). Patients ≥70 years of age with comorbid conditions (congestive heart failure, stroke, and diabetes) showed a significantly higher JESS score (≥16). The JESS score did not show interaction by age. Results showed that the degree of sleepiness is related to survival in Japanese HD patients, particularly in elderly patients.
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Affiliation(s)
- Kunitoshi Iseki
- Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan
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28
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Tsutsui H, Ohkubo T, Tsuruta Y, Kato S, Yasuda Y, Oshida Y. Development and validation of a short-version checklist for patients undergoing hemodialysis based on the International Classification of Functioning, Disability and Health. Clin Exp Nephrol 2014; 19:953-60. [PMID: 25543186 DOI: 10.1007/s10157-014-1075-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/14/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND In 2009, we developed a "100-category checklist" for patients undergoing hemodialysis (HD) based on the International Classification of Functioning, Disability and Health, and we confirmed its validity. However, we found that for patients' daily assessment, 100 categories were too many. The purpose of the present study was to develop and validate a short version of the "100-category checklist." METHODS A total of 100 outpatients undergoing HD were recruited. They were interviewed using the "100-category checklist" and asked whether they had experienced problems after starting HD. From the "100-category checklist," we extracted categories that had greater than a 50 % rate of "yes" responses. Content validity was evaluated using the frequency of patients who had a problem in each category. Criterion validity was evaluated based on the correlation of the score from the "short-version checklist" categories with that from the Kidney Disease Quality of Life (KDQOL™) questionnaire. Construct validity was evaluated using Spearman correlation coefficients between the number of problem categories and the presence of HD-related complications. Cronbach's coefficient alpha was calculated to evaluate internal consistency. RESULTS Twenty-two categories were identified as problem categories. Criterion validity showed that 12 categories were significantly correlated with subscales of the KDQOL™. Construct validity showed that the presence of complications contributed to an increased number of problems associated with HD. Cronbach's coefficient alpha of this checklist was 0.79. CONCLUSION The "short-version checklist" had a certain degree of validity, suggesting its usefulness in a simplified assessment of patients undergoing HD.
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Affiliation(s)
- Hideyo Tsutsui
- Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. .,Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan.
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | | | - Sawako Kato
- Department of Nephrology, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-0064, Japan
| | - Yoshinari Yasuda
- Department of Chronic Kidney Disease Initiatives, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-0064, Japan
| | - Yoshiharu Oshida
- Research Center of Health, Physical Fitness, and Sports, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8601, Japan
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29
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Watanabe Y, Ohno Y, Inoue T, Takane H, Okada H, Suzuki H. Home hemodialysis and conventional in-center hemodialysis in Japan: A comparison of health-related quality of life. Hemodial Int 2014; 18 Suppl 1:S32-8. [DOI: 10.1111/hdi.12221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yusuke Watanabe
- Department of Nephrology; Saitama Medical University; Saitama Japan
| | - Yoichi Ohno
- Department of Nephrology; Saitama Medical University; Saitama Japan
| | - Tsutomu Inoue
- Department of Nephrology; Saitama Medical University; Saitama Japan
| | - Hiroshi Takane
- Department of Nephrology; Saitama Medical University; Saitama Japan
| | - Hirokazu Okada
- Department of Nephrology; Saitama Medical University; Saitama Japan
| | - Hiromichi Suzuki
- Department of Nephrology; Saitama Medical University; Saitama Japan
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30
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Tsutsui H, Ojima T, Tsuruta Y, Kato S, Yasuda Y, Oshida Y. Validity of a checklist for hemodialysis patients based on the International Classification Of Functioning, Disability and Health. Ther Apher Dial 2014; 18:473-80. [PMID: 25195794 DOI: 10.1111/1744-9987.12163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In 2009, we reported a "100-category checklist" for hemodialysis (HD) patients based on the International Classification of Functioning, Disability and Health. The purpose of the present study is to evaluate the validity and reliability of this checklist. The present study included 100 participants who had been on HD for at least 5 years when they were interviewed using the checklist. Subjects were asked whether they had experienced problems in each category since starting HD treatment. Categories for which more than 25% of subjects answered "yes" were extracted as problem categories. Additionally, the Kidney Disease Quality of Life (KDQOL) instrument was administered to the study subjects. Content validity was evaluated using the frequency and percentage of subjects who had a problem in each category. Criterion validity was performed based on correlation of the findings from the "100-category checklist" categories with the findings of the KDQOL. Construct validity was assessed based on the number of problem categories extracted as external criteria in carpal tunnel syndrome (CTS), anemia, and secondary hyperparathyroidism (SHPT). For reliability evaluation, we used Cronbach's coefficient alpha. Content validity showed that 54 were identified as problem categories. Criterion validity showed that 45 categories in all components correlated significantly with each subscale of the KDQOL. Construct validity showed that CTS, anemia, and SHPT contributed to an increased number of problems associated with HD. Cronbach's coefficient alpha of the "100-category checklist" was 0.86. This study confirmed the validity and reliability of the "100-category checklist".
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Affiliation(s)
- Hideyo Tsutsui
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan; Research Center of Health, Physical Fitness, and Sports, Nagoya University, Nagoya, Japan
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Fujii H, Koyama H, Fukuda S, Tokai H, Tajima S, Koizumi JI, Yamaguti K, Kuratsune H, Watanabe Y, Hirayama Y, Shoji T, Inaba M, Nishizawa Y. Autonomic Function is Associated With Health-Related Quality of Life in Patients With End-Stage Renal Disease: A Case-Control Study. J Ren Nutr 2013; 23:340-7. [DOI: 10.1053/j.jrn.2012.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 12/21/2012] [Accepted: 12/26/2012] [Indexed: 11/11/2022] Open
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Yokoyama Y, Sasaki S, Suzukamo Y, Yamazaki S, Takegami M, Kakudate N, Hasegawa T, Haga M, Kawaguchi T, Moriya T, Hotta O, Fukuhara S. Interpersonal Psychosocial Factors Associated With Underreported Dietary Energy Intake in Hemodialysis Patients. J Ren Nutr 2013; 23:37-44. [DOI: 10.1053/j.jrn.2012.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 01/09/2012] [Accepted: 01/14/2012] [Indexed: 11/11/2022] Open
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Abd ElHafeez S, Sallam SA, Gad ZM, Zoccali C, Torino C, Tripepi G, ElWakil HS, Awad NM. Cultural adaptation and validation of the "Kidney Disease and Quality of Life--Short Form (KDQOL-SF™) version 1.3" questionnaire in Egypt. BMC Nephrol 2012; 13:170. [PMID: 23237591 PMCID: PMC3583144 DOI: 10.1186/1471-2369-13-170] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 11/22/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Health Related Quality of Life (HRQOL) instruments need disease and country specific validation. In Arab countries, there is no specific validated questionnaire for assessment of HRQOL in chronic kidney disease (CKD) patients. The aim of this study was to present an Arabic translation, adaptation, and the subsequent validation of the kidney disease quality of life-short form (KDQOL-SFTM) version 1.3 questionnaire in a representative series of Egyptian CKD patients. METHODS KDQOL-SFTM version 1.3 was translated into Arabic by two independent translators, and then subsequently translated back into English. After translation disparities were reconciled, the final Arabic questionnaire was tested by interviewing 100 pre-dialysis CKD (stage 1-4) patients randomly selected from outpatients attending the Nephrology clinic at the Main Alexandria University Hospital. Test re-test reliability was performed, with a subsample of 50 consecutive CKD patients, by two interviews 7 days apart and internal consistency estimated by Cronbach's α. Discriminant, concept, and construct validity were assessed. RESULTS All items of SF-36 met the criterion for internal consistency and were reproducible. Of the 10 kidney disease targeted scales, only three had Cronbach's α <0.7: quality of social interaction (0.23), work status (0.28), and cognitive function (0.60). All disease specific scales were reproducible. Results from discriminant validity showed that the study questionnaire could discriminate between patients' subgroups. As for concept validity, the correlation between all domains of the questionnaire with overall health ratewas significant for all domains except for the work status, sexual function, emotional wellbeing, and role emotional. Furthermore, the correlation between the disease specific domains and the two composite summaries of SF-36 (physical and mental composite summaries) was significant for all domains except for sexual function with mental composite summary. Construct validity was indicated by the observation that the majority of the domains of the kidney disease targeted scale of KDQOL-SFTM 1.3 were significantly inter-correlated. Finally, principal component analysis of the kidney disease targeted scale indicated that this part of the questionnaire could be summarized into 10 factors that together explained 70.9% of the variance. CONCLUSION The results suggest that this Arabic version of the KDQOL-SFTM 1.3 questionnaire is a valid and reliable tool for use in Egyptian patients with CKD.
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Affiliation(s)
- Samar Abd ElHafeez
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Sunny A Sallam
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Zahira M Gad
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Carmine Zoccali
- CNR-IBM, Epidemiology and Pathophysiology of Renal diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy
| | - Claudia Torino
- CNR-IBM, Epidemiology and Pathophysiology of Renal diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy
| | - Giovanni Tripepi
- CNR-IBM, Epidemiology and Pathophysiology of Renal diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy
| | - Hala S ElWakil
- Nephrology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Noha M Awad
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Cheung YB, Seow YY, Qu LM, Yee ACP. Measurement properties of the Chinese Version of the Kidney Disease Quality of Life-Short Form (KDQOL-SF™) in end-stage renal disease patients with poor prognosis in Singapore. J Pain Symptom Manage 2012; 44:923-32. [PMID: 22795902 DOI: 10.1016/j.jpainsymman.2011.12.282] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 12/26/2011] [Accepted: 12/31/2011] [Indexed: 11/26/2022]
Abstract
CONTEXT The Kidney Disease Quality of Life (KDQOL™) instrument is widely used to assess care of end-stage renal disease (ESRD) patients. OBJECTIVES This study aimed to demonstrate the measurement properties of the Chinese (simplified characters) version of the KDQOL-Short Form™ (KDQOL-SF™) in ethnic Chinese ESRD patients in Singapore. METHODS Seventy-eight new ESRD patients, initially conservatively managed, were interviewed and followed-up; 31 later commenced dialysis. Quality of life (with the KDQOL-SF), Karnofsky Performance Status, and estimated glomerular filtration rate (eGFR) were assessed at 0, 3, 6, 9, 12, 18, and 24 months. Nonparametric statistics were used to assess correlation and changes. RESULTS The patterns of descriptive summary and floor and ceiling effects were similar to those reported in the original English version. Most of the kidney disease-targeted scales and the generic scales of the KDQOL-SF demonstrated 1) criterion validity in terms of correlation with objectively measured and/or subjectively rated variables, 2) convergent/divergent validity in terms of correlation patterns between kidney disease-targeted and generic scales, and 3) responsiveness to change in terms of difference before and after dialysis, except for Work Status. Internal consistency reliability was satisfactory, but that for the Work Status scale was too low (alpha=0.32) and for two other kidney disease-targeted scales, Sexual Function and Dialysis Staff Encouragement, was too high (1.0). CONCLUSION Most of the scales in the Chinese version of the KDQOL-SF were valid and achieved internal consistency reliability, except for the Work Status scale. Also, the internal consistency reliability of two disease-targeted scales was too high, suggesting room for reduction of some items to reduce burden on respondents.
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Affiliation(s)
- Yin Bun Cheung
- Singapore Clinical Research Institute, Singapore, Republic of Singapore
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Yamamoto K, Kobayashi N, Kutsuna T, Ishii A, Matsumoto T, Hara M, Aiba N, Tabata M, Takahira N, Masuda T. Excessive fall of blood pressure during maintenance hemodialysis in patients with chronic renal failure is induced by vascular malfunction and imbalance of autonomic nervous activity. Ther Apher Dial 2012; 16:219-25. [PMID: 22607564 DOI: 10.1111/j.1744-9987.2011.01053.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Acute hypotension during maintenance hemodialysis (HD) is not only a critical complication, but also an independent risk factor for mortality in patients with chronic renal failure (CRF). This study was designed to clarify the mechanisms underlying excessive fall of blood pressure during HD. Fifty-six CRF patients with HD thrice a week were divided into two groups according to the intradialytic hypotension episodes after 4 weeks of the observation period; the hypotension group, showing four or more episodes of intradialytic hypotension, and the non-hypotension group, showing three episodes of intradialytic hypotension or less. The intradialytic hypotension was defined as a fall of ≥30 mm Hg in the systolic blood pressure during HD. The brachial-ankle pulse wave velocity (ba-PWV), serum high-sensitivity (hs)-CRP, reactive oxygen species (ROS) generation, and serum malondialdehyde-modified LDL (MDA-LDL) were measured before HD. The high- frequency (HF) and low-frequency components (LF) of the heart rate variability and entropy were analyzed by the maximal entropy method. The ba-PWV, hs-CRP, ROS generation, and MDA-LDL were significantly higher in the hypotension group than in the non-hypotension group. HF, LF/HF, and entropy during HD increased significantly in the non-hypotension group, while entropy during HD decreased significantly in the hypotension group as compared with the baseline. LF/HF and entropy during HD were significantly lower in the hypotension group than in the non-hypotension group. These findings suggest that the major factors causing excessive fall of blood pressure during HD in patients with CRF might be vascular malfunction and imbalance of autonomic nervous activity.
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Affiliation(s)
- Kazuya Yamamoto
- Department of Angiology and Cardiology, Kitasato University Graduate School of Medical Sciences, Kanagawa, Japan
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Ujszaszi A, Czira ME, Fornadi K, Novak M, Mucsi I, Molnar MZ. Quality of life and protein-energy wasting in kidney transplant recipients. Int Urol Nephrol 2012; 44:1257-68. [PMID: 22246594 DOI: 10.1007/s11255-012-0122-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2011] [Accepted: 01/05/2012] [Indexed: 12/14/2022]
Abstract
PURPOSE Chronic kidney disease has profound effects on the health-related quality of life (HRQoL) of patients, with serious physiological, psychological and socio-economic implications. The co-occurrence of protein-energy wasting and inflammation in end-stage renal disease patients is associated with worse HRQoL and increased mortality. We designed this study to examine the relationship between nutritional and inflammatory status and HRQoL in kidney transplant recipients. METHODS Data from 100 randomly selected kidney transplant patients were analyzed in a cross-sectional survey. Socio-demographic parameters, laboratory results, transplantation-related data, comorbidities, medication and malnutrition-inflammation score (MIS) (Kalantar Score) were tabulated at baseline. Patients completed the Kidney Disease Quality of Life-SF (KDQoL-SF™) self-administered questionnaire. RESULTS Mean age was 51 ± 13 years, median (interquartile range, IQR) time since transplantation 66 (83) months, 57% were men, and 19% had diabetes. The median (IQR) MIS was 3 (3). The MIS significantly and negatively correlated with almost all HRQoL domains analyzed, and this association remained significant in multivariate linear regression analysis for the log-transformed scores on energy/fatigue (β = -0.059 P < 0.001), bodily pain (β = -0.056 P = 0.004), physical functioning (β = -0.029, P = 0.022) and symptoms/problems (β = -0.023 P = 0.005) domains after statistical correction for age, gender, eGFR, dialysis vintage, Charlson Comorbidity Index and occupational status. Additionally, cubic spline analyses revealed linearly increasing, "dose-response" relationship between almost all domains of KDQoL-SF™ and the MIS. CONCLUSIONS Malnutrition-inflammation score is independently associated with different dimensions of HRQoL in kidney transplant recipients.
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Affiliation(s)
- Akos Ujszaszi
- Institute of Pathophysiology, Semmelweis University, Nagyvarad ter 4, 1089 Budapest, Hungary
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Pakpour AH, Yekaninejad M, Molsted S, Harrison AP, Hashemi F, Saffari M. Translation, cultural adaptation assessment, and both validity and reliability testing of the Kidney Disease Quality of Life--Short Form version 1.3 for use with Iranian patients. Nephrology (Carlton) 2011; 16:106-12. [PMID: 21175986 DOI: 10.1111/j.1440-1797.2010.01389.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The aims of the study were to translate the Kidney Disease Quality of Life--Short Form version 1.3 (KDQOL-SF ver. 1.3) questionnaire into Iranian (Farsi), and to then assess it in terms of validity and reliability on Iranian patients. METHODS The questionnaire was first translated into Farsi by two independent translators, and then subsequently translated back into English. After translation disparities had been reconciled, the final Iranian questionnaire was tested. An initial test-retest reliability evaluation was performed over a 10 day period on a sample of 20 patients recruited from a larger group (212 patients with end-stage renal disease on haemodialysis). Afterwards, reliability was estimated by internal consistency, and validity was assessed using known group comparisons and constructs for the patient group as a whole. Finally, the factor structure of the questionnaire was extracted by performing exploratory factor analysis. RESULTS All of the scales in the questionnaire showed good test-retest reliability (i.e. intraclass correlations between test and retest scores were >0.7). All of the scales met the minimal criteria (0.7) for internal consistency and Cronbach's-α ranged 0.71-0.93. Furthermore, results from a discriminate validity evaluation showed that the questionnaire could be used to discriminate between subgroups of the patients. Finally, a principal component analysis of the disease-specific scales indicated that this part of the questionnaire could be summarized into an 11 factor structure that jointly accounted for 79.81% of the variance. CONCLUSION The Iranian version of the KDQOL-SF questionnaire is both highly reliable and valid for use with Iranian patients on haemodialysis.
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Affiliation(s)
- Amir H Pakpour
- Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran.
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Koyama H, Fukuda S, Shoji T, Inaba M, Tsujimoto Y, Tabata T, Okuno S, Yamakawa T, Okada S, Okamura M, Kuratsune H, Fujii H, Hirayama Y, Watanabe Y, Nishizawa Y. Fatigue is a predictor for cardiovascular outcomes in patients undergoing hemodialysis. Clin J Am Soc Nephrol 2010; 5:659-66. [PMID: 20185601 DOI: 10.2215/cjn.08151109] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite potential significance of fatigue and its underlying components in the occurrence of cardiovascular diseases, epidemiologic data showing the link are virtually limited. This study was designed to examine whether fatigue symptoms or fatigue's underlying components are a predictor for cardiovascular diseases in high-risk subjects with ESRD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS 788 volunteer patients under hemodialysis therapy (506 male, 282 female) completed the survey between October and November 2005, with the follow-up period up to 26 months to monitor occurrence of fatal or nonfatal cardiovascular events. The questionnaire consisted of 64 questions, and promax rotation analysis of the principal component method conceptualized eight fatigue-related factors: fatigue itself, anxiety and depression, loss of attention and memory, pain, overwork, autonomic imbalance, sleep problems, and infection. RESULTS 14.7% of the patients showed fatigue scores higher than twice the SD of the mean for healthy volunteers. These highly fatigued patients exhibited a significantly higher risk for cardiovascular events (hazard ratio: 2.17; P < 0.01), with the relationship independent of the well-known risk factors, including age, diabetes, cardiovascular disease history, and inflammation and malnutrition markers. Moreover, comparisons of the risk in key subgroups showed that the risk of high fatigue score for cardiovascular events was more prominent in well-nourished patients, including lower age, absence of past cardiovascular diseases, higher serum albumin, and high non-HDL cholesterol. CONCLUSIONS Fatigue can be an important predictor for cardiovascular events in patients with ESRD, with the relationship independent of the nutritional or inflammatory status.
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Affiliation(s)
- Hidenori Koyama
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
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Bataclan RP, Dial MAD. Cultural adaptation and validation of the Filipino version of Kidney Disease Quality of Life--Short Form (KDQOL-SF version 1.3). Nephrology (Carlton) 2009; 14:663-8. [PMID: 19796025 DOI: 10.1111/j.1440-1797.2009.01130.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Chronic kidney disease is the 10th leading cause of death among Filipinos. Those with chronic kidney disease are exposed to stressors which effect their daily lives. Therefore, assessment of health-related quality of life is important in these patients. The objective of the present study was to translate the Kidney Disease Quality of Life--Short Form version 1.3 (KDQOL-SF ver. 1.3) into Filipino and measure its validity and reliability. METHODS Translation and cultural adaptation began with two translations into Filipino, with reconciliation of the forward translators. Pretesting with 10 renal patients, review by experts (nephrologist, translator and dialysis nurse) and back-translation was also done. The final questionnaire was administered to 80 patients with chronic renal disease undergoing haemodialysis for at least 3 months, who could understand Filipino, and were without life-threatening or terminal conditions at the time of the test. A convenience sample of 30 patients from the group had a repeat test 10-14 days after to determine test-retest reliability. Test-retest reliability was assessed by intraclass correlation coefficient and internal consistency reliability was measured by determining the Cronbach's alpha value. Validity was measured using Pearson's correlation between the overall health rating scale and the items from the questionnaire. RESULTS All of the items showed good test-retest reliability (intraclass correlation coefficient >0.40), ranging from 0.58 (social interaction) to 0.98 (role--emotional). Internal consistency reliability values were acceptable, with Cronbach's alpha ranging from 0.60 (cognitive function) to 0.80 (physical functioning and role--physical). Regarding construct validity, overall health rating in kidney disease-targeted scales was significantly correlated with symptoms/problems, effects of kidney disease and burden of kidney disease. All items in the SF 36 scales had significant correlation with overall health rating (P < 0.05) except for role--emotional. CONCLUSION The Filipino version of the Kidney Disease Quality of Life--Short Form can be used to evaluate the health-related quality of life of Filipinos with chronic renal disease on haemodialysis.
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Affiliation(s)
- Rommel P Bataclan
- Department of Internal Medicine, VRP Medical Center, Mandaluyong City, the Philippines.
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Yamamoto Y, Hayashino Y, Yamazaki S, Akiba T, Akizawa T, Asano Y, Saito A, Kurokawa K, Miyachi Y, Fukuhara S. Depressive symptoms predict the future risk of severe pruritus in haemodialysis patients: Japan Dialysis Outcomes and Practice Patterns Study. Br J Dermatol 2009; 161:384-9. [DOI: 10.1111/j.1365-2133.2009.09088.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Molsted S, Heaf J, Prescott L, Eidemak I. Reliability testing of the Danish version of the Kidney Disease Quality of Life Short Form™. ACTA ACUST UNITED AC 2009; 39:498-502. [PMID: 16303727 DOI: 10.1080/00365590500240253] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The questionnaire Kidney Disease Quality of Life Short Form version 1.3 (KDQOL-SF) is valuable for assessing the health-related quality of life in patients treated with chronic dialysis. The aim of this study was to translate and test the reliability of the KDQOL-SF for use in Denmark. MATERIAL AND METHODS Translation into Danish and back-translation into English were performed. Pilot, field and internal consistency reliability tests were performed. RESULTS Cronbach's alpha coefficients for the internal reliability test ranged from 0.77 to 0.93 for the eight generic scales. In a test involving all patients, two of the disease-specific scales had Cronbach's alpha coefficients of <0.70 ("social support" = 0.67; and "quality of social interaction" = 0.43). After removing one item from the scale "quality of social interaction", Cronbach's alpha reached 0.63. A test of the scores of peritoneal dialysis (PD) patients discovered low reliability for three disease-specific scales. The KDQOL-SF manual and the Danish manual for the Short Form 36 (SF36) differed in the scoring of four generic scales: "role limitation-physical", "bodily pain", "general health" and "social function". CONCLUSIONS With the exception of the scale "quality of social interaction" the Danish translation of the KDQOL-SF achieved values in the internal consistency reliability test of the same level as the original U.S. version. When data were stratified according to dialysis treatment, the reliability of PD patients scores was lower. Generic data from the questionnaire SF36 should be scored according to the Danish SF36 manual.
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Affiliation(s)
- Stig Molsted
- Department of Nephrology, Herlev Hospital, Herlev, Denmark.
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Yamana E. The relationship of clinical laboratory parameters and patient attributes to the quality of life of patients on hemodialysis. Jpn J Nurs Sci 2009; 6:9-20. [PMID: 19566635 DOI: 10.1111/j.1742-7924.2009.00116.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM With advances in medicine, the subjective assessment of patients on hemodialysis regarding their quality of life (QOL) is gaining importance. Clinicians cannot rely solely on objective markers, such as the rates of complications and mortality, when evaluating responses to dialysis. In clinical settings, laboratory values are used as measures of patients' health. However, the relationship between clinical laboratory values and QOL has not been elucidated yet. Therefore, the present study aimed to define the relationship of laboratory values and patient attributes to the QOL of outpatients on hemodialysis in order to obtain basic data for reevaluating nursing support for patients on hemodialysis in the future. METHODS The participants were 44 outpatients receiving hemodialysis at Hospital B. The QOL was surveyed using a self-administered questionnaire, the Kidney Disease Quality of Life Short Form. The following patient attributes and laboratory values were taken from the medical records: age; sex; primary disease; number of years on hemodialysis; complications; number of hours of hemodialysis per session; percentage weight gain; cardiothoracic ratio; blood pressure; hematocrit; and the serum levels of albumin, potassium, phosphorus, and calcium. RESULTS The serum potassium level significantly affected mental health, social functioning, symptoms, and the effect of kidney disease, with the 3.5-5.0 mEq/L target range group scoring higher than the > or =5.1 mEq/L group. CONCLUSIONS The serum potassium level significantly affected not only physical health, but also QOL, a measure of psychosocial health. This suggests that providing nursing support to patients, guided by the serum potassium target range of 3.5-5.0 mEq/L, might improve and maintain QOL.
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Affiliation(s)
- Eiko Yamana
- Fukuoka Prefectural University, 4395 Ita Tagawa, Fukuoka 825-8585, Japan.
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Molnar MZ, Novak M, Szeifert L, Ambrus C, Keszei A, Koczy A, Lindner A, Barotfi S, Szentkiralyi A, Remport A, Mucsi I. Restless legs syndrome, insomnia, and quality of life after renal transplantation. J Psychosom Res 2007; 63:591-7. [PMID: 18061749 DOI: 10.1016/j.jpsychores.2007.06.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Restless legs syndrome (RLS) is associated with insomnia and impaired quality of life (QoL) in patients on maintenance dialysis; however, no information has been published on the association of RLS and QoL in kidney-transplanted patients. In a cross-sectional study, we analyzed the complex relationship between RLS, insomnia, and health-related QoL in kidney-transplanted patients. METHODS In a cross-sectional survey at a single transplant center, 1067 patients were invited to participate. Complete data set was available from 785 kidney-transplanted patients. The RLS Questionnaire and the Athens Insomnia Scale were used to assess the prevalence of RLS and insomnia, respectively. QoL was measured using the Kidney Disease QoL-SF Questionnaire. RESULTS Patients with RLS were three times more likely to have insomnia than patients without RLS (29% vs. 9%, P=.001), and the presence of RLS was a significant and independent predictor of insomnia in multivariate analysis. The presence of RLS was independently associated with impaired health-related QoL along several QoL domains after statistical adjustment for clinical and sociodemographic covariables. Importantly, this association remained significant even after adjusting for insomnia for some QoL domains. CONCLUSION RLS is associated with poor sleep, increased odds for insomnia, and impaired QoL in kidney-transplanted patients. Our results suggest that both sleep-related and sleep-independent factors may contribute to the association of RLS and QoL.
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Affiliation(s)
- Miklos Zsolt Molnar
- Institute of Behavioral Sciences, Fresenius Medical Care Dialysis Center, and 1st Department of Internal Medicine, Semmelweis University, Budapest, Hungary
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Park HJ, Kim S, Yong JS, Han SS, Yang DH, Meguro M, Han CW, Kohzuki M. Reliability and validity of the Korean version of Kidney Disease Quality of Life instrument (KDQOL-SF). TOHOKU J EXP MED 2007; 211:321-9. [PMID: 17409671 DOI: 10.1620/tjem.211.321] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although the Kidney Disease Quality of Life instrument (KDQOL-SF), which was designed to measure the comprehensive quality of life in patients with end stage renal disease, has been tested and widely administered in many other counties, it has not yet been translated, validated and reported for Korea. The primary purpose of this study was to validate a Korean version of KDQOL-SF and to evaluate its psychometric properties. The study subjects were 164 patients with hemodialysis or continuous ambulatory peritoneal dialysis in university dialysis centers in Korea. In order to investigate the reliability, test-retest reliability and internal consistency reliability were assessed. Both test-retest reliability and internal consistency reliability were found to be high. In order to investigate the construct validation, all the items of the SF-36 scales, an established generic QOL measures, were compared with an overall health rating scale in kidney disease-targeted scale. They found to be highly correlated with each other. Moreover, overall health rating scale was significantly correlated with symptoms/problems, effects of kidney disease, burden of kidney disease, cognitive function (p < 0.001), and quality of social interaction (p < 0.05). These results suggest that the Korean version of KDQOL-SF satisfies its reliability and validity in Korean patients with hemodialysis or continuous ambulatory peritoneal dialysis. This questionnaire provides important and clinically valuable information for understanding the health related quality of life in the Korean patients with dialysis.
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Affiliation(s)
- Hye J Park
- Department of Nursing, College of Medicine, Pochon CHA University, Pochan, Kyeonggi Do, Republic of Korea
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Yildirim A, Ogutmen B, Bektas G, Isci E, Mete M, Tolgay HI. Translation, cultural adaptation, initial reliability, and validation of the Kidney Disease and Quality of Life-Short Form (KDQOL-SF 1.3) in Turkey. Transplant Proc 2007; 39:51-4. [PMID: 17275473 DOI: 10.1016/j.transproceed.2006.10.196] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2006] [Indexed: 11/18/2022]
Abstract
Health-related quality of life (HRQoL) is an important factor that can interfere with treatment outcomes. The aim of the present study was cultural adaptation, validation, and translation of the Kidney Disease Quality of Life-Short Form (KDQoL-SF 1.3) questionnaire into Turkish for the Turkish population. The KDQOL-SF was translated into Turkish and back-translated into English. Patient difficulties in understanding the questionnaire were evaluated and solved by a panel of experts. Measurement properties such as reliability and validity were determined by applying the questionnaire to 82 patients on dialysis, who were randomly selected from the dialysis units of 3 educational and research hospitals in Istanbul: 65% were females; mean patient age was 51 +/- 12 years. The most common primary causes of renal failure were glomerulonephritis (47%), hypertension (31%), and diabetes (7%). The median time on dialysis among the patients was 3 years. Test and retest methods were used for reliability. The total test-retest reliability Cronbach alpha coefficient of the Turkish KDQOL-SF questionnaire was 0.84 to 0.91. These coefficients were statistically significant (P < .05) for 19 dimensions of the KDQOL-SF that ranged from 0.75 to 0.91. The Cronbach alpha coefficient was higher than 0.80 for most components. To evaluate its construct validity, the KDQOL-SF was compared with the Turkish version of the 15D, an instrument for global assessment that contains 15 items divided into 5 dimensions. The scores range from 0 to 1 (0 = worse health status, 1 = better health status). Significant correlations were observed between the scores of the similar domains of the 15D and the KDQOL-SF. The best correlations were observed between physical functioning (KDQOL-SF) and mobility (15D; r = -.810) and between emotional well-being of (KDQOL-SF), and with the mental functions of 15D; (r = -.784), sexual function (KDQOL-SF) and sexual activity (15D; r = -.781), and patient satisfaction and distress (r = -.801). These findings support the construct validity of the new Turkish adapted KDQOL-SF. This study is reporting the complete process of translation and validation of the KDQOL-SF in the literature. These results demonstrate the high reliability and validity of this questionnaire for Turkish patients on dialysis.
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Affiliation(s)
- A Yildirim
- Marmara University Health Education Faculty, Kartal-Cevizli-Istanbul, Turkey
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Saitoh M, Matsunaga A, Yokoyama M, Fukuda M, Yoshida A, Masuda T. Effects of long-term hemodialysis therapy on physical function in patients with chronic renal failure. ACTA ACUST UNITED AC 2007. [DOI: 10.4009/jsdt.40.147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Stavem K, Ganss R. Reliability and validity of the ESRD Symptom Checklist--Transplantation Module in Norwegian kidney transplant recipients. BMC Nephrol 2006; 7:17. [PMID: 17109746 PMCID: PMC1660533 DOI: 10.1186/1471-2369-7-17] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2006] [Accepted: 11/16/2006] [Indexed: 11/30/2022] Open
Abstract
Background The aim of the study was to validate the Norwegian version of a self-administered 43-item questionnaire designed to assess quality of life in kidney transplant recipients, the End-Stage Renal Disease Symptom Checklist – Transplantation Module (ESRD-SCL). Methods In total, 53 kidney transplant recipients from one university-affiliated hospital responded to a questionnaire including the ESRD-SCL and the Short Form 36 (SF-36). We assessed internal consistency reliability and test-retest reliability with 2 weeks between assessments. Construct validity was assessed by correlations of the ESRD-SCL subscales with related and unrelated SF-36 scales, demographic, and clinical characteristics. Results Subscales of the ESRD-SCL showed good internal consistency reliability (Cronbach's = 0.72–0.81) and for the aggregate total scale α was 0.94. Test-retest reliability median 14 days apart was excellent with intraclass coefficients ranging from 0.87 to 0.95. The pattern of correlations of the ESRD-SCL scales with related and unrelated scales SF-36 scales and demographic and clinical characteristics gave support to the construct validity of the ESRD-SCL. Conclusion The Norwegian translation of the ESRD-SCL showed satisfactory internal consistency reliability, test-retest reliability and construct validity, at the level of the original German version.
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Affiliation(s)
- Knut Stavem
- Medical Department, Akershus University Hospital, Lørenskog, Norway
- Helse-Øst Health Services Research Centre, Lørenskog, Norway
| | - Rüdiger Ganss
- Medical Department, Akershus University Hospital, Lørenskog, Norway
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Barotfi S, Molnar MZ, Almasi C, Kovacs AZ, Remport A, Szeifert L, Szentkiralyi A, Vamos E, Zoller R, Eremenco S, Novak M, Mucsi I. Validation of the Kidney Disease Quality of Life-Short Form questionnaire in kidney transplant patients. J Psychosom Res 2006; 60:495-504. [PMID: 16650590 DOI: 10.1016/j.jpsychores.2005.09.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to determine the basic psychometric properties, reliability, and validity of the Kidney Disease Quality of Life-Short Form (KDQOL-SF) questionnaire in kidney transplant patients. METHODS The reliability and validity of the instrument were determined in 418 kidney transplant patients followed in a single outpatient transplant centre. RESULTS Internal consistency of all the Medical Outcome Study Short Form 36 (SF-36) domains was very good, and the Cronbach's alpha value was above .70 for all but three of the disease-specific subscales. We found significant, moderate to strong negative correlations between most of the KDQOL-SF domains and the Center for Epidemiologic Studies-Depression (CES-D) scores. Finally, substantial differences in KDQOL-SF scores were seen between groups of transplanted patients who were expected to be clinically different, supporting the discriminant validity of the KDQOL-SF instrument. CONCLUSION We propose that the KDQOL-SF is a reliable and valid tool and most of its subscales can be used to assess health-related quality of life (HRQOL) in kidney transplant patients and to compare HRQOL between different end stage renal disease (ESRD) patient populations.
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Affiliation(s)
- Szabolcs Barotfi
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
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Kontodimopoulos N, Niakas D. Determining the basic psychometric properties of the Greek KDQOL-SF. Qual Life Res 2006; 14:1967-75. [PMID: 16155785 DOI: 10.1007/s11136-005-3868-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2005] [Indexed: 12/16/2022]
Abstract
The aim of this study was to determine the basic psychometric properties, i.e. reliability and validity, of the Greek version of the Kidney Disease Quality of Life Short Form (KDQOL-SF). The instrument was self-administered to a homogenous group of 665 end stage renal disease patients in 20 dialysis units throughout Greece and the overall response rate was 72.6%. Reliability was demonstrated by Cronbach's alpha exceeding the recommended minimum value of 0.70 in all, except one, scales. Tests of item-internal consistency, after correction for overlap, resulted in correlations between items and their hypothesized scales, which exceeded the 0.40 standard in 94.5% of the cases. Item discriminant validity tests indicated 100% scaling success for six out of eight generic and disease-targeted scales. Validity was supported by the confirmation of expected correlations between scales and the overall health-rating item included in the instrument and with sociodemographic and self-reported health variables. Multiple stepwise linear regression analysis demonstrated that all disease-targeted scales were important predictors of SF-36 general health scales and the variance explained ranged from 37% to 57%. Overall, the psychometric properties of the KDQOL-SF, resulting from this first-time administration of the instrument to a Greek dialysis population, were good and the disease targeted scales were informative and of high internal consistency reliability. Cross-sectional construct validity is demonstrated, despite the lack of external validity criteria based on clinical ratings of severity. The results support administering the Greek KDQOL-SF in studies evaluating dialysis therapy and contribute to transnational comparison of findings.
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Stack AG, Molony DA, Rives T, Tyson J, Murthy BVR. Association of physical activity with mortality in the US dialysis population. Am J Kidney Dis 2005; 45:690-701. [PMID: 15806472 DOI: 10.1053/j.ajkd.2004.12.013] [Citation(s) in RCA: 165] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND It is unclear whether the protective benefits of regular physical activity on mortality extend to patients with end-stage renal disease (ESRD). We tested this hypothesis in a national cohort of new patients with ESRD in the United States. METHODS Data for a subset of patients (n = 2,507; 62%) from the Dialysis Morbidity and Mortality Wave 2 study were used to explore the associations of exercise and limitations in physical activity with mortality. RESULTS Overall, 56% of patients exercised less than once a week, whereas the remainder reported more frequent physical activity; 2 to 3 times/wk in 18%, 4 to 5 times/wk in 6%, and daily exercise in 20%. Severe limitations in vigorous and moderate physical activities were reported by 75% and 42%, respectively. Mortality risks were greatest for those with severe limitations in either moderate (relative risk [RR], 1.72; 95% confidence interval [CI], 1.44 to 2.05) or vigorous physical activities (RR, 1.51; 95% CI, 1.20 to 1.90) compared with those reporting minimal or no limitations. Conversely, mortality risks were lower for patients who exercised 2 to 3 (RR, 0.74; 95% CI, 0.58 to 0.95) or 4 to 5 times/wk (RR, 0.70; 95% CI, 0.47 to 1.07), whereas no advantage was associated with daily exercise (RR, 1.06; 95% CI, 0.86 to 1.30). CONCLUSION Although limitations in physical activity are common among new patients with ESRD in the United States and correlate highly with increased mortality risk, this study shows an association of frequent exercise of up to 4 to 5 times/wk with improved survival. The surprising lack of association of daily exercise with increased survival deserves additional study.
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Affiliation(s)
- Austin G Stack
- Regional Kidney Center, Department of Internal Medicine, Letterkenny General Hospital, North Western Health Board, Letterkenny, Ireland.
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