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Sarofim M, Ahmadi N, Morris DL. Shifting the paradigm of long-term total parenteral nutrition: Lessons from renal dialysis. JPEN J Parenter Enteral Nutr 2024; 48:372-374. [PMID: 38297819 DOI: 10.1002/jpen.2602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 02/02/2024]
Affiliation(s)
- Mina Sarofim
- Liver and Peritonectomy Unit, St George Hospital, Kogarah, New South Wales, Australia
- St George and Sutherland School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- School of Medicine, University of Sydney, Camperdown, New South Wales, Australia
| | - Nima Ahmadi
- Liver and Peritonectomy Unit, St George Hospital, Kogarah, New South Wales, Australia
- St George and Sutherland School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - David L Morris
- Liver and Peritonectomy Unit, St George Hospital, Kogarah, New South Wales, Australia
- St George and Sutherland School of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Knowles SR, Apputhurai P, Jenkins Z, O'flaherty E, Ierino F, Langham R, Ski CF, Thompson DR, Castle DJ. Impact of chronic kidney disease on illness perceptions, coping, self-efficacy, psychological distress and quality of life. PSYCHOL HEALTH MED 2023; 28:1963-1976. [PMID: 36794381 DOI: 10.1080/13548506.2023.2179644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
Chronic kidney disease (CKD) negatively impacts psychological well-being and quality of life (QoL). Underpinned by the Common Sense Model (CSM), this study evaluated the potential mediating role of self-efficacy, coping styles and psychological distress on the relationship between illness perceptions and QoL in patients living with CKD. Participants were 147 people with stage 3-5 kidney disease. Measures included eGFR, illness perceptions, coping styles, psychological distress, self-efficacy and QoL. Correlational analyses were performed, followed by regression modelling. Poorer QoL was associated with greater distress, engagement in maladaptive coping, poorer illness perceptions and lower self-efficacy. Regression analysis revealed that illness perceptions predicted QoL, with psychological distress acting as a mediator. The proportion of variance explained was 63.8%. These findings suggest that psychological interventions are likely to enhance QoL in CKD, if they target the mediating psychological processes associated with illness perceptions and psychological distress.
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Affiliation(s)
- Simon R Knowles
- School of Health Sciences, Swinburne University, Melbourne, Australia
| | | | - Zoe Jenkins
- Mental Health Services, St. Vincent's Hospital, Melbourne, Australia
| | - Emmet O'flaherty
- Nephrology Service, St. Vincent's Hospital, Melbourne, Australia
| | - Francesco Ierino
- Nephrology Service, St. Vincent's Hospital, Melbourne, Australia
| | - Robyn Langham
- St. Vincent's Hospital, University of Melbourne Department of Medicine, Melbourne, Australia
| | - Chantal F Ski
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- Integrated Care Academy, University of Suffolk, Ipswich, UK
| | - David R Thompson
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - David J Castle
- Mental Health Services, St. Vincent's Hospital, Melbourne, Australia
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Floria I, Kontele I, Grammatikopoulou MG, Sergentanis TN, Vassilakou T. Quality of Life of Hemodialysis Patients in Greece: Associations with Socio-Economic, Anthropometric and Nutritional Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215389. [PMID: 36430108 PMCID: PMC9696256 DOI: 10.3390/ijerph192215389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 05/13/2023]
Abstract
Chronic kidney disease (CKD) is a serious public health problem that, in recent decades, has taken on significant dimensions with serious effects on the quality of life (QoL) of patients. The purpose of this cross-sectional study is to evaluate the QoL of a sample of hemodialysis patients in Greece and the possible correlations with socio-economic and anthropometric factors, as well as with adherence to the Mediterranean Diet (MD). During September-November 2019, one-hundred and five (n = 105) patients with end-stage CKD (63.4 ± 13.09 years of age) who were regularly monitored in five public and private hemodialysis units in the region of Attica, completed a demographic questionnaire, the MedDietScore questionnaire, and the KDQOL-SF questionnaire. Females presented worse QoL than males (p < 0.05), and older patients presented worse QoL than younger patients (p < 0.01). Patients of higher educational status presented better QoL scores than those of lower educational status (p < 0.01), while those with low financial status presented lower QoL scores than patients of middle and high financial status (p < 0.01). Obese patients had lower QoL scores than overweight patients (p < 0.05), and overweight males scored higher than normal weight males (p < 0.05). Age was negatively correlated to the total and most of the scales of QoL (p < 0.01). A majority of the patients (90.5%) showed a moderate adherence to MD, although "work status" was the only QoL scale that was correlated to MD. Age, educational status and financial status accounted for 28.1% of the variance in the KDQOL-SF total score. Hemodialysis patients need support in various levels, such as social, financial and educational, as well as nutritional counseling to adopt a balanced diet and maintain a healthy weight, in order to achieve a better quality of life.
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Affiliation(s)
- Ioanna Floria
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
| | - Ioanna Kontele
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
| | - Maria G. Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41110 Larissa, Greece
| | - Theodoros N. Sergentanis
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
- Correspondence:
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Assessment of the Nutritional Status and Quality of Life in Chronic Kidney Disease and Kidney Transplant Patients: A Comparative Analysis. Nutrients 2022; 14:nu14224814. [PMID: 36432502 PMCID: PMC9692759 DOI: 10.3390/nu14224814] [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: 10/31/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) can significantly influence a patient's nutritional status, leading to malnutrition. Malnutrition is associated with an increase in morbidity and hospital admissions, as well as a decrease in functional status. All these factors impact emotional, physical, and psychosocial health, leading to a lower quality of life (QOL). The aim of the study was to assess the nutritional status and QOL in patients with CKD compared to patients after kidney transplantation and determine what factors influence nutritional status and QOL in this patient population. METHODS The study included 167 patients: 39 pre-dialysis patients-group 1; 65 dialysis patients-group 2; 63 kidney transplant patients-group 3. Patients completed the Kidney Disease Quality of Life questionnaire (KDQoL) and the Mini Nutritional Assessment questionnaire (MNA). RESULTS A comparative analysis of the QOL of patients in the three study groups showed no statistically significant differences in the overall KDQoL scores. Factors that affected quality of life included the designated group, determined by disease status, MNA score, patient age, and WHR. Nearly 1/3 of patients from groups 2 and 3 were at risk of malnutrition. CONCLUSIONS A systematic assessment of nutritional status and monitoring of QOL should be integrated into the standard management guidelines for CKD patients.
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Health-Related Quality of Life (HRQoL) and the Effect on Outcome in Patients Presenting with Coronary Artery Disease and Treated with Percutaneous Coronary Intervention (PCI): Differences Noted by Sex and Age. J Clin Med 2022; 11:jcm11175231. [PMID: 36079161 PMCID: PMC9457487 DOI: 10.3390/jcm11175231] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Background and aim: poor quality of life (QoL) has been identified as an independent risk factor for mortality and major cardiac events (MACE) in patients with cardiovascular disease (CVD). The aim of this study was to assess health-related quality of life (HRQoL) at baseline and its association with outcome in patients with coronary artery disease presenting for percutaneous coronary intervention (PCI). The outcome was measured by mortality and MACE at 1-year, and whether there was any difference for sex and different age groups. Methods and results: all patients prospectively enrolled into the GenesisCare Outcome Registry (GCOR) over a 11-year period were included in the study. The EQ-5D-5L and VAS patient survey were used for assessment of baseline HRQoL. Of the 15,198 patients, only 6591 (43.4%) completed the self-assessment. Women had significantly more impairment of all five dimensions of the EQ-5D-5L survey, and their self-reported QoL was significantly lower than men (68.3 in women vs. 71.9 in men, p < 0.001). Poor QoL was strongly associated with increased mortality (HR 2.85; 95% CI 1.76 to 4.62, p < 0.001) and MACE (HR 1.40; 95% CI 1.10 to 1.79, p = 0.01). A similar trend was noted for women and men, but did not reach significance in women due to the smaller number of female patients. Conclusion: poor HRQoL is associated with subsequent mortality and MACE in patients undergoing PCI. By not assessing quality of life as a standard of care, an opportunity is lost to identify high-risk patients who may benefit from targeted interventions to improve health outcomes.
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Comorbid Depression and Diabetes Are Associated with Impaired Health-Related Quality of Life in Chronic Kidney Disease Patients. J Clin Med 2022; 11:jcm11164671. [PMID: 36012909 PMCID: PMC9410519 DOI: 10.3390/jcm11164671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
Abstract
Given the increasing prevalence of chronic kidney disease (CKD) and its impact on health care, it is important to better understand the multiple factors influencing health-related quality of life (HRQOL), particularly since they have been shown to affect CKD outcomes. Determinants of HRQOL as measured by the validated Kidney Disease Quality of Life questionnaire (KDQOL) and the Patient Health Questionnaire depression screener (PHQ-9) were assessed in a routine CKD patient sample, the Greifswald Approach to Individualized Medicine (GANI_MED) renal cohort (N = 160), including a wide range of self-reported data, sociodemographic and laboratory measures. Compared to the general population, CKD patients had lower HRQOL indices. Dialysis was associated with (1) low levels of physical functioning, (2) increased impairments by symptoms and problems, and (3) more effects and burden of kidney disease. HRQOL is seriously affected in CKD patients. However, impairments were found irrespective of eGFR decline and albuminuria. Rather, the comorbid conditions of depression and diabetes predicted a lower HRQOL (physical component score). Further studies should address whether recognizing and treating depression may not only improve HRQOL but also promote survival and lower hospitalization rates of CKD patients.
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Hladek MD, Zhu J, Crews DC, McAdams-DeMarco MA, Buta B, Varadhan R, Shafi T, Walston JD, Bandeen-Roche K. Physical Resilience Phenotype Trajectories in Incident Hemodialysis: Characterization and Mortality Risk Assessment. Kidney Int Rep 2022; 7:2006-2015. [PMID: 36090502 PMCID: PMC9459128 DOI: 10.1016/j.ekir.2022.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/13/2022] [Indexed: 12/19/2022] Open
Abstract
Introduction Methods Results Conclusion
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Ryu JH, Koo TY, Ro H, Cho JH, Kim MG, Huh KH, Park JB, Lee S, Han S, Kim J, Oh KH, Yang J. Better health-related quality of life in kidney transplant patients compared to chronic kidney disease patients with similar renal function. PLoS One 2021; 16:e0257981. [PMID: 34606505 PMCID: PMC8489710 DOI: 10.1371/journal.pone.0257981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022] Open
Abstract
Renal functional deterioration is associated with physical and mental burdens for kidney transplant (KT) and chronic kidney disease (CKD) patients. However, the change in health-related quality of life (HRQOL) over time in KT patients compared to that of native CKD patients has not been evaluated. We addressed this issue using KT patients registered in the KNOW-KT cohort study and patients at CKD stage 1–3 registered in the KNOW-CKD cohort study. HRQOL scores were assessed using the Kidney Disease Quality of Life Short Form at baseline, 2-, and 4-years follow-up in 842 KT patients and at baseline and 5-year follow-up in 1,355 CKD patients. SF-36 scores declined at the 4-year follow-up, whereas CKD-targeted scores showed no change in the KT group. In contrast, CKD-targeted scores as well as SF-36 scores were decreased at the 5-year follow-up in CKD patients. When prognostic factors were analyzed for longitudinal HRQOL data over time, renal functions, diabetes, cardiovascular and cerebrovascular diseases, hemoglobin level, marital status, income, employment, and health care were significant prognostic factors. Furthermore, KT was an independent prognostic factor for better HRQOL. These results highlight that KT can offer a better HRQOL than that of CKD patients, even when renal function is similar.
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Affiliation(s)
- Jung-Hwa Ryu
- Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
- Nephrology, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Tai Yeon Koo
- Nephrology, Seongnam Citizens Medical Center, Seongnam, Republic of Korea
| | - Han Ro
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jang-Hee Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Myung-Gyu Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyu Ha Huh
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Berm Park
- Department of Surgery, Seoul Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Sik Lee
- Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Seungyeup Han
- Department of Internal Medicine, Keimyung University, Dongsan Medical Center, Daegu, Republic of Korea
| | - Jayoun Kim
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jaeseok Yang
- Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- * E-mail: ,
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Firipis K, Nisbet DR, Franks SJ, Kapsa RMI, Pirogova E, Williams RJ, Quigley A. Enhancing Peptide Biomaterials for Biofabrication. Polymers (Basel) 2021; 13:polym13162590. [PMID: 34451130 PMCID: PMC8400132 DOI: 10.3390/polym13162590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 12/20/2022] Open
Abstract
Biofabrication using well-matched cell/materials systems provides unprecedented opportunities for dealing with human health issues where disease or injury overtake the body’s native regenerative abilities. Such opportunities can be enhanced through the development of biomaterials with cues that appropriately influence embedded cells into forming functional tissues and organs. In this context, biomaterials’ reliance on rigid biofabrication techniques needs to support the incorporation of a hierarchical mimicry of local and bulk biological cues that mimic the key functional components of native extracellular matrix. Advances in synthetic self-assembling peptide biomaterials promise to produce reproducible mimics of tissue-specific structures and may go some way in overcoming batch inconsistency issues of naturally sourced materials. Recent work in this area has demonstrated biofabrication with self-assembling peptide biomaterials with unique biofabrication technologies to support structural fidelity upon 3D patterning. The use of synthetic self-assembling peptide biomaterials is a growing field that has demonstrated applicability in dermal, intestinal, muscle, cancer and stem cell tissue engineering.
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Affiliation(s)
- Kate Firipis
- Biofab3D, Aikenhead Centre for Medical Discovery, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (K.F.); (R.M.I.K.); (E.P.)
- Biomedical and Electrical Engineering, School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
| | - David R. Nisbet
- Laboratory of Advanced Biomaterials, The Australian National University, Acton, Canberra, ACT 2601, Australia; (D.R.N.); (S.J.F.)
- The Graeme Clark Institute, Faculty of Engineering and Information Technology, Melbourne, VIC 3000, Australia
- Faculty of Medicine, Dentistry and Health Services, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Stephanie J. Franks
- Laboratory of Advanced Biomaterials, The Australian National University, Acton, Canberra, ACT 2601, Australia; (D.R.N.); (S.J.F.)
| | - Robert M. I. Kapsa
- Biofab3D, Aikenhead Centre for Medical Discovery, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (K.F.); (R.M.I.K.); (E.P.)
- Biomedical and Electrical Engineering, School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
- Department of Medicine, Melbourne University, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3064, Australia
| | - Elena Pirogova
- Biofab3D, Aikenhead Centre for Medical Discovery, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (K.F.); (R.M.I.K.); (E.P.)
- Biomedical and Electrical Engineering, School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
| | - Richard J. Williams
- Biofab3D, Aikenhead Centre for Medical Discovery, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (K.F.); (R.M.I.K.); (E.P.)
- Institute of Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia
- Correspondence: (R.J.W.); (A.Q.)
| | - Anita Quigley
- Biofab3D, Aikenhead Centre for Medical Discovery, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (K.F.); (R.M.I.K.); (E.P.)
- Biomedical and Electrical Engineering, School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
- Department of Medicine, Melbourne University, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3064, Australia
- Correspondence: (R.J.W.); (A.Q.)
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Kim JH, Han JM, Kim H, Lee KB, Chung W, Kim YS, Park SK, Chae DW, Ahn C, Oh KH, Hyun YY. Low serum adiponectin level is associated with better physical health-related quality of life in chronic kidney disease. Sci Rep 2021; 11:10928. [PMID: 34035377 PMCID: PMC8149720 DOI: 10.1038/s41598-021-90339-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/06/2021] [Indexed: 12/16/2022] Open
Abstract
Hyperadiponectemia is paradoxically associated with renal disease progression and mortality in chronic kidney disease (CKD). Its association with health-related quality of life (HR-QOL) is unknown. This study aimed to verify the association between adiponectin and HR-QOL in Korean pre-dialysis CKD cohort. This cross-sectional study analyzed 1551 pre-dialysis CKD patients from KNOW-CKD (KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease). Participants were categorized into three tertiles (T1–T3) according to adiponectin levels. HR-QOL was assessed using SF-36. High physical component summary (PCS) and mental component summary (MCS) were defined as highest quartile of each score. Multivariate logistic regression was used to analyze odds ratio (OR) and 95% confidence interval (CI) for high PCS and MCS. Prevalence of high PCS were 33.3%, 27.5%, and 17.0% and that of high MCS were 31.7%, 24.8%, and 21.3% for T1, T2, and T3 (both p for trend < 0.001). The adjusted OR [95% CI] of T1 and T2 in reference to T3 were 1.56 [1.09–2.23] and 1.19 [0.85–1.68] for high PCS and 1.19 [0.85–1.68] and 0.94 [0.68–1.29] for high MCS. Serum adiponectin level was inversely associated with physical HR-QOL in Korean pre-dialysis CKD patients. This relationship was independent of various cardiovascular risk factors.
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Affiliation(s)
- Ji Hye Kim
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-Gu, Seoul, 03181, Republic of Korea
| | - Ji Min Han
- Jung Jaemyun Internal Medicine Clinic, Seoul, Republic of Korea
| | - Hyang Kim
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-Gu, Seoul, 03181, Republic of Korea
| | - Kyu-Beck Lee
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-Gu, Seoul, 03181, Republic of Korea
| | - Wookyung Chung
- Department of Internal Medicine, Gachon University, Gil Medical Center, Incheon, Republic of Korea
| | - Yong-Soo Kim
- Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Wan Chae
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Youl Hyun
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-Gu, Seoul, 03181, Republic of Korea.
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Altun E, Paydas S, Kaya B, Balal M, Seydaoğlu G. Blood pressure, inflammation, and quality of life in patients treated with different renal replacement therapies. Ther Apher Dial 2021; 26:115-121. [PMID: 34032378 DOI: 10.1111/1744-9987.13692] [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: 03/12/2021] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 11/28/2022]
Abstract
Our aim was to determine the relationship between the modality of renal replacement therapy and inflammation markers, BP control, and quality of life (QoL). Sixteen hemodialysis, 17 peritoneal dialysis patients, and 27 kidney transplant receivers (KTr) have been included in this study. Short Form-36 (SF-36) for the evaluation of QoL and ambulatory BP monitoring were performed on the same day. Erythrocyte sedimentation rate, CRP, IL-6, and IL-10 were measured. While the mean IL-10, IL-6, and CRP levels were the highest in the dialysis groups, there were no significantly differences any parameters for all groups. QoL was better in the KTr almost as in healthy controls but worse in the dialysis patients. It should be taken into account that hypertension may occur at night even if the daytime BP is normal in KTr.
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Affiliation(s)
- Eda Altun
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Saime Paydas
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Bülent Kaya
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Mustafa Balal
- Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Gülsah Seydaoğlu
- Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, Turkey
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Erbay E, Arslan K, Hatipoğlu E, Yildirim T. The Quality of Life, Depression Levels and Coping Styles of Patients on Kidney Transplant Waiting List. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:432-447. [PMID: 33771077 DOI: 10.1080/19371918.2021.1903645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study aims to understand the coping strategies, depression levels, sociodemographic characteristics of Turkish patients with hemodialysis, and the other factors explain quality of life levels. This research is a cross-sectional study. The convenience sampling consisted of 292 patients with hemodialysis. The data were collected using the brief COPE, QOL, Beck Depression Inventory and sociodemographic form. According to the research results, patients show mild (score range 10-16) depression symptoms. One of the most important findings of this study is that the coping strategies and level of depression with chronic kidney patients accounted for a significant amount of variance in their quality of life. The relationship between emotion-focused coping strategy and quality of life was not statistically significant. In addition, high level of depression in chronic renal failure patients significantly reduce the quality of life. As a result of the study, the relationship between the high quality of life of patients who use problem-focused coping strategy more intensively and patients with low depression levels was determined. The findings point to the importance of taking individual coping strategies into account when evaluating the impact of a disease on psychosocial wellbeing. Delineation of coping strategies might be useful for identifying patients in need of particular counseling and support. These patients should have frequent contact with a multidisciplinary team of health care givers, possibly allowing for early diagnosis and prompt treatment. Results suggest targeted interventions to stimulate future research regarding the psychological care of patients with chronic kidney disease.
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Affiliation(s)
- Ercüment Erbay
- Faculty of Economics and Administrative Sciences, Department of Social Work, Hacettepe University, Ankara, Turkey
| | - Kübra Arslan
- Faculty of Health Sciences, Department of Social Work, Kırıkkale University, Kırıkkale, Turkey
| | - Ertuğrul Hatipoğlu
- Faculty of Economics and Administrative Sciences, Department of Social Work, Hacettepe University, Ankara, Turkey
| | - Tolga Yildirim
- Faculty of Medicine Department of Internal Diseases Nephrology Subdivision, Hacettepe University, Ankara, Turkey
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Hussien H, Apetrii M, Covic A. Health-related quality of life in patients with chronic kidney disease. Expert Rev Pharmacoecon Outcomes Res 2020; 21:43-54. [PMID: 33213186 DOI: 10.1080/14737167.2021.1854091] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction: In the last three decades, health systems have continued to pay increasing attention to the quality of life (QOL) due to definitional changes in the concept of health and disease. The health-related quality of life (HRQOL) in patients with chronic kidney disease (CKD) is significantly affected, regardless of the stage of CKD. Areas covered: We attempt to thoroughly explore how CKD affects HRQOL domains with a quick primer on HRQOL assessment instruments in patients with CKD. Also, we pointed out the factors affecting HRQOL in patients with CKD as well as the clinical application of HRQOL in CKD management. Expert opinion: The general population enjoys higher HRQOL than patients with CKD in all domains. Similarly, pre-dialysis and kidney-transplant patients have better HRQOL than dialysis population. There are many factors which negatively impact HRQOL in CKD which include for example depression, anxiety, and cognitive impairment for the social domain, inactivity, and frailty for the physical domain as well as lack of social support and extroversion in the social domain. Additionally, social disparities and CKD-related factors would influence HRQOL. Of note, there is no global standard HRQOL assessment tool. Finally, HRQOL should be included in future CKD management guidelines.
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Affiliation(s)
- Hani Hussien
- Department of Nephrology, Grigore T Popa University of Medicine and Pharmacy, Faculty of Medicine , Iasi, Romania.,Department of Nephrology Dr C I Parhon University Hospital , Iasi, Romania
| | - Mugurel Apetrii
- Department of Nephrology, Grigore T Popa University of Medicine and Pharmacy, Faculty of Medicine , Iasi, Romania.,Department of Nephrology Dr C I Parhon University Hospital , Iasi, Romania
| | - Adrian Covic
- Department of Nephrology, Grigore T Popa University of Medicine and Pharmacy, Faculty of Medicine , Iasi, Romania.,Department of Nephrology Dr C I Parhon University Hospital , Iasi, Romania
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Chan K, Wong F, Tam SL, Kwok CP, Fung YP, Wong PN. The effects of a brief hope intervention on decision-making in chronic kidney disease patients: A study protocol for a randomized controlled trial. J Adv Nurs 2020; 76:3631-3640. [PMID: 33038022 DOI: 10.1111/jan.14520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/15/2020] [Accepted: 07/15/2020] [Indexed: 11/26/2022]
Abstract
AIMS This study describes the study protocol of a manualized brief hope intervention that is based on the theoretical proposition - hope theory. BACKGROUND Patients with stage 5 chronic kidney disease often had decisional regret when facing the tension of treatment alternatives between dialysis initiation and palliative care. Hope has been found to account for therapeutic changes in clients with depressive symptoms, heightens positive expectations, and striving to accomplish chosen goals. Nevertheless, little is known about the effect of hope on decisional conflict and its influences to the quality of life in these chronic kidney disease patients. DESIGN This study is a single-blinded, randomized controlled trial. METHODS Participants will be recruited from a regional hospital (approved in April 2018). They will be randomly assigned in equal numbers to either the brief hope intervention or the control arm on completion of the baseline assessment on the possible need of dialysis initiation. Participants in the intervention group will receive the pre-dialysis education and a 4-week Brief Hope Intervention [consisting of four sessions at weekly intervals (two face-to-face sessions and two telephone follow-up sessions in between)], while those allocated to the control arm will receive the renal education and social chats. Outcome measures will be carried out prior to the intervention (baseline), immediately, and 1 month after the intervention. These consist of the hope level, decisional conflict, and quality of life. Healthcare resources use data will be reported. IMPACT The study results have the potential to add scientific evidence to the research-tested programme when developing renal services integral to multimodal care management to optimize decision-making and attain better health outcomes.
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Affiliation(s)
- Kitty Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Frances Wong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Suet Lai Tam
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
| | - Ching Ping Kwok
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
| | - Yuen Ping Fung
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
| | - Ping Nam Wong
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
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15
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Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186552. [PMID: 32916843 PMCID: PMC7559218 DOI: 10.3390/ijerph17186552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/22/2022]
Abstract
We examined factors associated with healthcare cost, health-related quality of life (HRQOL), and kidney disease quality of life (KDQOL) in hemodialysis patients. We conducted a cross-sectional study on 160 patients from January to April 2019 at a hemodialysis center. Socio-demographic, clinical, and laboratory parameters and quality of life (QOL) (using KDQOL-SF-v1.3) were assessed. Monthly healthcare costs were extracted from the hospital information system. The means of healthcare cost, HRQOL, and KDQOL were VND 9.4 ± 1.6 million, VND 45.1 ± 21.9 and VND 51.3 ± 13.0, respectively. In the multivariate analysis, the healthcare cost was higher in patients with a longer hemodialysis vintage (regression coefficient (B): 0.74; 95% confidence interval (95% CI): 0.25; 1.23), comorbidity (B: 0.77; 95% CI: 0.24; 1.31); and lower in those with a higher hematocrit concentration (B: −0.07; 95% CI: −0.13; −0.01). Patients that lived in urban areas (B: 9.08; 95% CI: 2.30; 15.85) had a better HRQOL; those with a comorbidity (B: −14.20; 95% CI: −21.43; −6.97), and with hypoalbuminemia (B: −9.31; 95% CI: −16.58; −2.04) had a poorer HRQOL. Patients with a higher level of education (B: 5.38~6.29) had a better KDQOL; those with a comorbidity had a poorer KDQOL (B: −6.17; 95% CI: −10.49; −1.85). In conclusion, a longer hemodialysis vintage, a comorbidity and a lower hematocrit concentration were associated with higher healthcare costs. Patients who lived in urban areas had a better HRQOL and a higher level of education led to a better KDQOL. Patients with a comorbidity had a lower HRQOL and KDQOL. Malnourished patients had a lower HRQOL.
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16
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Legrand K, Speyer E, Stengel B, Frimat L, Ngueyon Sime W, Massy ZA, Fouque D, Laville M, Combe C, Jacquelinet C, Durand AC, Edet S, Gentile S, Briançon S, Ayav C. Perceived Health and Quality of Life in Patients With CKD, Including Those With Kidney Failure: Findings From National Surveys in France. Am J Kidney Dis 2020; 75:868-878. [DOI: 10.1053/j.ajkd.2019.08.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023]
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17
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Çevik B, Taşcı S. The effect of acupressure on upper extremity pain and quality of life in patients hemodialysis treatment: A Randomized Controlled Trial. Complement Ther Clin Pract 2020; 39:101128. [PMID: 32379666 DOI: 10.1016/j.ctcp.2020.101128] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/19/2020] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND AIMS Acupressure is a commonly used method to reduce the severity of pain. This study was conducted to determine the effect of acupressure on pain severity and quality of life in patients with upper extremity pain due to hemodialysis. METHOD The study was completed with a total of 50 patients, consisting of 25 intervention group and 25 control group patients. In the intervention group, acupressure was applied to five acupressure points on the arms and shoulders in the first half of the dialysis sessions carried out for six weeks and for three days per week. RESULTS There was a significant decrease (p < .05) between the VAS pain score median values of the preliminary monitoring of patients in the intervention group and their VAS pain score median values recorded six weeks later. CONCLUSIONS Acupressure reduces extremity pain and increases the quality of life in dialysis patients.
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Affiliation(s)
- Banu Çevik
- Başkent Unıversity Faculty of Health Sciences, Department of Nursing, Ankara, Turkey.
| | - Sultan Taşcı
- Erciyes University Faculty of Health Sciences Department of Nursing, Kayseri, Turkey.
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18
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Bonenkamp AA, van Eck van der Sluijs A, Hoekstra T, Verhaar MC, van Ittersum FJ, Abrahams AC, van Jaarsveld BC. Health-Related Quality of Life in Home Dialysis Patients Compared to In-Center Hemodialysis Patients: A Systematic Review and Meta-analysis. Kidney Med 2020; 2:139-154. [PMID: 32734235 PMCID: PMC7380444 DOI: 10.1016/j.xkme.2019.11.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
RATIONALE & OBJECTIVE Dialysis patients judge health-related quality of life (HRQoL) as an essential outcome. Remarkably, little is known about HRQoL differences between home dialysis and in-center hemodialysis (HD) patients worldwide. STUDY DESIGN Systematic review and meta-analysis. SETTING & STUDY POPULATIONS Search strategies were performed on the Cochrane Library, Pubmed, and EMBASE databases between 2007 and 2019. Home dialysis was defined as both peritoneal dialysis and home HD. SELECTION CRITERIA FOR STUDIES Randomized controlled trials and observational studies that compared HRQoL in home dialysis patients versus in-center HD patients. DATA EXTRACTION The data extracted by 2 authors included HRQoL scores of different questionnaires, dialysis modality, and subcontinent. ANALYTICAL APPROACH Data were pooled using a random-effects model and results were expressed as standardized mean difference (SMD) with 95% CIs. Heterogeneity was explored using subgroup analyses. RESULTS Forty-six articles reporting on 41 study populations were identified. Most studies were cross-sectional in design (90%), conducted on peritoneal dialysis patients (95%), and used the 12-item or 36-item Short-Form Health Survey questionnaires (83%). More than half the studies showed moderate or high risk of bias. Pooled analysis of 4,158 home dialysis patients and 7,854 in-center HD patients showed marginally better physical HRQoL scores in home dialysis patients compared with in-center HD patients (SMD, 0.14; 95% CI, 0.04 to 0.24), although heterogeneity was high (I 2>80%). In a subgroup analysis, Western European home dialysis patients had higher physical HRQoL scores (SMD, 0.39; 95% CI, 0.17 to 0.61), while home dialysis patients from Latin America had lower physical scores (SMD, -0.20; 95% CI, -0.28 to -0.12). Mental HRQoL showed no difference in all analyses. LIMITATIONS No randomized controlled trials were found and high heterogeneity among studies existed. CONCLUSIONS Although pooled data showed marginally better physical HRQoL for home dialysis patients, the quality of design of the included studies was poor. Large prospective studies with adequate adjustments for confounders are necessary to establish whether home dialysis results in better HRQoL. TRIAL REGISTRATION PROSPERO 95985.
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Affiliation(s)
- Anna A. Bonenkamp
- Department of Nephrology, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | | | - Tiny Hoekstra
- Department of Nephrology, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Marianne C. Verhaar
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Frans J. van Ittersum
- Department of Nephrology, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
| | - Alferso C. Abrahams
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Brigit C. van Jaarsveld
- Department of Nephrology, Amsterdam University Medical Centers, Location AMC, Amsterdam, the Netherlands
- Diapriva Dialysis Center, Amsterdam, the Netherlands
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Intas G, Rokana V, Stergiannis P, Chalari E, Anagnostopoulos F. Sleeping Disorders and Health-Related Quality of Life in Hemodialysis Patients with Chronic Renal Disease in Greece. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1196:73-83. [DOI: 10.1007/978-3-030-32637-1_7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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Jesse MT, Eshelman A, Christian T, Abouljoud M, Denny J, Patel A, Kim DY. Psychiatric Profile of Patients Currently Listed for Kidney Transplantation: Evidence of the Need for More Thorough Pretransplant Psychiatric Evaluations. Transplant Proc 2019; 51:3227-3233. [DOI: 10.1016/j.transproceed.2019.08.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/30/2019] [Indexed: 11/28/2022]
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Witberg G, Shamekhi J, Van Mieghem NM, Ferrero-Guadagnoli A, Soendergaard L, Dvir D, Latib A, Testa L, Guerrero M, Piazza N, Bleiziffer S, Webb JG, Barbash I, Finkelstein A, Makkar R, Mylotte D, Sinning JM, El Faquir N, Masiano F, De Backer O, Birs A, Lanzillo G, Bedogni F, Iftikhar O, Pighi M, Deutsch MA, Attinger-Toller A, Maor E, Rozenbaum Z, Yoon SH, Neylon A, Kornowski R. Transcatheter Aortic Valve Replacement Outcomes in Patients With Native vs Transplanted Kidneys: Data From an International Multicenter Registry. Can J Cardiol 2019; 35:1114-1123. [DOI: 10.1016/j.cjca.2019.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/08/2019] [Accepted: 01/10/2019] [Indexed: 10/27/2022] Open
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22
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Işık Ulusoy S, Kal Ö. Relationship Among Coping Strategies, Quality of Life, and Anxiety and Depressive Disorders in Hemodialysis Patients. Ther Apher Dial 2019; 24:189-196. [DOI: 10.1111/1744-9987.12914] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/17/2019] [Accepted: 06/19/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Selen Işık Ulusoy
- Başkent University School of MedicinePsychiatry Department Konya Turkey
| | - Öznur Kal
- Başkent University School of MedicineNephrology Department Konya Turkey
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Gaiffe E, Crepin T, Bamoulid J, Courivaud C, Büchler M, Cassuto E, Albano L, Chemouny JM, Choukroun G, Hazzan M, Kessler L, Legendre C, Le Meur Y, Ouali N, Thierry A, Anota A, Nerich V, Limat S, Bonnetain F, Vernerey D, Ducloux D. PRODIG (Prevention of new onset diabetes after transplantation by a short term treatment of Vildagliptin in the early renal post-transplant period) study: study protocol for a randomized controlled study. Trials 2019; 20:375. [PMID: 31227028 PMCID: PMC6588872 DOI: 10.1186/s13063-019-3392-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/02/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Post-transplant diabetes is a frequent and serious complication of kidney transplantation. There is currently no treatment to prevent or delay the disease. Nevertheless, identification of risk factors make it possible to target a population at risk of developing de novo diabetes. We hypothesized that a short-term treatment with vildagliptin may prevent new onset diabetes after transplantation (NODAT) in high-risk patients. METHODS/DESIGN This is a multicenter, double-blind, placebo-controlled randomized clinical trial. Patients undergoing first kidney transplantation will be included from ten French transplant centers. Included patients will be randomized (1:1) to receive either vildagliptin 100 or 50 mg/day (depending on glomerular filtration rate) during 2 months (the first dose being administered before entering the operating theatres) or placebo. Additional antidiabetic therapy could be administered according to glycemic control. The primary outcome is the proportion of diabetic patients 1 year after transplantation, defined as patients receiving a diabetic treatment, or having a fasting glucose above 7 mmol/l, and/or with an abnormal oral glucose tolerance test. Secondary outcomes include glycated hemoglobin, the occurrence of acute rejection, infection, graft loss and patient death at 3 months, 6 months, and 12 months after transplantation. Outcomes will be correlated to clinical and general characteristics of the patient, cardiovascular history, nephropathy, dialysis history, transplantation data, biological data, health-related quality of life, and the cost-effectiveness of prevention of diabetes with vildagliptin. DISCUSSION We have scarce data on the pharmacological prevention of post-transplant diabetes. If our hypothesis is verified, our results will have a direct application in clinical practice and could limit diabetes-associated morbidity, reduce cardiovascular complications, increase quality of life of renal transplant patients, and consequently promote graft and patient survival. Our results may possibly serve for non-transplant patients carrying a high-risk of diabetes associated with other co-morbidities. TRIAL REGISTRATION ClinicalTrials.gov, NCT02849899 . Registered on 8 February 2016.
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Affiliation(s)
- E. Gaiffe
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
| | - T. Crepin
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
| | - J. Bamoulid
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
| | - C. Courivaud
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
| | - M. Büchler
- CHU Bretonneau, Department of Nephrology and Clinical Immunology, EA 4245 Transplantation, Immunology, Inflammation, F-37044 Tours, France
| | - E. Cassuto
- Pasteur hospital, L’Archet hospital group, Department of Nephrology, Dialysis, and Renal Transplantation, F-06000 Nice, France
| | - L. Albano
- Pasteur hospital, L’Archet hospital group, Department of Nephrology, Dialysis, and Renal Transplantation, F-06000 Nice, France
| | - J. M. Chemouny
- CHU de Rennes, Department of Nephrology, F-35033 Rennes, France
| | - G. Choukroun
- CHU Amiens, Department of Nephrology, Dialysis, and Renal Transplantation, F-80054 Amiens, France
| | - M. Hazzan
- CHU de Lille, Nephrology department, University of Lille UMR 995, F-59000 Lille, France
| | - L. Kessler
- CHU Strasbourg, Department of Endocrinology, Diabetes and Nutrition, F-67000 Strasbourg, France
| | - C. Legendre
- Necker hospital, Department of Nephrology, Dialysis, and Renal Transplantation, F-75743 Paris, France
| | - Y. Le Meur
- Department of Nephrology, CHU de Brest, UMR1227, Université de Brest, Inserm, F-29609 Brest, France
| | - N. Ouali
- Tenon hospital, Nephrological Emergencies and Kidney Transplantation, F-75571 Paris, France
| | - A. Thierry
- CHU de Poitiers, Department of Nephrology, Dialysis, and Renal Transplantation, F-86021 Poitiers, France
| | - A. Anota
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, Methodology and quality of life unit, F-25000 Besançon, France
| | - V. Nerich
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, department of Pharmacy, F-25030 Besançon, France
| | - S. Limat
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, department of Pharmacy, F-25030 Besançon, France
| | - F. Bonnetain
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, Methodology and quality of life unit, F-25000 Besançon, France
| | - D. Vernerey
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, Methodology and quality of life unit, F-25000 Besançon, France
| | - D. Ducloux
- CHU Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Federation Hospitalo-Universitaire INCREASE, F-25000 Besançon, France
- INSERM, UMR1098, EFS-BFC, University Burgundy Franche-Comte, LabEx LipSTIC, FHU INCREASE, F-25000 Besançon, France
- CHU Besançon, CIC Biothérapie, INSERM CIC1431, F-25000 Besançon, France
- Service de Néphrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon, 3, boulevard Alexandre Fleming, 25030 Besançon, cedex France
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Bertocchio JP, Baranger T, Isnard-Rouchon M, Zaoui P, Mousson C, Deray G. Divergences (et convergences) de perceptions entre patients et néphrologues de l’impact de l’insuffisance rénale chronique non terminale sur l’élan vital en France : résultats de l’enquête MAEVA. Nephrol Ther 2018; 14:222-230. [DOI: 10.1016/j.nephro.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 09/27/2017] [Accepted: 10/02/2017] [Indexed: 11/16/2022]
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25
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Mouelhi Y, Jouve E, Alessandrini M, Pedinielli N, Moal V, Meurette A, Cassuto E, Mourad G, Durrbach A, Dussol B, Gentile S. Factors associated with Health-Related Quality of Life in Kidney Transplant Recipients in France. BMC Nephrol 2018; 19:99. [PMID: 29703170 PMCID: PMC5921567 DOI: 10.1186/s12882-018-0893-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 04/11/2018] [Indexed: 02/07/2023] Open
Abstract
Background Health-Related Quality of Life (HRQoL) assessment after kidney transplantation has become an important tool in evaluating outcomes. This study aims to identify the associated factors with HRQoL among a representative sample size of Kidney Transplant Recipients (KTR) at the time of their inclusion in the study. Methods Data of this cross-sectional design is retrieved from a longitudinal study conducted in five French kidney transplant centers in 2011, and included KTR aged 18 years with a functioning graft for at least 1 year. Measures include demographic, psycho-social and clinical characteristics. To evaluate HRQoL, the Short Form-36 Health Survey (SF-36) and a HRQoL instrument for KTR (ReTransQol) were administered. Multivariate linear regression models were performed. Results A total of 1424 patients were included, with 61.4% males, and a mean age of 55.7 years (±13.1). Demographic and clinical characteristics were associated with low HRQoL scores for both questionnaires. New variables were found in our study: perceived poor social support and being treated by antidepressants were associated with low scores of Quality of Life (QoL), while internet access was associated with high QoL scores. Conclusion The originality of our study’s findings was that psycho-social variables, particularly KTR treated by antidepressants and having felt unmet needs for any social support, have a negative effect on their QoL. It may be useful to organize a psychological support specifically adapted for patients after kidney transplantation.
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Affiliation(s)
- Yosra Mouelhi
- Laboratoire de Santé Publique, Faculté de Médecine, Université Aix-Marseille, 3279, Marseille, EA, France.
| | - Elisabeth Jouve
- Service Santé Publique et Information Médicale, CHU Marseille, Marseille, France
| | - Marine Alessandrini
- Laboratoire de Santé Publique, Faculté de Médecine, Université Aix-Marseille, 3279, Marseille, EA, France
| | - Nathalie Pedinielli
- Service Santé Publique et Information Médicale, CHU Marseille, Marseille, France
| | - Valérie Moal
- Centre de Néphrologie et de Transplantation Rénale, CHU Marseille, Marseille, France
| | - Aurélie Meurette
- Transplantation, Urology and Nephrology Institute (ITUN), CHU Nantes, Nantes, France
| | | | - Georges Mourad
- Département de Néphrologie, Dialyse et Transplantation, CHU Montpellier, Montpellier, France
| | | | - Bertrand Dussol
- Centre de Néphrologie et de Transplantation Rénale, CHU Marseille, Marseille, France
| | - Stéphanie Gentile
- Laboratoire de Santé Publique, Faculté de Médecine, Université Aix-Marseille, 3279, Marseille, EA, France.,Service Santé Publique et Information Médicale, CHU Marseille, Marseille, France
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Fülöp T, Tapolyai MB, Zsom L, Molnar MZ, Abdul Salim S, Újhelyi L, Becs G, Balla J, Hamrahian M. Successful Practice Transitioning Between Hemodialysis and Hemodiafiltration in Outpatient Units: Ten Key Issues for Physicians to Remember. Artif Organs 2018; 42:925-932. [PMID: 29682748 DOI: 10.1111/aor.13135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 12/17/2022]
Abstract
Hemodiafiltration (HDF) during chronic renal replacement therapy (RRT) is a relatively new practice phenomenon, emerging over the last two decades. While the technological platforms utilized during chronic RRT are in many cases similar or effectively identical to conventional hemodialysis (HD), significant differences may emerge in daily practice. Several authors of this review moved practice site between the United States and the European Union and transitioned from an HD-based practice to predominantly HDF-practicing networks. In doing so, we became keenly aware of the potential pitfalls nephrologists may be facing during such transitions. This brief review is intended to provide a succinct overview of several practical concerns and complications nephrologists may encounter in daily practice of end-stage renal disease care, including but not limited to management of electrolytes, renal anemia and treatment goals and settings during HDF.
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Affiliation(s)
- Tibor Fülöp
- Department of Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, Hungary.,FMC Extracorporeal Life Support Center - Fresenius Medical Care Hungary
| | | | - Lajos Zsom
- Cegléd Hemodialysis Units, Fresenius Medical Care Hungary
| | - Miklos Z Molnar
- Division of Transplant Surgery, Methodist University Hospital Transplant Institute, Memphis, TN, USA.,Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.,Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Sohail Abdul Salim
- Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, MS, USA
| | - László Újhelyi
- Department of Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, Hungary.,FMC Extracorporeal Life Support Center - Fresenius Medical Care Hungary
| | - Gergely Becs
- Department of Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, Hungary.,FMC Extracorporeal Life Support Center - Fresenius Medical Care Hungary
| | - József Balla
- Department of Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, Hungary.,FMC Extracorporeal Life Support Center - Fresenius Medical Care Hungary
| | - Mehrdad Hamrahian
- Department of Medicine, Division of Nephrology, Thomas Jefferson University, Philadelphia, PA, USA
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Rogan A, McCarthy K, McGregor G, Hamborg T, Evans G, Hewins S, Aldridge N, Fletcher S, Krishnan N, Higgins R, Zehnder D, Ting SM. Quality of life measures predict cardiovascular health and physical performance in chronic renal failure patients. PLoS One 2017; 12:e0183926. [PMID: 28910330 PMCID: PMC5598960 DOI: 10.1371/journal.pone.0183926] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 08/14/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients with advanced chronic kidney disease (CKD) experience complex functional and structural changes of the cardiopulmonary and musculoskeletal system. This results in reduced exercise tolerance, quality of life and ultimately premature death. We investigated the relationship between subjective measures of health related quality of life and objective, standardised functional measures for cardiovascular and pulmonary health. METHODS Between April 2010 and January 2013, 143 CKD stage-5 or CKD5d patients (age 46.0±1.1y, 62.2% male), were recruited prospectively. A control group of 83 healthy individuals treated for essential hypertension (HTN; age 53.2±0.9y, 48.22% male) were recruited at random. All patients completed the SF-36 health survey questionnaire, echocardiography, vascular tonometry and cardiopulmonary exercise testing. RESULTS Patients with CKD had significantly lower SF-36 scores than the HTN group; for physical component score (PCS; 45.0 vs 53.9, p<0.001) and mental component score (MCS; 46.9 vs. 54.9, p<0.001). CKD subjects had significantly poorer exercise tolerance and cardiorespiratory performance compared with HTN (maximal oxygen uptake; VO2peak 19.9 vs 25.0ml/kg/min, p<0.001). VO2peak was a significant independent predictor of PCS in both groups (CKD: b = 0.35, p = 0.02 vs HTN: b = 0.27, p = 0.001). No associations were noted between PCS scores and echocardiographic characteristics, vascular elasticity and cardiac biomarkers in either group. No associations were noted between MCS and any variable. The interaction effect of study group with VO2peak on PCS was not significant (ΔB = 0.08; 95%CI -0.28-0.45, p = 0.7). However, overall for a given VO2peak, the measured PCS was much lower for patients with CKD than for HTN cohort, a likely consequence of systemic uremia effects. CONCLUSION In CKD and HTN, objective physical performance has a significant effect on quality of life; particularly self-reported physical health and functioning. Therefore, these quality of life measures are indeed a good reflection of physical health correlating highly with objective physical performance measures.
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Affiliation(s)
- A. Rogan
- Department of Emergency Medicine, Wellington Hospital, Capital and Coast District Health Board, Wellington, New Zealand
- Department of Renal Medicine and Transplantation, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- * E-mail:
| | - K. McCarthy
- Department of Renal Medicine and Transplantation, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - G. McGregor
- Department of Renal Medicine and Transplantation, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
- Department of Cardiac Rehabilitation and Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - T. Hamborg
- Division of Health Sciences Statistics and Epidemiology, University of Warwick, Coventry, United Kingdom
| | - G. Evans
- Department of Renal Medicine and Transplantation, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - S. Hewins
- Department of Renal Medicine and Transplantation, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - N. Aldridge
- Department of Renal Medicine and Transplantation, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - S. Fletcher
- Department of Renal Medicine and Transplantation, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - N. Krishnan
- Department of Renal Medicine and Transplantation, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - R. Higgins
- Department of Renal Medicine and Transplantation, University Hospital Coventry and Warwickshire NHS Trust, Coventry, United Kingdom
| | - D. Zehnder
- Department of Acute Medicine, North Cumbria University Hospital NHS Trust, Carlisle, United Kingdom
- Division of Translational Medicine, University of Warwick, Coventry, United Kingdom
| | - S. M. Ting
- Division of Translational Medicine, University of Warwick, Coventry, United Kingdom
- Department of Acute Medicine, Heart of England NHS Foundation Trust, Birmingham, United Kingdom
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Romano-Zelekha O, Golan E, Ifrah A, Weinstein T, Shohat T. Differences in quality of life between Jewish and Arab patients on hemodialysis. Qual Life Res 2017; 26:3343-3352. [PMID: 28791563 DOI: 10.1007/s11136-017-1661-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE Higher health-related quality of life (HRQOL) in dialysis patients has been associated with fewer hospitalizations and lower mortality. Since Arab patients on dialysis have better survival rates than Jewish patients, we hypothesized that they would have higher HRQOL. We also studied the impact of several risk factors on HRQOL in each population. METHODS Based on a national dialysis registry, patients from 64 hemodialysis units were recruited to participate. Patients who consented were interviewed face-to-face, using the Kidney Disease Quality of Life Short Form (KDQOL-SF36) questionnaire. RESULTS Five hundred and fifty-eight (50.6%) Jewish and 544 (49.4%) Arab patients participated in the study. For Arab patients mean crude scores for the "mental component summary" and KDQOL scores were significantly lower than for Jewish patients [31.6 (95% Cl 30.0-33.3) vs. 38.0 (95% Cl 36.1-39.9), p < 0.0001 and 55.6 (95% Cl 54.5-56.7) vs. 59.8 (95% Cl 58.6-60.9), p < 0.0001, respectively]. Much lower scores were observed for Arabs in the "emotional role" and "work status" subscales. The two populations had similar general health assessments and albumin level. For both, HRQOL was positively associated with higher educational level, higher albumin level, and dialysis connection by fistula or graft; and negatively associated with low income and diabetes. HRQOL was negatively associated with previous cerebrovascular accident among Arabs and with female gender among Jews. CONCLUSIONS Differences between Jews and Arabs in subscales related to psychosocial factors suggest that cultural differences in the perceptions of sickness and health may be relevant here. Future studies should explore such possibility and focus on the large gap in the "work status" subscale.
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Affiliation(s)
- Orly Romano-Zelekha
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, 52621, Israel.
| | - Eliezer Golan
- Hemodialysis Unit, Meir Medical Center, Kfar Saba, Israel
- Israel Renal Registry, ISNH, Tel Hashomer, Israel
- Sourasky Medical Center Tel-Aviv, Tel-Aviv, Israel
| | - Anneke Ifrah
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, 52621, Israel
| | - Talia Weinstein
- Sourasky Medical Center Tel-Aviv, Tel-Aviv, Israel
- The Israeli Society of Nephrology and Hypertension, Tel-Aviv, Israel
| | - Tamy Shohat
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, 52621, Israel
- Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
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29
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Akbas F, Atmaca HU, Kose S, Bag S. Dialysis and Depression in the Light of Suicide Attempt with Fruits. BANTAO JOURNAL 2017. [DOI: 10.1515/bj-2016-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Depression is a common morbidity seen in chronic renal failure patients but it is often underdiagnosed and undertreated. Here we present a 36-year-old male dialysis patient who had undiagnosed severe depression and attempted to commit suicide with overconsumption of fruits. Fortunately, he was saved with emergent dialysis treatment and was referred to a psychiatry clinic for treatment and observation. In the light of this case we want to point out that diagnosing and treating psychiatric problems of dialysis patients is of vital importance to prevent suicides and also to improve quality of life.
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Affiliation(s)
- Feray Akbas
- Istanbul Training and Research Hospital, Internal Medicine Clinic, Istanbul , Turkey
| | - Hanife Usta Atmaca
- Istanbul Training and Research Hospital, Internal Medicine Clinic, Istanbul , Turkey
| | - Sennur Kose
- Istanbul Training and Research Hospital, Nephrology Clinic, Istanbul , Turkey
| | - Sevda Bag
- Istanbul Training and Research Hospital, Psychiatry Clinic, Istanbul , Turkey
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Elbasvir plus grazoprevir in patients with hepatitis C virus infection and stage 4-5 chronic kidney disease: clinical, virological, and health-related quality-of-life outcomes from a phase 3, multicentre, randomised, double-blind, placebo-controlled trial. Lancet Gastroenterol Hepatol 2017; 2:585-594. [PMID: 28576451 DOI: 10.1016/s2468-1253(17)30116-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND In the C-SURFER study, therapy with the all-oral elbasvir plus grazoprevir regimen for 12 weeks in patients with chronic hepatitis C virus (HCV) infection and stage 4-5 chronic kidney disease resulted in a high rate of virological cure compared with placebo. Here, we report sustained virological response (SVR), safety data, health-related quality-of-life (HRQOL), and virological resistance analyses in patients in C-SURFER who received immediate antiviral therapy or who received placebo before therapy. METHODS In this phase 3, multicentre, randomised, placebo-controlled study, we randomly assigned adults with HCV genotype 1 infection and stage 4-5 chronic kidney disease enrolled at 68 centres worldwide to either elbasvir 50 mg plus grazoprevir 100 mg once per day for 12 weeks (immediate treatment group) or placebo for 12 weeks followed by elbasvir 50 mg plus grazoprevir 100 mg once per day for 12 weeks beginning at week 16 (deferred treatment group). The primary safety and efficacy endpoints for the immediate treatment group and placebo phase of the deferred treatment group have been reported previously. Here, we report safety and efficacy data for the treatment phase of the deferred treatment group, as well as HRQOL assessed using the 36-Item Short Form Health Survey for all groups, and baseline and treatment-emergent resistance-associated substitutions (RASs). SVR at 12 weeks (SVR12) was assessed in the modified full analysis set (FAS), defined as all patients excluding those who did not receive at least one dose of study drug, who died, or who discontinued the study before the end of treatment for reasons determined to be unrelated to HCV treatment. This trial is registered with ClinicalTrials.gov, Number NCT02092350. FINDINGS Between March 30 and Nov 28, 2014, 235 patients were enrolled and received at least one dose of study drug. The modified FAS included 116 patients assigned to immediate treatment and 99 assigned to deferred treatment. 115 (99·1%; 95% CI 95·3-100·0) of 116 assigned to immediate treatment achieved SVR12 compared with 97 (98·0%; 92·9-99·7) of 99 assigned to deferred treatment. In patients with genotype 1a infections, SVR12 was achieved by 11 (84·6%) of 13 patients with detectable baseline NS5A RASs and in 98 (100%) of 98 without. HRQOL did not differ at week 12 between immediate treatment and the placebo phase of deferred treatment. Safety was generally similar between patients receiving immediate treatment and those receiving placebo in the deferred treatment group. One serious adverse event during deferred treatment (interstitial nephritis) and one during the placebo phase of deferred treatment (raised lipase concentration) were deemed related to study drug. Four patients died, one who received immediate treatment (cardiac arrest) and three who received deferred treatment (aortic aneurysm, pneumonia, and unknown cause); all four deaths were considered unrelated to study drugs. Of the three deaths in the deferred treatment group, one occurred during placebo treatment and two occurred before starting active treatment. There were no notable differences in aminotransferase elevations in the deferred treatment group compared with the immediate treatment group, and no patients in the deferred treatment group had total bilirubin elevations. INTERPRETATION These data add to the growing body of clinical evidence for the fixed-dose combination regimen of elbasvir plus grazoprevir for 12 weeks and support use of this therapy in patients with HCV genotype 1 infection and stage 4-5 chronic kidney disease. FUNDING Merck Sharp & Dohme.
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Rebollo Rubio A, Morales Asencio JM, Eugenia Pons Raventos M. Depression, anxiety and health-related quality of life amongst patients who are starting dialysis treatment. J Ren Care 2017; 43:73-82. [PMID: 28239953 DOI: 10.1111/jorc.12195] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) has a severe impact on patients' health-related quality of life (HRQL). The start of renal replacement therapy (RRT) significantly influences psychological, physical and social aspects of life. OBJECTIVES To analyse the HRQL and psychological status (anxiety and depression) at the start of RRT. METHODS We undertook an observational descriptive cross-sectional study. A total of 152 patients starting RRT were recruited for the study. HRQL was measured by the Kidney Disease and Quality of Life Short Form questionnaire. Levels of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale questionnaire. Comorbidities and sociodemographic and clinical factors were also evaluated. FINDINGS HRQL in patients with end-stage kidney disease (ESKD) is significantly affected by the initiation of RRT in all respects. States of anxiety and depression were present in 26.6% and 27% of patients, respectively. These states are significantly related to the emotional component of the quality of life. CONCLUSION The initiation of RRT has a strong impact on HRQL in comparison with a reference population and with other stages of CKD. The early detection of an altered psychological state is important, as this condition should be treated from the first stages of the disease, as it can significantly affect the subsequent development of RRT and the patient's quality of life.
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Affiliation(s)
- Ana Rebollo Rubio
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Málaga, Málaga, Spain
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32
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Raymond J, Johnson ST, Diehl-Jones W, Vallance JK. Walking, Sedentary Time and Health-Related Quality Life Among Kidney Transplant Recipients: An Exploratory Study. Transplant Proc 2016; 48:59-64. [PMID: 26915844 DOI: 10.1016/j.transproceed.2015.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 12/22/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The primary objectives of this study were to: 1) establish walking and physical activity prevalence and sedentary time estimates; and 2) determine associations of health-related quality of life (HRQoL) with objectively assessed walking, self-reported physical activity, and sedentary time among kidney transplant recipients. METHODS Using a cross-sectional design, kidney transplant recipients received a survey package containing measures of sedentary time, moderate-to-vigorous physical activity, and HRQoL, and a step pedometer. RESULTS Thirty-two participants returned a completed survey, for a response rate of 82% (32 of 39 interested participants). The average steps per day were 9752 steps (SD = 3685) and 59% achieved public health guidelines of at least 150 minutes of moderate-to-vigorous physical activity per week. Total sedentary time during the week was 11.6 h/d whereas total sedentary time during the weekend was 8.9 h/d. Compared to those not achieving at least 10,000 steps/d, respondents who were achieving at least 10,000 steps/d had a significantly higher physical component score for HRQoL (Mdiff = 7.8, P = .018). Similar patterns emerged for meeting physical activity guidelines and sedentary time. CONCLUSION For kidney transplant recipients, greater participation in walking, overall physical activity, and lower engagement in sedentary activity, was associated with better HRQoL.
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Affiliation(s)
- J Raymond
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - S T Johnson
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - W Diehl-Jones
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - J K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada.
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Alexopoulou M, Giannakopoulou N, Komna E, Alikari V, Toulia G, Polikandrioti M. THE EFFECT OF PERCEIVED SOCIAL SUPPORT ON HEMODIALYSIS PATIENTS' QUALITY OF LIFE. Mater Sociomed 2016; 28:338-342. [PMID: 27999480 PMCID: PMC5149438 DOI: 10.5455/msm.2016.28.338-342] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 10/11/2016] [Indexed: 11/13/2022] Open
Abstract
Background: Association between perceived social support and quality of life in hemodialysis patients represents a new area of interest. Aim: The aim of this study was to explore the effect of social support on the quality of life of hemodialysis patients. Material and Methods: In this study 258 hemodialysis patients were enrolled. Data was collected using a questionnaire which consisted of three parts: a) the Multidimensional Scale of Perceived Social Support (MSPSS) to assess perceived social support, b) the Missoula-VITAS Quality of Life Index (MVQOLI–15) to assess quality of patients’ life and c) the socio-demographic, clinical and other variables of patients. To test the existence of association between quality of life and social support the correlation coefficient of Spearman was used. Multiple linear regression was performed to estimate the effect of social support on quality of life (dependent variable), adjusted for potential confounders. The analysis was performed on SPSS v20. Results: Patients felt high support from significant others and family and less from friends (median 6, 6 and 4.5 respectively). Patients evaluated their quality of life in its entirety as moderate in the total and “overall quality of life” score (median 17.2 and 3 respectively). Regarding the association between social support and quality of life, results showed that the more support patients had from their significant others, family and friends, the better quality of life they had. (rho =0,395, rho =0,399 and rho=0,359, respectively). Conclusions: Understanding the relation between social support and quality of life should prompt health professionals to provide beneficial care to hemodialysis patients.
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Affiliation(s)
- Margarita Alexopoulou
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
| | | | - Eleni Komna
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
| | - Victoria Alikari
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
| | - Georgia Toulia
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
| | - Maria Polikandrioti
- Department of Nursing, Technological Educational Institute of Athens, Athens, Greece
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Freburger JK, Ellis AR, Wang L, Butler AM, Kshirsagar AV, Winkelmayer WC, Brookhart MA. Comparative Effectiveness of Iron and Erythropoiesis-Stimulating Agent Dosing on Health-Related Quality of Life in Patients Receiving Hemodialysis. Am J Kidney Dis 2016; 67:271-82. [DOI: 10.1053/j.ajkd.2015.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 09/08/2015] [Indexed: 11/11/2022]
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Associations among Spirituality, Health-Related Quality of Life, and Depression in Pre-Dialysis Chronic Kidney Disease Patients: An Exploratory Analysis in Thai Buddhist Patients. RELIGIONS 2015. [DOI: 10.3390/rel6041249] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Gerasimoula K, Lefkothea L, Maria L, Victoria A, Paraskevi T, Maria P. QUALITY OF LIFE IN HEMODIALYSIS PATIENTS. Mater Sociomed 2015; 27:305-9. [PMID: 26622195 PMCID: PMC4639348 DOI: 10.5455/msm.2015.27.305-309] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 10/05/2015] [Indexed: 11/06/2022] Open
Abstract
Purpose: To explore the quality of life in hemodialysis patients. Material and Methods: The sample studied consisted of 320 patients undergoing hemodialysis in one-day dialysis center. Data were collected by the completion of a specially designed questionnaire which apart from the sociodemographic and clinical variables, it also included the scale Missoula-VITAS Quality of Life Index (MVQOLI) for assessing quality of life. Results: Of the 320 hemodialysis patients, 57,2% were men while 28,1% of the participants were 71-80 years old. The average total score of quality of life was found to be 17.43 (in a range 0-30). The total score of quality of life was found to be higher in participants <60 years (p= 0,009), of higher educational level (p=0.001), being very informed about the health problem (p=0,013), complied with therapeutic recommendations and the proposed diet (p=0,025 & p=0,012, respectively), having very good relations with the medical and nursing staff or other patients (p<0,001), not experiencing difficulties with social or family environment (p=0,001), had help at home (p <0,001) and in those who did not conceal their health problem from the social environment (p<0.001). Furthermore, it was found that the increasing duration of hemodialysis session entailed poorer quality of life (p<0,001). These results were largely confirmed by multiple linear regression. Conclusions: Sociodemographic and clinical characteristics seems to influence the quality of life in hemodialysis patients.
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Affiliation(s)
- Kousoula Gerasimoula
- Department of Nursing, Technological Educational Institution (TEI) of Athens, Greece
| | - Lagou Lefkothea
- Department of Nursing, Technological Educational Institution (TEI) of Athens, Greece
| | - Lena Maria
- Department of Nursing, Technological Educational Institution (TEI) of Athens, Greece
| | - Alikari Victoria
- Department of Nursing, Technological Educational Institution (TEI) of Athens, Greece
| | | | - Polikandrioti Maria
- Department of Nursing, Technological Educational Institution (TEI) of Athens, Greece
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Chen SF, Wang IJ, Lang HC. Risk of major depression in patients with chronic renal failure on different treatment modalities: A matched-cohort and population-based study in Taiwan. Hemodial Int 2015; 20:98-105. [PMID: 26179222 DOI: 10.1111/hdi.12334] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The influence of different treatment modalities on the risk of developing major depression in patients with chronic renal failure (CRF) is not well understood. We aimed to explore the incidence of major depression among patients with CRF who were on different dialysis modalities, who had received renal transplantation (RT), and those who had not yet received any of the aforementioned renal replacement therapies. We conducted a population-based retrospective cohort study using a national health insurance research database. This study investigated 89,336 study controls, 17,889 patients with chronic kidney disease on conservative treatment, 3823 patients on hemodialysis (HD), 351 patients on peritoneal dialysis (PD), and 322 patients who had RT. We followed all individuals until the occurrence of major depression or the date of loss to follow-up. The PD group had the highest risk (hazard ratio [HR] 2.43; 95% confidence interval [CI] 1.26-4.69), whereas the RT group had the lowest risk (HR 0.18; 95% CI 0.03-1.29) of developing major depression compared with the control group. Patients initiated on PD had a higher risk of developing major depression than patients initiated on HD (pairwise comparison: HR 2.20; 95% CI 1.09-4.46). Different treatment modalities are associated with different risks of developing major depression in patients with CRF. Among renal replacement therapies, patients who have had RT have the lowest risk of developing major depression. Patients who initiate renal therapy on PD may have a higher risk of major depression compared with patients who initiate renal therapy on HD.
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Affiliation(s)
- Shih-Feng Chen
- Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - I-Jen Wang
- Psychiatry Department, Taipei City Hospital Jen-Ai Branch, Taipei, Taiwan
| | - Hui-Chu Lang
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
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Ikonomou M, Skapinakis P, Balafa O, Eleftheroudi M, Damigos D, Siamopoulos KC. THE IMPACT OF SOCIOECONOMIC FACTORS ON QUALITY OF LIFE OF PATIENTS WITH CHRONIC KIDNEY DISEASE IN GREECE. J Ren Care 2015; 41:239-46. [PMID: 26119629 DOI: 10.1111/jorc.12132] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Quality of Life (QoL) is often poor in people undergoing dialysis and this sometimes contributes to the high rate of morbidity and mortality. The aim of our study is to assess the QoL of patients on haemodialysis in Greece and discuss the socio-demographic factors that affect QoL in this period of financial crisis. DESIGN/PATIENTS Patients with CKD not on dialysis, plus those undergoing Haemodialysis (HD) and Peritoneal Dialysis (PD) were invited to complete the SF-36 questionnaire electronically, supervised by a trained nurse. Patients were asked about their marital status, education level and monthly household income. Additionally, patients were requested to comment on their subjective financial difficulties. RESULTS A total of 172 patients were enrolled in the study, 39 of them were undergoing PD, 90 on HD and 43 had CKD. Among those with CKD, on HD and PD, 9.3%, 17.8% and 23.1%, respectively, had 'some/a lot' difficulties in copying with financial problems. The physical component summary score was significant lower in HD, while the summary score of the mental component showed no differences between the groups. In multiple linear regression analysis, age and dialysis had significantly negative correlations with physical functioning scores. Those who were divorced or widowed tended to perform worse in physical scores compared with those who were married. Mental scores were affected only by coping with financial difficulties. CONCLUSIONS In general terms, people with CKD patients present with a poor QoL. Apart from the burden of the renal disease per se, social and economic factors (divorce, financial difficulties) seem to aggravate their status, especially in this period of financial crisis.
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Affiliation(s)
- Margarita Ikonomou
- Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece.,Psychonephrology Unit, Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Petros Skapinakis
- Psychonephrology Unit, Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece.,Department of Psychiatry, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Olga Balafa
- Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece.,Psychonephrology Unit, Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece
| | | | - Dimitrios Damigos
- Psychonephrology Unit, Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece.,Department of Psychiatry, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Kostas C Siamopoulos
- Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece.,Psychonephrology Unit, Department of Nephrology, School of Medicine, University of Ioannina, Ioannina, Greece
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Abstract
BACKGROUND It is a struggle to identify the most adaptive coping strategies with disease-mediated stress. Here, we hypothesize that intensity of coping strategies, including denial, in patients with end-stage renal disease (ESRD), varies with type of renal replacement therapy (RRT). MATERIAL AND METHODS We enrolled 60 in-center hemodialyzed patients (HD) and 55 patients treated with continuous ambulatory peritoneal dialysis (CAPD). We administered the Coping Inventory with Stressful Situation, Profile of Mood States, and Stroop Anxiety Inventory to measure patient coping strategies in the context of their ESRD. Denial defense mechanism was measured via the IBS-R/ED. The Nottingham Health Profile was used to evaluate self-perceived quality of life. Serum potassium, urea, creatinine, phosphorus, calcium, albumin, and hematocrit were utilized as the measurements of adequacy of dialysis. RESULTS HD patients had higher self-reported intensity of denial mechanism and avoidance-oriented strategies versus CAPD patients. Because a single strategy is almost never employed, we conducted cluster analysis. We identify 3 patterns of coping strategies using cluster analysis. "Repressors" employed denial and avoidance strategies and were predominant in HD. The second cluster consists of subjects employing predominantly task-oriented strategies with equal distribution among dialyzed patients. The third cluster encompassed a small group of patients who shared higher intensity of both denial and task-oriented strategies. Health-related outcome, anxiety, and mood profile were similar across all patients. CONCLUSIONS HD patients predominantly used "repressive" strategies. Patients on RRT utilized denial and avoidance-based strategies to achieve satisfactory outcome in terms of perceived quality of life. We conclude that these coping mechanisms that were previously thought to be inferior are beneficial to patient compliance with RRT.
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Affiliation(s)
- Zbigniew Nowak
- Department of Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland
| | - Zofia Wańkowicz
- Department of Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland
| | - Krzysztof Laudanski
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA
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Lee SJ, Son H, Shin SK. Influence of frailty on health-related quality of life in pre-dialysis patients with chronic kidney disease in Korea: a cross-sectional study. Health Qual Life Outcomes 2015; 13:70. [PMID: 26021987 PMCID: PMC4460686 DOI: 10.1186/s12955-015-0270-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 05/20/2015] [Indexed: 12/24/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a progressive and lifelong condition with multiple medical comorbidities. Patients with CKD experience frailty more frequently and have lower health-related quality of life than do those with other chronic diseases. The purpose of this study was to examine the prevalence of frailty and investigate the contribution of frailty to quality of life in pre-dialysis CKD patients in Korea. Methods Using a cross-sectional survey design, data were collected at an outpatient CKD clinic in a general hospital in Korea. The frailty criterion was modified from previous studies. The Short Form-36 Health Survey version 2 was used to measure physical and mental component summary scores. Data were analyzed using chi-square, t-tests, and hierarchical linear regression. Results Of the 168 CKD patients, 63 (37.5 %) were frail. Frail patients were significantly older and had lower physical and mental quality of life than those who were non-frail. In hierarchical regression evaluating the influence of frailty on physical and mental quality of life, the initial model was significantly improved when frailty was included. Frail patients had lower physical and mental quality of life. Conclusions Frailty affected both physical and mental quality of life in pre-dialysis patients with CKD. More attention should be paid to the potential role of early detection and prevention of frailty to improve patients’ quality of life.
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Affiliation(s)
- Suk Jeong Lee
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, South Korea.
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, South Korea.
| | - Sug Kyun Shin
- National Health Insurance Cooperation Ilsan Hospital Clinical Professor, Yonsei University Medical College, Seoul, South Korea
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41
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Broers NJH, Usvyat LA, Kooman JP, van der Sande FM, Lacson E, Kotanko P, Maddux FW. Quality of Life in Dialysis Patients: A Retrospective Cohort Study. Nephron Clin Pract 2015; 130:105-12. [PMID: 26044799 DOI: 10.1159/000430814] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 04/20/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM Physical component summary (PCS) and mental component summary (MCS) scores are associated with hospitalization and mortality in patients with end-stage renal disease. Most studies in these patients are cross-sectional in nature. This study aimed to assess the dynamics of health-related quality of life (HRQOL) over time, as well as determinants of changes in HRQOL. Also, the relation between changes in HRQOL with respect to both hospitalization and mortality was assessed. METHODS A cross-sectional analysis was performed in 77,848 hemodialysis (HD) patients whereas changes in HRQOL were assessed in 8,339 patients over a 1-year time period. HRQOL measurements were assessed with Kidney Disease Quality of Life-36 questionnaires. Also, relevant biomarkers (albumin, creatinine, hemoglobin, sodium) and equilibrated normalized protein catabolic rate (enPCR) were measured. RESULTS HRQOL were found to be decreased in HD patients. Nutritional indices like creatinine (r = 0.23; p < 0.0001) and serum albumin (r = 0.21; p < 0.0001) positively correlated with PCS scores. An increase in levels of albumin, creatinine, hemoglobin, enPCR and serum sodium over time are significantly (p < 0.0001) associated with positive changes in PCS scores. Changes in PCS scores were found to be predictive for hospitalization and mortality. The correlates of predictors for MCS scores were less strong compared to that of PCS scores. The strongest positive predictors of MCS scores were age (r = 0.08; p < 0.0001), albumin (r = 0.05; p < 0.0001) and sodium (r = 0.05; p < 0.0001). CONCLUSIONS Nutritional factors are strongly associated with changes in HRQOL, especially with regard to PCS scores (change over time in HRQOL was an independent predictor of hospitalization and mortality). Increased scores of HRQOL over time are positively associated with survival.
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Affiliation(s)
- Natascha J H Broers
- Department of Internal Medicine, Division of Nephrology, University Hospital Maastricht, Maastricht, The Netherlands
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42
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Vasilopoulou C, Bourtsi E, Giaple S, Koutelekos I, Theofilou P, Polikandrioti M. The Impact of Anxiety and Depression on the Quality of Life of Hemodialysis Patients. Glob J Health Sci 2015; 8:45-55. [PMID: 26234986 PMCID: PMC4803985 DOI: 10.5539/gjhs.v8n1p45] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 03/23/2015] [Indexed: 01/16/2023] Open
Abstract
Material and Methods: The sample studied consisted of 395 hemodialysis patients. Data was collected by the completion of a specially designed questionnaire for the needs of the present study which apart from socio-demographic and clinical, it also included HADS scale to assess the level of anxiety and depression as well as the scale Missoula-VITAS Quality of Life Index (MVQOLI) to assess patients’ quality of life. Results: The results of this study showed that 47.8% had high anxiety levels and 38.2% had high levels of depression. The average total score of quality of life was found to be 17.14. It was also shown that the total score of quality of life presented statistically significant association with family status (p=0.007), educational level (p<0.001), the number of children (p=0.001), patients’ adherence to doctors’ orders (p=0.003) and proposed diet (p=0.002) and the relations of patients with healthcare professionals and the other patients (p<0.001). The multiple linear regression showed that the overall quality of life score was statistically associated with the levels of depression after adjusted for possible confounders. More specifically, it was found that total score of quality of life was 2.5 and 4.4 points lower for patients with moderate and high levels of depression, respectively, compared to patients with low levels of depression (p<0.001). Conclusions: Evaluation of anxiety and depression in conjunction with quality of life in hemodialysis patients should be an integral part of the therapeutic regimen.
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Quality of life and stressors in patients with chronic kidney disease depending on treatment. SPANISH JOURNAL OF PSYCHOLOGY 2015; 18:E25. [PMID: 25919086 DOI: 10.1017/sjp.2015.17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study evaluated health-related quality of life (HRQOL) in a Spanish sample of chronic kidney disease patients (n = 90) undergoing different renal replacement therapies, considering the influence of treatment stressors, mood, anxiety and quality of sleep. While all patients had worse physical functioning than controls (p < .01), only those undergoing haemodialysis (HD) showed worse physical well-being, occupational functioning, spiritual fulfillment and more health interference with work (p < .05). They also obtained higher depression scores than renal transplant patients (TX) (p = .005). Those TX receiving the immunosuppressor sirolimus exhibited more cardiac/renal, cognitive and physical limitations than the rest (p < .05). Dialysis vintage correlated positively with sleep disturbances and depression scores and negatively with total Quality of Life (QLI) (p < .05). HD patients experienced more psychological distress than peritoneal dialysis patients (PD) (p = .036). Regression models including sleep, anxiety and depression were estimated for subscales of HRQOL. In TX patients, low depressive scores related to an optimal QLI in almost all subscales, while in HD patients they explained part of the variability in psychological well-being, interpersonal functioning and personal fulfillment. HD condition results in a QLI more distant to the standards of controls.
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45
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Does the Spiritual Well-Being of Chronic Hemodialysis Patients Differ from that of Pre-dialysis Chronic Kidney Disease Patients? RELIGIONS 2014. [DOI: 10.3390/rel6010014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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46
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Chamienia A, Dębska-Ślizień A, Król E, Biedunkiewicz B, Rutkowski B. Open prospective study to evaluate cardiovascular risk factors and renal function in 2 dosage regimens of tacrolimus combined with mycophenolate mofetil and steroids in renal transplant patients: 5-year results. Transplant Proc 2014; 46:2714-8. [PMID: 25380901 DOI: 10.1016/j.transproceed.2014.09.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cyclosporine and tacrolimus (TAC) are the most potent immunosuppressants. TAC is considered less nephrotoxic, but may be an important factor in chronic graft dysfunction. The aim of the study was to evaluate kidney function and cardiovascular risk profile in 2 groups of low immunological risk kidney allograft recipients receiving 2 TAC dosages. MATERIALS AND METHODS Patients were randomly assigned to 2 TAC-based treatments (group I [n = 14], standard dose; group II [n = 15], reduced dose). Patient and graft survival, graft function, occurrence of cardiovascular events (cardiac death, myocardial infarction, stroke), incidence of new-onset diabetes mellitus after transplantation, and cardiovascular risk factors were assessed over a 5-year period. RESULTS Patient demographics and transplant characteristics were not statistically different between groups. TAC trough levels were significantly higher in group I for 24 months post transplant. Patient survival did not differ, but there were more acute rejection episodes and graft losses in group II. There were no significant differences in the rate of cardiac events. Graft function measured as serum creatinine levels and calculated glomerular filtration rate did not differ between groups. The same applies to new-onset diabetes mellitus after transplantation incidence. Office blood pressures were numerically higher in group I up to 24 months but this difference did not reach significance at any time. Similar results were obtained for serum lipids. CONCLUSIONS Immunosuppression based on low doses of tacrolimus seems to be safe in the group of low immunological risk patients but in the 60-month follow-up does not offer any clear benefits in terms of potential nephrotoxicity or cardiovascular risk.
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Affiliation(s)
- A Chamienia
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdańsk, Poland; Department of General Nursing, Medical University of Gdańsk, Poland.
| | - A Dębska-Ślizień
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdańsk, Poland
| | - E Król
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdańsk, Poland
| | - B Biedunkiewicz
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdańsk, Poland
| | - B Rutkowski
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdańsk, Poland
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Beauger D, Gentile S, Jacquelinet C, Dussol B, Briançon S. [Comparison of two national quality of life surveys for patients with end stage renal disease between 2005-2007 and 2011: indicators slightly decreased]. Nephrol Ther 2014; 11:88-96. [PMID: 25540878 DOI: 10.1016/j.nephro.2014.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 09/10/2014] [Accepted: 10/14/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Epidemiology Network and Nephrology Information provides since 2001 the epidemiological monitoring of end stage renal disease (ESRD) in France. Two cross-sectional studies to estimate the level of quality of life in ESRD patients were performed in 2005 and 2007 and repeated in 2011. The main objective is to analyze the evolution of the quality of life of ESRD between these two surveys. METHODS The studies were conducted on a representative sample of subjects aged 18 and over, prevalent dialysis or holders of a functioning kidney transplant last year, followed in center dialysis and/or transplantation in one of the eight French regions selected. The quality of life was measured by a generic questionnaire, and two specifics questionnaires. RESULTS The evolution of the quality of life deteriorated slightly between 2005-2007 and 2011. There is however few dimensions affected. The variation in scores is not meaningful in general, with maximum decreases less than 4 points according to the statistical methods used. This diminution is not clinically significant. DISCUSSION The quality of life in dialysis patients or transplant did not evolve between 2005-2007 and 2011. Currently, it is difficult to assess the benefits of the national plan for improving the quality of life of people with chronic diseases because the last data are too close to the end of the plan.
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Affiliation(s)
- Davy Beauger
- Laboratoire de santé publique, SPMC EA3279, Aix-Marseille université, 13385 Marseille, France; Service de santé publique et information médicale, hôpital de la Conception, 13005 Marseille, France.
| | - Stéphanie Gentile
- Laboratoire de santé publique, SPMC EA3279, Aix-Marseille université, 13385 Marseille, France; Service de santé publique et information médicale, hôpital de la Conception, 13005 Marseille, France
| | - Christian Jacquelinet
- Agence de la biomédecine, 1, avenue du Stade-de-France, 93212 Saint-Denis-La-Plaine cedex, France
| | - Bertrand Dussol
- Centre de néphrologie et de transplantation rénale, hôpital de la Conception, CHU de Marseille, 147, boulevard Baillé, 13005 Marseille, France
| | - Serge Briançon
- Université de Lorraine, université Paris Descartes, Apemac, EA4360, 54000 Nancy, France
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Iorember FM, Bamgbola OF. Pilot validation of objective malnutrition-inflammation scores in pediatric and adolescent cohort on chronic maintenance dialysis. SAGE Open Med 2014; 2:2050312114555564. [PMID: 26770746 PMCID: PMC4607232 DOI: 10.1177/2050312114555564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 09/22/2014] [Indexed: 02/06/2023] Open
Abstract
Background: In recognition of the challenges inherent with the use of single-item indices for the diagnosis of malnutrition–inflammation morbidity in pediatric dialysis patients, to enhance accuracy, we validated a composite scoring system in a pilot study. The objective malnutrition—inflammation score seeks to validate the use of a composite scoring system as a tool for assessing malnutrition—inflammation burden in a pediatric dialysis population. Methods: We enrolled 20 patients on hemodialysis (n = 14) and peritoneal dialysis (n = 6) over a period of 12 months. We derived composite scores from selected indices of renal pathology, nutrition, dialysis adequacy, protein catabolism, and dialysis modality. We assessed reliability by a test–retest method and measured validity by defining the relationship of the indices with serum C-reactive protein in a multiple regression analysis. We calculated sensitivity, specificity, accuracy, and precision for the malnutrition—inflammation score. Results: The mean age was 12.8 years (standard deviation = 6.1), and male–female ratio was 12:8. Patients (n = 8) with elevated serum C-reactive protein (>0.3 mg/dL) had higher composite score for malnutrition—inflammation morbidity. Similarly, the pediatric cohort on hemodialysis had higher score than those on peritoneal dialysis. Upon reliability testing, a low value of typical error (0.07) and high correlation coefficient (r = 0.95) supported validity of the instrument. Moreover, multiple regression analysis showed a strong predictive relationship (R2 = 0.9, p = 0.03) between the indices and serum C-reactive protein. Sensitivity of malnutrition—inflammation score was 62.5%, specificity was 83%, accuracy was 75%, and precision was 71%. Conclusion: Using criterion-validation method, we established the potential use of multi-diagnostic approach to quantify malnutrition—inflammation morbidity in a pediatric dialysis cohort. Given the small sample size, large-scale population-specific studies are needed to ratify these findings and to demonstrate its clinical effectiveness.
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Affiliation(s)
- Franca M Iorember
- Division of Pediatric Nephrology, Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Oluwatoyin F Bamgbola
- The Children's Hospital at Downstate, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, New York 11203
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Greco A, Paroni G, Seripa D, Addante F, Dagostino MP, Aucella F. Frailty, disability and physical exercise in the aging process and in chronic kidney disease. Kidney Blood Press Res 2014; 39:164-8. [PMID: 25117919 DOI: 10.1159/000355792] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2014] [Indexed: 11/19/2022] Open
Abstract
Frailty in the elderly is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. It is usually associated to adverse health outcomes and to one-year mortality risk. Physical exercise has found to be effective in preventing frailty and disability in this population. Chronic kidney disease (CKD) is also a clinical condition where protein energy-wasting, sarcopenia and dynapenia ,very common symptoms in the frail elderly, may occur. Moreover elderly and CKD patients are both affected by an impaired physical performance that may be reversed by physical exercise with an improvement of the survival rate. These similarities suggest that frailty may be a common pathway of aging and CKD that may induce disability and that can be prevented by a multidimensional approach in which physical exercise plays an important role.
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Affiliation(s)
- Antonio Greco
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
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Li C, Mao W, Liu X. Depression, anxiety and reduced quality of life in predialysis: differences across the CKD stages? Int J Clin Pract 2014; 68:657-8. [PMID: 24750530 DOI: 10.1111/ijcp.12422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- C Li
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China; Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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