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Al Sharji A, Alaloul F, Al Yazeedi B, Alharrasi M. Fatalistic and Optimistic Coping Strategies Predict Depression in Arab Muslim Patients With End-Stage Renal Disease. J Transcult Nurs 2024; 35:134-141. [PMID: 38140779 DOI: 10.1177/10436596231217696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Depression is one of the common psychological problems in patients on hemodialysis. We aimed to identify the predictors associated with depressive symptoms among patients on hemodialysis from a population under-represented in research and minoritized in countries like the United States. METHODS This cross-sectional study used a convenience sample of patients in Oman. Data were analyzed using linear multiple regression. RESULTS A total of 157 patients on hemodialysis participated in the study, with 40.5% reporting different levels of depressive symptoms. Higher stress levels (β = .643; p < .01) and higher perceived effectiveness of the fatalistic coping style (β = .144; p < .05) were significant predictors of depressive symptoms. Patients with a higher optimistic coping style (β = -.182; p < .01) had lower levels of depressive symptoms. CONCLUSION Arab Muslim hemodialysis patients have significant levels of depressive symptoms. Identifying predictors of depressive symptoms may help identify those at risk and provide culturally appropriate interventions.
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Affiliation(s)
- Amal Al Sharji
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Fawwaz Alaloul
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Basma Al Yazeedi
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Maryam Alharrasi
- College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman
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Alkubati SA, Al-Sayaghi KM, Salameh B, Halboup AM, Ahmed WAM, J. Alkuwaisi M, Zoromba MA. Prevalence of Depression and Its Associated Factors Among Hemodialysis Patients in Hodeida City, Yemen. J Multidiscip Healthc 2024; 17:689-699. [PMID: 38370607 PMCID: PMC10874630 DOI: 10.2147/jmdh.s452935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/01/2024] [Indexed: 02/20/2024] Open
Abstract
Background Depression has a negative impact on the health outcomes of hemodialysis (HD) patients, including decreased quality of life and increased morbidity and mortality rates. Therefore, this study aimed to determine the prevalence of depression and its associated factors among HD patients in Hodeida city, Yemen. Methods A cross-sectional study involving 200 HD patients at the Dialysis Center in Hodeida was conducted from February to May 2022. Data on depression were collected using the 9-item Patient Health Questionnaire (PHQ-9). Association of sociodemographic characteristics of patients with depression were assessed using chi-square, subsequently by multivariable logistic regression. Statistical significance was set at P-values <0.05. Results The response rate was 98% (200/204). Depression was prevalent among 63% of HD patients at the Dialysis Center in Hodeida city. Sex was significantly associated with depression, where female patients were more frequently depressed than males (82.4% vs 56.4%, P < 0.001). In addition, employment status and medical insurance were significantly associated with depression, where unemployed patients were more frequently depressed than employed patients (67.6% vs 52.5%, P = 0.041) and patients with medical insurance were less frequently depressed than their counterparts (47.1% vs 66.3%, P = 0.035). Conclusion Depression is highly prevalent among HD patients in Hodeida city. Female sex, unemployment and lack of medical insurance are predictors of depression among HD patients. These findings emphasize the urgent need for targeted interventions. Implications for practice Depression is common among HD patients, so that, psychiatric physicians and nurses are increasingly needed in HD centers to implement mental health assessment of patients for depression signs and symptoms to help in early diagnosis and management of depression in order to improve patients' quality of life and preventing negative outcomes.
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Affiliation(s)
- Sameer A Alkubati
- Department of Medical Surgical Nursing, University of Hail, Hail, Saudi Arabia
- Department of Nursing, Hodeida University, Hodeida, Yemen
| | - Khaled M Al-Sayaghi
- Department of Medical Surgical Nursing, Taibah University, Al‐Madinah Al‐Munawarah, Saudi Arabia
- Nursing Division, Sana’a University, Sana’a, Yemen
| | - Basma Salameh
- Department of Nursing, Arab American University, Jenin, Palestine
| | - Abdulsalam M Halboup
- Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen
- Discipline of Clinical Pharmacy, Universiti Sains Malaysia, Penang, Malaysia
| | - Waled A M Ahmed
- Community Health Nursing Department, Al-Baha University, Al-Baha, Saudi Arabia
| | | | - Mohamed A Zoromba
- Department of Nursing, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia
- Department of Psychiatric and Mental Health Nursing, Mansoura University, Mansoura, Egypt
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Masoumi M, Shahidi M, Montazeri SMH, Vahedian M, Bitarafan B, Farhadi M, Feingold C, Smiley A. The Prevalence and Risk Factors of Metabolic Syndrome in Patients with Hemodialysis. J Caring Sci 2024; 13:27-35. [PMID: 38659432 PMCID: PMC11036168 DOI: 10.34172/jcs.2024.32974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/18/2023] [Indexed: 04/26/2024] Open
Abstract
Introduction Metabolic syndrome is a common disorder that puts patients at high risk for cardiovascular disease (CVD) and mortality. To our knowledge, there is no published study in Pub Med which evaluated both lifestyle and metabolic syndrome in hemodialysis patients. This study aimed to estimate the prevalence of metabolic syndrome and investigate the potential risk factors in hemodialysis patients. Methods This was a cross-sectional study conducted on 204 patients enrolled conveniently. National Cholesterol Education Program Adult Treatment Panel III criteria considered for Metabolic Syndrome. Demographics, lifestyle, and disease characteristics were gathered. The relationship between metabolic syndrome and its severity with independent variables was investigated through multivariable multivariate logistic and linear regressions. Results The mean (SD) age was 55 (14) years and 42% were women. 42.6% had metabolic syndrome. Low high-density lipoprotein (HDL), high fasting blood sugar, high blood pressure (BP), increased waist circumference (WC), and high triglyceride were observed in decreasing order of frequency in 54.4%, 44.1%, 38.7%, 33.3% 28.9% of patients, respectively. The logistic regression model revealed significant associations between metabolic syndrome and physical activity (OR=0.85, 95% CI : 0.74-0.97), mood (OR=1.04, 95% CI : 1.002-1.078), age (OR=1.023, 95% CI : 1.001-1.046), and missed work (OR=0.86, 95% CI : 0.76-0.97). The linear regression model revealed significant associations between metabolic syndrome severity score and physical activity (B=-0.12, 95% CI : -0.21-0.02) and sleep quality (B=0.017, 95% CI : 0.001-0.033). Conclusion Poorer sleep quality, lower physical activity, lower mood status, and older age were associated with higher odds of metabolic syndrome/metabolic syndrome severity score in hemodialysis patients.
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Affiliation(s)
- Maryam Masoumi
- Department of Rheumatology, Qom University of Medical Sciences, Clinical Research and Development Center, Qom, Iran
| | - Mohammad Shahidi
- Clinical Research Development Center, School of Medicine, Qom University of Medical Sciences, Qom, Iran
| | | | - Mostafa Vahedian
- Department of Biostatistics and Epidemiology, Neuroscience Research Center, School of Medicine, Qom University of Medical Science, Qom, Iran
| | - Bita Bitarafan
- Clinical Research Development Center, School of Medicine, Qom University of Medical Sciences, Qom, Iran
| | - Mohadeseh Farhadi
- Student Research Committee, Qom University of Medical Sciences, Qom, Iran
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Kose S, Mohamed NA. The Interplay of Anxiety, Depression, Sleep Quality, and Socioeconomic Factors in Somali Hemodialysis Patients. Brain Sci 2024; 14:144. [PMID: 38391719 PMCID: PMC10887329 DOI: 10.3390/brainsci14020144] [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: 11/22/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE This study aimed to assess anxiety, depression, and sleep quality in kidney failure patients receiving hemodialysis (HD) in Somalia and examine the relationship between anxiety, depression, and sleep quality. METHODS We conducted a study with 200 kidney failure patients on HD treatment for over 3 months. Participants completed sociodemographic questionnaires, the Patient Health Questionnaire-9 (PHQ-9), the Hospital Anxiety and Depression Scale (HADS), the Insomnia Severity Index (ISI), and the Pittsburgh Sleep Quality Index (PSQI). RESULTS Among the 200 participants (mean age = 52.3; SD = 14.13), 58.5% were men, 64% had CKD for 1-5 years, and 52.6% received HD for 1-5 years. Depressive symptoms were found in 61.5% (PHQ-9) and 37.5% (HADS depression subscale) of HD patients. Poor sleep quality (PSQI) was observed in 31.5% and significantly correlated with PHQ-9 (rs = 0.633), HADS anxiety (rs = 0.491), and HADS depression (rs = 0.529). The ISI score correlated significantly with PHQ-9 (rs = 0.611), HADS anxiety (rs = 0.494), and HADS depression (rs = 0.586). All PSQI components correlated with depression and anxiety, except sleep medication use. Hierarchical regression analysis revealed that HADS anxiety (β = 0.342) and HADS depression (β = 0.372) predicted ISI scores. HADS anxiety (β = 0.307) and HADS depression (β = 0.419) predicted PSQI scores. CONCLUSIONS Higher anxiety and depression levels negatively correlated with various dimensions of sleep quality in kidney failure patients. Early identification and appropriate management of these psychological disturbances are crucial for enhancing patients' overall quality of life.
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Affiliation(s)
- Samet Kose
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Turkey Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
- Department of Psychiatry, Basaksehir Cam Sakura City Hospital, Health Sciences University, Istanbul 34480, Türkiye
| | - Nur Adam Mohamed
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Turkey Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
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Stanisławska M, Roman M, Nowicki M. The Plasma Neurofilament Light Chain, Brain-Derived Neurotrophic Factor, and Risk of Depression in Chronic Hemodialysis Patients. Biomedicines 2024; 12:103. [PMID: 38255209 PMCID: PMC10813685 DOI: 10.3390/biomedicines12010103] [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: 12/16/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Depression is highly prevalent among hemodialysis patients. Understanding the relationship between the plasma neurofilament light chain (NfL) and brain-derived neurotrophic factor (BDNF) may help us to better understand the mechanisms of depression. This study determined their impact, alongside that of other factors, on the risk of depression in hemodialysis patients. METHODS The study enrolled 82 patients undergoing chronic hemodialysis. Serum NfL, BDNF, uric acid, urea, potassium, calcium, phosphorus, intact parathyroid hormone, and C-reactive protein (CRP) levels were measured. The patients completed the Beck Depression Inventory (BDI). Blood pressure values, body mass before and after hemodialysis, and weekly duration of hemodialysis in hours were assessed. For 19-month survival analysis, the patients were stratified according to baseline BDI scores. RESULTS Based on the BDI score, 18.3% of the patients had an increased risk of depression. Lower scores were associated with significantly longer duration of hemodialysis treatment (37.5 (25-57) 24 (14-37) months, p = 0.01). Within the 19-month survival analysis, 31.7% of patients died. The patients with BDI scores above the median had significantly lower survival than those below the median (log-rank test p = 0.02). No significant differences in serum BDNF levels (192.7 [125.2-278.2]; 207.7 [142.8-265.8] pg/mL, p = 0.40), or NfL concentrations (1431.5 [1182.6-1625.7]; 1494.6 [1335.7-1667] kDa, p = 0.52) were found between patients with lower and higher risk of depression. Patients with BDI scores above the median had significantly higher levels of CRP (9.6 [4.4-14]) than those with scores below the median (3.6 [2.2-7.5], p = 0.01). A significant positive correlation was found between the BDI score and serum CRP level (r = 0.38, p = 0.01). A significant negative correlation was observed between the BDI score and URR% value (r = -0.36, p = 0.02). CONCLUSIONS Patients with lower BDI scores had a longer dialysis duration, indicating a potential negative association between depression risk and length of dialysis treatment. Neither serum NfL nor BDNF levels can serve as markers of depression risk in the dialysis population.
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Affiliation(s)
| | | | - Michał Nowicki
- Department of Nephrology, Hypertension and Kidney Transplantation, Central University Hospital, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland; (M.S.); (M.R.)
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El Shamy O. The Peritoneal Dialysis Surprise Question and Technique Survival: Are you surprised? Perit Dial Int 2024; 44:3-5. [PMID: 38192083 DOI: 10.1177/08968608231223291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Affiliation(s)
- Osama El Shamy
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA
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Liu HH, Wu CL, Chiang YC, Tsai KH, Chu TL, Hsiao YC. Religion and Spiritual Health in Patients With and Without Depression Receiving Hemodialysis: A Cross-Sectional Correlational Study. J Nurs Res 2024; 32:e309. [PMID: 38190331 DOI: 10.1097/jnr.0000000000000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Hemodialysis is the most common therapy for managing patients with end-stage renal disease. Depression is one of the most common psychological problems faced by dialysis patients, and there is limited research on the influences of religion and spirituality on dialysis patients. PURPOSE This study was designed to compare religion and spiritual health status between hemodialysis patients with and without depressive symptoms. METHODS A cross-sectional survey was conducted on 137 hemodialysis patients living in Taiwan. The self-report instruments used included the Religious Beliefs Scale, Spiritual Health Scale-Short Form, and Beck Depression Inventory-II. Data were analyzed using t test, chi-square test, point-biserial correlation of variance, and logistic regression. RESULTS Most (63.5%) of the participants were classified with depression, of which most were male (70.1%), older (mean = 62.56 years), and unemployed (73.6%) and had less formal education. Fifty-two of the participants with depression had a 1- to 5-year duration of hemodialysis, whereas the nondepressed group had a higher mean score for number of religious activities, positive religious beliefs, and total score for spiritual health. Logistic regression showed an increased odds ratio ( OR ) of depression for participants with a duration of hemodialysis of 1-5 years ( OR = 3.64, 95% CI [1.01, 13.15]). Participants with higher scores for spiritual health had a lower risk of depression ( OR = 0.82, 95% CI [0.75, 0.90]), indicating a positive association between spiritual health and lower depression risk. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The prevalence rate of depression in hemodialysis patients is higher than that in the general population. Providing screenings for spiritual health and depression as part of routine medical care for hemodialysis patients is recommended to detect spiritual distress and depression early.
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Affiliation(s)
- Hsiao-Hui Liu
- MS, RN, Nurse, Hemodialysis Room, Taipei Veterans General Hospital, Taoyuan Branch, Taiwan, ROC
| | - Chia-Ling Wu
- PhD, RN, Assistant Professor, Department of Nursing, Chang Gung University of Science and Technology, Taiwan, ROC
| | - Yi-Chien Chiang
- PhD, RN, Associate Professor, Department of Nursing, Chang Gung University of Science and Technology; and Division of Pediatric Hematology and Oncology, Chang Gung Memorial Hospital (Linkou Branch), Taiwan, ROC
| | - Kun-Hung Tsai
- MPH, MD, Physician, Division of Nephrology, Department of Medicine, Taipei City Hospital - Heping Branch, Taiwan, ROC
| | - Tsung-Lan Chu
- MSN, RN, Director, Administration Center of Quality Management Department, Chang Gung Medical Foundation, Taiwan, ROC
| | - Ya-Chu Hsiao
- EdD, RN, Professor, Department of Nursing, Chang Gung University of Science and Technology; and Researcher, Administration Center of Quality Management Department, Chang Gung Memorial Hospital (Linkou Branch), Taiwan, ROC
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Bulathwatta DT, Borchet J, Rudnik A, Bidzan M. Psychosocial well-being among individuals with chronic kidney disease undergoing hemodialysis treatment and their caregivers: a protocol of a mixed method study in Sri Lanka and Poland. Front Psychol 2023; 14:1194991. [PMID: 38144983 PMCID: PMC10740214 DOI: 10.3389/fpsyg.2023.1194991] [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: 03/27/2023] [Accepted: 11/16/2023] [Indexed: 12/26/2023] Open
Abstract
Chronic Kidney Disease (CKD) can be identified as one of the non-communicable diseases (NCDs) which affect millions of people worldwide, including in Sri Lanka and Poland. The prevalence of CKD has been rising over the last three decades due to the identification of CKD with unknown etiology and the increment of NCDs such as hypertension and diabetes mellitus among the Sri Lankan population. Poland can be identified as a European country that has 4 million patients with CKD, which is the second most common chronic disease in the country. CKD is associated with the physical, economic, psychological, and social burden on patients and their caregivers. The current study is aimed to investigate the psychosocial well-being of CKD patients and their caregivers in Sri Lanka and Poland. The current study is a mixed-method study aimed to investigate the psychosocial well-being of individuals with chronic kidney disease undergoing hemodialysis and their caregivers in Sri Lanka and Poland. Participants in the quantitative part of the project will be individuals with chronic kidney disease undergoing hemodialysis from Sri Lanka (n = 63) and Poland (n = 63) who are currently undergoing hemodialysis treatment. Kidney Disease Quality of Life-Sort Form, Beck Depression Scale, Test of Self-Conscious Affect, The Courtauld Emotional Control Scale, Acceptance of Illness Scale, and a demographic and medical information sheet will be used in both Sri Lankan and Polish samples. Apart from that, the qualitative phase of the study will involve semi-structured interviews with individuals diagnosed with CKD, selected randomly from the initial part of the research, and their close relatives. Notably, the participant count will remain undetermined, as this approach addresses the inherent challenges of exploratory research.
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Affiliation(s)
- Darshika Thejani Bulathwatta
- Department of Psychology and Counseling, Faculty of Health Sciences, The Open University of Sri Lanka, Colombo, Sri Lanka
- Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdansk, Poland
- Academic Center for Psychological Support, University of Gdansk, Gdansk, Poland
- Ateneum-University in Gdansk, Gdansk, Poland
| | - Judyta Borchet
- Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdansk, Poland
- Institute of Pedagogy and Languages, University of Applied Sciences in Elbląg, Elbląg, Poland
| | - Agata Rudnik
- Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdansk, Poland
- Academic Center for Psychological Support, University of Gdansk, Gdansk, Poland
- Institute of Pedagogy and Languages, University of Applied Sciences in Elbląg, Elbląg, Poland
| | - Mariola Bidzan
- Institute of Psychology, Faculty of Social Sciences, University of Gdańsk, Gdansk, Poland
- Institute of Pedagogy and Languages, University of Applied Sciences in Elbląg, Elbląg, Poland
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Cho H, Kwon SK, Lee SW, Yang YM, Kim HY, Kim SM, Heo TY, Seong CH, Kim KR. The Association Among Post-hemodialysis Blood Pressure, Nocturnal Hypertension, and Cardiovascular Risk Factors. Electrolyte Blood Press 2023; 21:53-60. [PMID: 38152598 PMCID: PMC10751209 DOI: 10.5049/ebp.2023.21.2.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/20/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023] Open
Abstract
Background Most hemodialysis (HD) patients suffer from hypertension and have a heightened cardiovascular risk. While blood pressure (BP) control is essential to end-stage kidney disease (ESKD) patients, overly stringent control can lead to intradialytic hypotension (IDH). This study aimed to examine BP variations during and after HD to determine whether these variations correlate with IDH risk. Methods BP measurements during dialysis were taken from 28 ESKD patients, and ambulatory BP monitoring was applied post-dialysis. Laboratory parameters and risk factors, including diabetes, coronary disease, and LV mass index, were compared between IDH and non-IDH groups using an independent t-test. Results Of the 28 patients with an average age of 57.4 years, 16 (57.1%) had diabetes, 5 (17.9%) had coronary artery disease, and 1 (3.6%) had cerebrovascular disease. The mean systolic blood pressure (SBP) during and post-HD was 142.26 mmHg and 156.05 mmHg, respectively (p=0.0003). Similarly, the mean diastolic blood pressure (DBP) also demonstrated a significant increase, from 74.59 mmHg during HD to 86.82 mmHg post-HD (p<0.0001). Patients with IDH exhibited a more substantial SBP difference (delta SBP, 36.38 vs. 15.07 mmHg, p=0.0033; age-adjusted OR=1.58, p=0.0168) and a lower post-dialysis BUN level (12.75 vs. 18.77 mg/dL, p=0.0015; age-adjusted OR=0.76, p=0.0242). No significant variations were observed in daytime and nocturnal BP between the IDH and non-IDH groups. Conclusion Hemodialysis patients exhibited a marked increase in post-dialysis BP and lacked a nocturnal BP dip, suggesting augmented cardiovascular risks. This highlights the importance of more stringent BP control after hemodialysis.
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Affiliation(s)
- Hyunjeong Cho
- Renal Division, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Soon Kil Kwon
- Renal Division, Chungbuk National University Hospital, Cheongju, Republic of Korea
- Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Seung Woo Lee
- Renal Division, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Yu Mi Yang
- Renal Division, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Hye Young Kim
- Renal Division, Chungbuk National University Hospital, Cheongju, Republic of Korea
- Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Sun Moon Kim
- Renal Division, Chungbuk National University Hospital, Cheongju, Republic of Korea
- Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Tae-Young Heo
- Department of Information and Statistics, Chungbuk National University Graduate School, Cheongju, Republic of Korea
| | - Chang Hwan Seong
- Department of Information and Statistics, Chungbuk National University Graduate School, Cheongju, Republic of Korea
| | - Kyeong Rok Kim
- Department of Information and Statistics, Chungbuk National University Graduate School, Cheongju, Republic of Korea
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Musolino M, Presta P, Cianfrone P, Errante MA, Andreucci M, Coppolino G, Bolignano D. Self-Reported Physical Inactivity and Mood Disturbances in End-Stage Kidney Disease (ESKD) Patients on Chronic Dialysis Treatment. J Clin Med 2023; 12:7160. [PMID: 38002771 PMCID: PMC10672008 DOI: 10.3390/jcm12227160] [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: 10/23/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Physical inactivity and mood disturbances are key issues in individuals with end-stage kidney disease (ESKD) and may lead to poor clinical outcomes. METHODS We performed a pilot, observational study to explore the possible relationships between the self-reported level of physical activity (IPAQ) and the severity of mood disturbances (BDI score) in a cohort of 58 ESKD patients undergoing chronic hemodialysis (HD; n = 30) or peritoneal dialysis (PD; n = 28). RESULTS Overall, ESKD patients were severely inactive (median METs: 590 [460-1850]) and the intensity of overall and walking physical activity was mostly low to moderate. HD individuals appeared less active than PD (METs 550 [250-1600] vs. 1080 [750-1730]; p = 0.003) and were also less prone to walking (METs 180 ± 90 vs. 320 ± 100; p = 0.01), while a barely statistical difference was noticed for the time spent sitting. ESKD individuals displayed a median BDI score of 17 [12-21], which indicated, on average, the presence of borderline depression, which was apparently more evident among HD individuals. A strong, inverse correlation was found between self-reported METs and BDI scores (R = -0.78; p < 0.0001), while such scores paralleled the time spent sitting during a weekday (R = 0.45; p = 0.0004) and a weekend day (R = 0.40; p = 0.002). CONCLUSIONS In ESKD patients on chronic dialysis, physical inactivity and mood disturbances might be significantly inter-connected, thereby amplifying their relative impact on quality of life, dysautonomia and long-term outcomes. Future studies on larger populations are recommended to confirm these preliminary observations. Promoting strategies to improve fitness, along with greater attention to physiological aspects, should be incorporated into the clinical management of ESKD patients.
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Affiliation(s)
- Michela Musolino
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Pierangela Presta
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Paola Cianfrone
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | | | - Michele Andreucci
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Department of Health Sciences, University “Magna-Graecia” of Catanzaro, Viale Europa SNC, 88100 Catanzaro, Italy
| | - Giuseppe Coppolino
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Department of Health Sciences, University “Magna-Graecia” of Catanzaro, Viale Europa SNC, 88100 Catanzaro, Italy
| | - Davide Bolignano
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Department of Medical and Surgical Sciences, University “Magna-Graecia” of Catanzaro, Viale Europa SNC, 88100 Catanzaro, Italy
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Mohamed NA, Eraslan A, Kose S. The impact of anxiety and depression on the quality of life of hemodialysis patients in a sample from Somalia. BMC Psychiatry 2023; 23:825. [PMID: 37950178 PMCID: PMC10636891 DOI: 10.1186/s12888-023-05312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE The main objective of the present study was to determine the quality of life (QoL), depression, and anxiety levels in kidney failure patients undergoing hemodialysis (HD) treatment and examine the impact of depression and anxiety on the QoL of these patients in a sample from Somalia. METHODS A sample of 200 patients with kidney failure who were undergoing HD treatment approximately two to three times a week was included. All participants were administered a sociodemographic data form, the Patient Health Questionnaire-9 (PHQ-9), the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life (WHO-QOL-BREF). Subjects on HD for less than 3 months prior to the study date were excluded. RESULTS Of the kidney failure patients, 200 patients, aged 18-86 years (median: 50.0; IQR: 25.0), consented and participated in the study. 58.5% of the participants were men; 64% had a kidney failure duration of 1-5 years, and 52.6% had a HD duration of 1-5 years. Mild symptoms of depression were found in 48%, while moderate-to-severe depressive symptoms were found in 13.5% of HD patients. Depression and anxiety were found to be significantly correlated with overall QoL, physical health, psychological health, social relationships, and environmental well-being. There were similar predictors of overall QoL, physical health, psychological well-being, social relationships, and environmental well-being relating to socio-demographic factors such as age, gender, family income, anxiety, and depression. CONCLUSIONS This study emphasizes the important role that anxiety, depression, and family income have in HD patients' QoL in Somalia. It highlights the significance of regular emotional assessment and efficient management in order to increase patient satisfaction. Future studies with larger samples are necessary for more accurate statistical analysis. To optimize patient care, a multidisciplinary healthcare team is recommended.
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Affiliation(s)
- Nur Adam Mohamed
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Türkiye Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia.
| | - Asir Eraslan
- Department of Urology, Mogadishu Somalia Türkiye Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
| | - Samet Kose
- Department of Psychiatry and Behavioral Sciences, Mogadishu Somalia Türkiye Recep Tayyip Erdogan Research and Training Hospital, Mogadishu, Somalia
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12
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Nagy E, Tharwat S, Elsayed AM, Shabaka SAEG, Nassar MK. Anxiety and depression in maintenance hemodialysis patients: prevalence and their effects on health-related quality of life. Int Urol Nephrol 2023; 55:2905-2914. [PMID: 37009953 PMCID: PMC10560136 DOI: 10.1007/s11255-023-03556-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/12/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE The aims of the study are to explore the prevalence and risk factors of anxiety and depression in hemodialysis (HD) patients and to study their relationship with quality of life (QOL). METHODS This cross-sectional study involved 298 HD patients. Sociodemographic, clinical, and laboratory data of the patients were obtained from their records. Anxiety and depression were assessed by utilizing Hospital Anxiety and Depression Scale (HADS). In addition, QOL of the patients were evaluated by fulfilling the Kidney Disease Quality of Life-36. RESULTS This study included 298 HD patients (male 59.1%) with a median age of 49 years. Abnormal and borderline cases of anxiety were recognized in 49.6%, 26.2% of the patients, respectively, while depression cases and borderline cases were identified in 55 and 28.2% of the patients, respectively. Percentages of females (41 and 48% vs 26.4%, respectively), and patients who were not working (92.3 and 93.9% vs 72.2%, respectively) increased significantly in borderline and abnormal anxiety groups. Patients who did not work, led an inactive lifestyle, and smoked had considerably greater percentages in the borderline and abnormal HADS-depression categories than normal patients. Abnormal cases of depression and anxiety had significantly longer duration of HD than other two groups. Abnormal and borderline cases of anxiety and depression had worse QOL components than the normal patients. CONCLUSION Anxiety and depression are prevalent among HD patients in Egypt, and several sociodemographic and clinical risk factors are associated. In addition, these mental disorders are associated with poor QOL.
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Affiliation(s)
- Eman Nagy
- Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Samar Tharwat
- Rheumatology and Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Shimaa Abd El-Galeel Shabaka
- Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohammed Kamal Nassar
- Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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13
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Tutan D, Erdoğan Kaya A, Eser B. The relationship between neutrophil lymphocyte ratio, platelet lymphocyte ratio, and depression in dialysis patients. Medicine (Baltimore) 2023; 102:e35197. [PMID: 37713848 PMCID: PMC10508398 DOI: 10.1097/md.0000000000035197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
Chronic kidney disease is a worldwide public health issue with rising incidence, morbidity/mortality, and cost. Depression and chronic renal disease often coexist, and psychological illnesses are associated with poor results. Early identification of depression reduces morbidity and death. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are reported as practical biomarkers of inflammation and immune system activation. In this study, we aimed to determine the association of NLR and PLR with depression in dialysis patients. This study included 71 adults over 18 without known hematologic or oncologic disease, drug use, or chronic inflammatory diseases. Comorbid chronic diseases, laboratory data, and Beck depression inventory scores were prospectively recorded. A comparison of 2 groups according to the existence of depression was made, and a binomial logistic regression test was used to determine the association between the variables and the presence of depression after adjusting for confounding factors. A receiver operating curve analysis was used to differentiate groups with and without severe depression. Seventy-one patients met the study criteria, with 46 hemodialysis and 25 peritoneal dialysis patients. The majority had hypertension and diabetes mellitus, with 47.89% having minimal-minor depression and 52.11% having moderate-major depression. The 2 groups were similar regarding chronic diseases, with no significant differences in serum creatinine levels, glucose, lipid profiles, or electrolytes. However, when the NLR of the 2 groups was compared, the median was higher in patients with moderate or major depression. Multivariate analysis showed no significant differences between the groups in PLR, triglyceride to glucose ratio, and C-reactive peptide to albumin ratio. The best NLR cutoff value was 3.26, with 48.6% sensitivity, 88.2% specificity, 81.8% positive predictive value, 61.2% negative predictive value, and 67.6% test accuracy. Depression is one of the most common psychiatric conditions in dialysis patients and is linked to increased morbidity, mortality, treatment failure, expense, and hospitalization. NLR helped predict moderate-to-major depression in dialysis patients, even after controlling for confounding factors in multivariate analysis. This study indicated that an NLR successfully identified depressive groups, and patients with an NLR value >3.26 were 6.1 times more likely to have moderate or major depression.
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Affiliation(s)
- Duygu Tutan
- Erol Olçok Training and Research Hospital, Department of Internal Medicine, Çorum, Turkey
| | - Ayşe Erdoğan Kaya
- Erol Olçok Training and Research Hospital, Department of Psychiatry, Çorum, Turkey
| | - Bariş Eser
- Hitit University Faculty of Medicine, Department of Nephrology, Çorum, Turkey
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14
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Li Y, Zhu B, Shen J, Miao L. Depression in maintenance hemodialysis patients: What do we need to know? Heliyon 2023; 9:e19383. [PMID: 37662812 PMCID: PMC10472011 DOI: 10.1016/j.heliyon.2023.e19383] [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: 01/16/2023] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
Chronic kidney disease (CKD) is now recognized as a major public health problem in the world. The global prevalence of CKD is estimated at 13.4% (11.7-15.1%), with an estimated 490.2 to 7.083 million patients with End stage renal disease requiring renal replacement therapy. Hemodialysis is the main treatment for End stage renal disease patients because of its high safety and efficiency. The survival time of these patients was significantly prolonged, but many psychological problems followed. Depression is a type of mood disorder caused by a variety of causes, often manifested as disproportionate depression and loss of interest, sometimes accompanied by anxiety, agitation, even hallucinations, delusions and other psychotic symptoms. Depression has become the most common mental disorder in maintenance hemodialysis (MHD) patients according to the meta-analysis. In recent years, depression has seriously affected the quality of life and prognosis of MHD patients from dietary, sleep, treatment adherence, energy and other dimensions. This article reviews the epidemiology, etiology, diagnosis and treatment of depression in MHD patients.
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Affiliation(s)
- Yulu Li
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Bin Zhu
- Department of Critical Care Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jianqin Shen
- Blood Purification Centre, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Liying Miao
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, China
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15
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Al-Jabi SW. Global research trends and mapping knowledge structure of depression in dialysis patients. World J Psychiatry 2023; 13:593-606. [PMID: 37701544 PMCID: PMC10494777 DOI: 10.5498/wjp.v13.i8.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/27/2023] [Accepted: 07/14/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Depression is one of the most common and important psychological issues faced by dialysis patients. It can make it more difficult for them to adhere to their treatment regimen, which, in turn, can worsen their physical symptoms and lead to poorer health outcomes. AIM To examine the evolution and growth of publications related to dialysis and depression. The objectives were to identify the number of publications, the top active countries, the contributed institutions, funding agencies and journals, as well as to perform citation and research theme analysis. METHODS The search was conducted using the Scopus database for publications related to dialysis and depression between 1970 and 2022. Subsequently, bibliometric analysis was carried out on the data obtained using VOSviewer software, version 1.6.9. This analysis included visualization analysis, co-occurrence analysis and examination of publication trends in dialysis and depression. RESULTS We identified 800 publications that met the search criteria. The number of publications related to dialysis and depression has increased significantly in the past two decades. The USA led the way with 144 publications, which is 18% of all publications on this topic. Turkey came second with 88 publications (11%), followed by China with 55 publications (6.88%) and Iran with 52 publications (6.5%). Analysis of the research theme identified three main clusters related to gender differences in prevalence, identification of depression as a risk factor, and effective interventions to relieve depression. Future research direction analysis shows a shift toward effective interventions to relieve depression in dialysis patients. CONCLUSION This study provides a comprehensive overview of growth, trends and research themes related to dialysis and depression that could help researchers identify gaps in the literature and develop future research.
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Affiliation(s)
- Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine
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16
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Turoń-Skrzypińska A, Tomska N, Mosiejczuk H, Rył A, Szylińska A, Marchelek-Myśliwiec M, Ciechanowski K, Nagay R, Rotter I. Impact of virtual reality exercises on anxiety and depression in hemodialysis. Sci Rep 2023; 13:12435. [PMID: 37528161 PMCID: PMC10394078 DOI: 10.1038/s41598-023-39709-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/29/2023] [Indexed: 08/03/2023] Open
Abstract
Renal replacement therapy is associated with reduced physical activity. The aim of the study was to assess the relationship between regular physical activity performed with the use of virtual reality and the occurrence of symptoms of anxiety and depression in hemodialysis patients. The study involved 85 patients from the dialysis station at the Department of Nephrology, Transplantology and Internal Medicine PUM. The examined patients were randomly divided into study group and control group. The study group consisted of patients undergoing renal replacement therapy by hemodialysis, whose task was to perform VR exercises using the prototype of the NefroVR system for 20 min during hemodialysis. The control group consisted of patients undergoing renal replacement therapy by hemodialysis who were not assigned an intervention. An intragroup analysis was performed for the Beck and GAD scales. After the end of the exercise cycle in the study group there was a decrease in the score while in the control group there was an increase in comparison to the first result. The research showed that after a 3-month exercises on a bicycle with the use of low-intensity virtual reality, a decrease in depression symptoms measured by the Beck Depression Inventory was observed. The research showed that regular physical activity using virtual reality may be associated with a reduction in the occurrence of anxiety and depression symptoms in patients included in the chronic hemodialysis program.
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Affiliation(s)
- Agnieszka Turoń-Skrzypińska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Natalia Tomska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland.
| | - Hanna Mosiejczuk
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Aleksandra Rył
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Aleksandra Szylińska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Małgorzata Marchelek-Myśliwiec
- Clinical Department of Nephrology, Transplantology, and Internal Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Kazimierz Ciechanowski
- Clinical Department of Nephrology, Transplantology, and Internal Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Radosław Nagay
- Department of Visual Communication, Faculty of Design, Academy of Art in Szczecin, Szczecin, Poland
| | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
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17
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Longley RM, Harnedy LE, Ghanime PM, Arroyo-Ariza D, Deary EC, Daskalakis E, Sadang KG, West J, Huffman JC, Celano CM, Amonoo HL. Peer support interventions in patients with kidney failure: A systematic review. J Psychosom Res 2023; 171:111379. [PMID: 37270909 PMCID: PMC10340538 DOI: 10.1016/j.jpsychores.2023.111379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Peer support has been associated with improved health-related outcomes (e.g., psychological well-being and treatment adherence) among patients with serious, chronic conditions, including kidney disease. Yet, there is little existing research evaluating the effects of peer support programs on health outcomes among patients with kidney failure being treated with kidney replacement therapy. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a systematic review using five databases to assess the effects of peer support programs on health-related outcomes (e.g., physical symptoms, depression) among patients with kidney failure undergoing kidney replacement therapy. RESULTS Peer support in kidney failure was assessed across 12 studies (eight randomized controlled trials, one quasi-experimental controlled trial, and three single-arm trials) with 2893 patients. Three studies highlighted the links between peer support and improved patient engagement with care, while one found peer support did not significantly impact engagement. Three studies showed associations between peer support and improvements in psychological well-being. Four studies underscored the effects of peer support on self-efficacy and one on treatment adherence. CONCLUSIONS Despite preliminary evidence of the positive associations between peer support and health-related outcomes among patients with kidney failure, peer support programs for this patient population remain poorly understood and underutilized. Further rigorous prospective and randomized studies are needed to evaluate how peer support can be optimized and incorporated into clinical care for this vulnerable patient population.
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Affiliation(s)
- Regina M Longley
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Lauren E Harnedy
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Pia Maria Ghanime
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Daniel Arroyo-Ariza
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Emma C Deary
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Elizabeth Daskalakis
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America
| | - Katrina G Sadang
- University of California San Francisco School of Medicine, San Francisco, CA, United States of America
| | - Jason West
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Jeff C Huffman
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Christopher M Celano
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Hermioni L Amonoo
- Brigham and Women's Hospital, Department of Psychiatry, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America; Dana-Farber Cancer Institute, Department of Psychosocial Oncology and Palliative Care, Boston, MA, United States of America.
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18
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Anderson BM, Qasim M, Correa G, Evison F, Gallier S, Ferro CJ, Jackson TA, Sharif A. Somatic Symptoms of Depression Lose Association with Mortality upon Adjustment for Frailty: Analysis from the Fitness Haemodialysis Cohort. Int J Nephrol 2023; 2023:4518843. [PMID: 37388527 PMCID: PMC10307017 DOI: 10.1155/2023/4518843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/25/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction The somatic symptom component of depression is associated with increased hospitalisation and mortality and poorer health-related quality of life (HRQOL). However, the relationship of subsets of depression symptoms with frailty and outcomes is not known. This study aimed to (1) explore the relationship between the Clinical Frailty Scale (CFS) and components of depression and (2) their association with mortality, hospitalisation, and HRQOL in haemodialysis recipients. Methods We conducted a prospective cohort study of prevalent haemodialysis recipients, with deep bio-clinical phenotyping including CFS and PHQ-9 somatic (fatigue, poor appetite, and poor sleep) and cognitive component scores. EuroQol EQ-5D summary index assessed HRQOL at the baseline. Electronic linkage to English national administration datasets ensured robust follow-up data for hospitalisation and mortality events. Findings. Somatic (β = 0.067; 95% C.I. 0.029 to 0.104; P < 0.001) and cognitive (β = 0.062; 95% C.I. 0.034 to 0.089; P<0.001) components were associated with increased CFS scores. Both somatic (β = -0.062; 95% C.I. -0.104 to -0.021; P<0.001) and cognitive (β = 0.052; 95% C.I. -0.081 to -0.024; P < 0.001) scores were associated with lower HRQOL. Somatic scores lost mortality association on addition of CFS to the multivariable model (HR1.06; 95% C.I. 0.977 to 1.14; P=0.173). Cognitive symptoms were not associated with mortality. Neither the component score was associated with hospitalisation on multivariable analyses. Conclusions Both somatic and cognitive depression symptoms are associated with frailty and poorer HRQOL in haemodialysis recipients but were not associated with mortality or hospitalisation when adjusted for frailty. The risk profile of depression somatic scores may be related to overlap with symptoms of frailty.
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Affiliation(s)
- Benjamin M. Anderson
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Muhammad Qasim
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Gonzalo Correa
- Department of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Felicity Evison
- Department of Health Informatics, Queen Elizabeth Hospital, Birmingham, UK
| | - Suzy Gallier
- Department of Health Informatics, Queen Elizabeth Hospital, Birmingham, UK
- PIONEER HDR-UK Hub in Acute Care, Edgbaston, Birmingham, UK
| | - Charles J. Ferro
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Thomas A. Jackson
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
- Department of Healthcare for Older People, Queen Elizabeth Hospital, Birmingham, UK
| | - Adnan Sharif
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
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Marin AE, Redolat R, Gil-Gómez JA, Mesa-Gresa P. Addressing Cognitive Function and Psychological Well-Being in Chronic Kidney Disease: A Systematic Review on the Use of Technology-Based Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3342. [PMID: 36834042 PMCID: PMC9961918 DOI: 10.3390/ijerph20043342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Patients with chronic kidney disease (CKD) are at risk of both a gradual decline in cognitive function and an increase in psychological distress. This includes symptoms of anxiety, depression, and sleep disturbances, all of which are factors that have been associated with increased morbidity and mortality. In response, we are now seeing that interventions based on new digital technologies are increasingly used in order to optimize patients' quality of life. Systematic research of the literature on electronic databases (MEDLINE/PubMed, Scopus, Web of Science, and PsycInfo/ProQuest) covering the period from 2012 to 2022 was conducted in order to methodically review the existing evidence regarding the implementation and effectiveness of technology-based interventions in the management of cognitive and psychological well-being symptoms in patients with CKD. A total of 739 articles were retrieved, 13 of which are included in the present review. All the studies focused on the usability, acceptability, and feasibility of technology-based interventions aimed at psychological symptoms, with no studies targeting cognitive functioning. Technology-based interventions offer feelings of safety, fun, and satisfaction, and they also have the potential to improve CKD patients' health outcomes regarding their psychological well-being. The diverseness of technologies allows an approximation towards the identification of those types of technologies most frequently used, as well as the symptoms targeted. There was considerable heterogeneity in the types of technologies used for interventions in so few studies, making it difficult to draw conclusive findings with regard to their efficiency. In order to adequately assess the technology-based health interventions effect, future lines of research should consider designing non-pharmacological treatments for the improvement of cognitive and psychological symptoms in this type of patient.
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Affiliation(s)
- Alexandra-Elena Marin
- Department of Psychobiology, Faculty of Psychology and Logopedics, Universitat de València, 46010 Valencia, Spain
| | - Rosa Redolat
- Department of Psychobiology, Faculty of Psychology and Logopedics, Universitat de València, 46010 Valencia, Spain
| | - José-Antonio Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Patricia Mesa-Gresa
- Department of Psychobiology, Faculty of Psychology and Logopedics, Universitat de València, 46010 Valencia, Spain
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20
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Ong KL, Marklund M, Huang L, Rye KA, Hui N, Pan XF, Rebholz CM, Kim H, Steffen LM, van Westing AC, Geleijnse JM, Hoogeveen EK, Chen YY, Chien KL, Fretts AM, Lemaitre RN, Imamura F, Forouhi NG, Wareham NJ, Birukov A, Jäger S, Kuxhaus O, Schulze MB, de Mello VD, Tuomilehto J, Uusitupa M, Lindström J, Tintle N, Harris WS, Yamasaki K, Hirakawa Y, Ninomiya T, Tanaka T, Ferrucci L, Bandinelli S, Virtanen JK, Voutilainen A, Jayasena T, Thalamuthu A, Poljak A, Bustamante S, Sachdev PS, Senn MK, Rich SS, Tsai MY, Wood AC, Laakso M, Lankinen M, Yang X, Sun L, Li H, Lin X, Nowak C, Ärnlöv J, Risérus U, Lind L, Le Goff M, Samieri C, Helmer C, Qian F, Micha R, Tin A, Köttgen A, de Boer IH, Siscovick DS, Mozaffarian D, Wu JH. Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts. BMJ 2023; 380:e072909. [PMID: 36653033 PMCID: PMC9846698 DOI: 10.1136/bmj-2022-072909] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess the prospective associations of circulating levels of omega 3 polyunsaturated fatty acid (n-3 PUFA) biomarkers (including plant derived α linolenic acid and seafood derived eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid) with incident chronic kidney disease (CKD). DESIGN Pooled analysis. DATA SOURCES A consortium of 19 studies from 12 countries identified up to May 2020. STUDY SELECTION Prospective studies with measured n-3 PUFA biomarker data and incident CKD based on estimated glomerular filtration rate. DATA EXTRACTION AND SYNTHESIS Each participating cohort conducted de novo analysis with prespecified and consistent exposures, outcomes, covariates, and models. The results were pooled across cohorts using inverse variance weighted meta-analysis. MAIN OUTCOME MEASURES Primary outcome of incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m2. In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m2 and <75% of baseline rate. RESULTS 25 570 participants were included in the primary outcome analysis and 4944 (19.3%) developed incident CKD during follow-up (weighted median 11.3 years). In multivariable adjusted models, higher levels of total seafood n-3 PUFAs were associated with a lower incident CKD risk (relative risk per interquintile range 0.92, 95% confidence interval 0.86 to 0.98; P=0.009, I2=9.9%). In categorical analyses, participants with total seafood n-3 PUFA level in the highest fifth had 13% lower risk of incident CKD compared with those in the lowest fifth (0.87, 0.80 to 0.96; P=0.005, I2=0.0%). Plant derived α linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I2=5.8%). Similar results were obtained in the sensitivity analysis. The association appeared consistent across subgroups by age (≥60 v <60 years), estimated glomerular filtration rate (60-89 v ≥90 mL/min/1.73 m2), hypertension, diabetes, and coronary heart disease at baseline. CONCLUSIONS Higher seafood derived n-3 PUFA levels were associated with lower risk of incident CKD, although this association was not found for plant derived n-3 PUFAs. These results support a favourable role for seafood derived n-3 PUFAs in preventing CKD.
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Affiliation(s)
- Kwok Leung Ong
- Lipid Research Group, School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Matti Marklund
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- The Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Liping Huang
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Kerry-Anne Rye
- Lipid Research Group, School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Nicholas Hui
- Lipid Research Group, School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Xiong-Fei Pan
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan, China
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hyunju Kim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lyn M Steffen
- University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Anniek C van Westing
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Johanna M Geleijnse
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Ellen K Hoogeveen
- Department of Nephrology, Jeroen Bosch Hospital, Den Bosch, The Netherlands
- Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nicholas J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Anna Birukov
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Susanne Jäger
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Olga Kuxhaus
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Vanessa Derenji de Mello
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaana Lindström
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Nathan Tintle
- The Fatty Acid Research Institute, Sioux Falls, SD, USA
- Department of Population Health Nursing Science, College of Nursing, University of Illinois-Chicago, Chicago, IL, USA
| | - William S Harris
- The Fatty Acid Research Institute, Sioux Falls, SD, USA
- Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keisuke Yamasaki
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichiro Hirakawa
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, National Institute of Health, Baltimore, MD, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institute of Health, Baltimore, MD, USA
| | | | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tharusha Jayasena
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Anne Poljak
- Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, Australia
| | - Sonia Bustamante
- Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, Australia
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | | | - Mackenzie K Senn
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Stephen S Rich
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Michael Y Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Maria Lankinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Xiaowei Yang
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Liang Sun
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Huaixing Li
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Xu Lin
- Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
- Key Laboratory of Systems Health Science of Zhejiang Province, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Hangzhou, China
| | - Christoph Nowak
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden
| | - Johan Ärnlöv
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Mélanie Le Goff
- Bordeaux Population Health Research Centre, INSERM, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Cécilia Samieri
- Bordeaux Population Health Research Centre, INSERM, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Catherine Helmer
- Bordeaux Population Health Research Centre, INSERM, UMR 1219, University of Bordeaux, Bordeaux, France
| | - Frank Qian
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Renata Micha
- Department of Food Science and Nutrition, University of Thessaly, Karditsa, Greece
- The Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Adrienne Tin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Anna Köttgen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Institute of Genetic Epidemiology, Department of Data Driven Medicine, Faculty of Medicine and Medical Centre, University of Freiburg, Freiburg, Germany
| | - Ian H de Boer
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, WA, USA
- Kidney Research Institute, University of Washington, Seattle, WA, USA
- Puget Sound VA Healthcare System, Seattle, WA, USA
| | | | - Dariush Mozaffarian
- The Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jason Hy Wu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
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21
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Alshelleh S, Alhawari H, Alhouri A, Abu-Hussein B, Oweis A. Level of Depression and Anxiety on Quality of Life Among Patients Undergoing Hemodialysis. Int J Gen Med 2023; 16:1783-1795. [PMID: 37193250 PMCID: PMC10183175 DOI: 10.2147/ijgm.s406535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023] Open
Abstract
Background Despite the growing concern worldwide regarding the quality of life (QoL) and mental well-being among chronic kidney disease (CKD), a few research has been done to address this issue. The study aims to measure depression, anxiety, and QoL prevalence among Jordanian patients with End Stage Renal Disease (ESRD) on hemodialysis and how all of these variables are correlated. Methods This is a cross-sectional, interview-based study on patients at the Jordan University Hospital (JUH) dialysis unit. Sociodemographic factors were collected, and the prevalence of depression, anxiety disorder, and QOL was assessed using the Patient Health Questionnaire 9 (PHQ9), the Generalized Anxiety Disorder 7-item (GAD7), and the WHOQOL-BREF, respectively. Results In a study of 66 patients, 92.4% had depression, and 83.3% had generalised anxiety disorder. Females had significantly higher depression scores than males (mean = 6.2 ± 3.77 vs 2.9 ± 2.8, p < 0.001), and single patients had significantly higher anxiety scores than married patients (mean = 6.1 ± 6 vs 2.9 ± 3.5, p = 0.03). Age was positively correlated with depression scores (rs= 0.269, p = 0.03), and QOL domains showed an indirect correlation with GAD7 and PHQ9 scores. Males had higher physical functioning scores than females (mean = 64.82 vs 58.87, p = 0.016), and patients who studied in universities had higher physical functioning scores than those with only school education (mean of College/University = 78.81 vs mean of School Education = 66.46, p = 0.046). Patients taking <5 medications had higher scores in the environmental domain (p = 0.025). Conclusion The high prevalence of depression, GAD, and low QOL in ESRD patients on dialysis highlights the need for caregivers to provide psychological support and counselling for these patients and their families. This can promote psychological health and prevent the onset of psychological disorders.
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Affiliation(s)
- Sameeha Alshelleh
- Division of Nephrology, Department of Medicine, The University of Jordan, Amman, Jordan
| | - Hussein Alhawari
- Division of Nephrology, Department of Medicine, The University of Jordan, Amman, Jordan
| | - Abdullah Alhouri
- Department of Medicine, Division of Gastroenterology, Royal Berkshire Hospital, Reading, UK
- Correspondence: Abdullah Alhouri, Department of Medicine, Division of Gastroenterology, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK, Email
| | | | - Ashraf Oweis
- Division of Nephrology, Department of Medicine, Jordan University of Science and Technology, Amman, Jordan
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22
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Ye W, Wang L, Wang Y, Wang C, Zeng J. Depression and anxiety symptoms among patients receiving maintenance hemodialysis: a single center cross-sectional study. BMC Nephrol 2022; 23:417. [PMID: 36585621 PMCID: PMC9804950 DOI: 10.1186/s12882-022-03051-8] [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: 08/30/2022] [Accepted: 12/21/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND To investigate depression and anxiety and related factors among patients receiving maintenance hemodialysis (MHD). METHODS This cross-sectional study included patients underwent MHD in 3/2022 at Jinshan Hospital affiliated to Fudan University. Depression and anxiety levels of patients were assessed using Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), respectively. SF-36 was used to assess patients' quality of life. Multiple linear regression analysis was used to determine the variables associated with the scores of BDI/BAI. RESULTS A total of 103 patients were included, 71 cases (68.93%) and 38 cases (36.89%) with depression and anxiety, respectively. The scores of almost all domains of the SF-36 showed a declining trend with increasing depression or anxiety among patients on MHD. Higher Charlson Comorbidity Index (CCI) (β =0.066, 95%CI: 0.016-0.116, P = 0.010), lower educational status (β = - 0.139, 95%CI: - 0.243- -0.036, P = 0.009), and number of oral medications (β =0.177, 95%CI: 0.031-0.324, P = 0.018) were significantly associated with higher BDI scores. Longer dialysis duration (β =0.098, 95%CI: 0.003-0.193, P = 0.044) and number of oral medications (β =4.714, 95%CI: 1.837-7.590, P = 0.002) were significantly associated with higher BAI scores. CONCLUSIONS Depression and anxiety may be likely to occur among patients undergoing MHD and impact their quality of life. Higher CCI, lower educational status and usage of multiple oral medications may be associated with depression, whereas longer dialysis duration and multiple oral medications may be associated with anxiety in MHD patients.
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Affiliation(s)
- Wei Ye
- grid.8547.e0000 0001 0125 2443Department of Nephrology, Jinshan Hospital, Fudan University, Shanghai, 201508 China
| | - Lizhen Wang
- grid.8547.e0000 0001 0125 2443Department of Nephrology, Jinshan Hospital, Fudan University, Shanghai, 201508 China
| | - Yu Wang
- grid.8547.e0000 0001 0125 2443Department of Nephrology, Jinshan Hospital, Fudan University, Shanghai, 201508 China
| | - Chengjun Wang
- grid.8547.e0000 0001 0125 2443Department of Nephrology, Jinshan Hospital, Fudan University, Shanghai, 201508 China
| | - Jingyi Zeng
- grid.415108.90000 0004 1757 9178Department of Nephrology, Fujian Provincial Hospital, Fuzhou, 350001 China
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23
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Bürker BS, Hardersen RI, Lappegård KT. Symptoms of Depression, Anxiety, and Posttraumatic Stress among Patients with Cardiac Pacemakers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16838. [PMID: 36554718 PMCID: PMC9778963 DOI: 10.3390/ijerph192416838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Despite being a prerequisite for tailoring specific therapeutic interventions, knowledge of pattern and prevalence of clinically significant psychiatric symptomatology among patients with cardiac pacemakers (PMs), especially of symptoms of posttraumatic stress, is limited. We studied symptoms of depression, anxiety, and posttraumatic stress among PM patients (PM due to syncope or presyncope) compared to participants of (i) a cardiac, (ii) a chronic disease, and (iii) a healthy control group. Symptoms of depression, anxiety and posttraumatic stress were measured by validated self-report scales at least 6 months after implantation of the PM (PM group; n = 38), percutaneous coronary intervention (PCI; PCI control group; n = 23), and first dialysis (Dialysis control group; n = 17). Blood donors constituted the Healthy control group (n = 42). Both PM, PCI, and dialysis patients reported depressive symptoms above clinical cut-off more frequently than the healthy controls (16.2, 26.1, 41.2, and 0%, respectively; p < 0.001). Self-report of symptoms of anxiety and posttraumatic stress did not differ significantly across study groups. However, a non-negligible proportion of PM patients reported on symptoms of posttraumatic stress of anticipated clinical relevance. Identification and treatment of depression deserves attention in clinical routine in all three patient populations. Further study of posttraumatic stress in PM patients seems advisable.
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Affiliation(s)
- Britta S. Bürker
- Department of Psychiatry, Nordland Hospital Trust Bodø, 8092 Bodø, Norway
- Norwegian National Unit for Sensory Loss and Mental Health, Oslo University Hospital, 0424 Oslo, Norway
| | - Randolf I. Hardersen
- Department of Nephrology, Nordland Hospital Trust Bodø, 8092 Bodø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Knut Tore Lappegård
- Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Division of Medicine, Department of Cardiology, Nordland Hospital Trust Bodø, 8092 Bodø, Norway
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24
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Anderson BM, Qasim M, Correa G, Evison F, Gallier S, Ferro CJ, Jackson TA, Sharif A. Depression is associated with frailty and lower quality of life in haemodialysis recipients, but not with mortality or hospitalization. Clin Kidney J 2022; 16:342-354. [PMID: 36755846 PMCID: PMC9900564 DOI: 10.1093/ckj/sfac241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Indexed: 11/12/2022] Open
Abstract
Background Frailty and depression are highly prevalent in haemodialysis recipients, exhibit a reciprocal relationship, and are associated with increased mortality and hospitalization, and lower quality of life. Despite this, there has been little exploration of the relationship between depression and frailty upon patient outcomes. We aimed to explore the relationship between depression and frailty, and their associations with mortality, hospitalization and quality of life. Methods We performed a prospective cohort study of prevalent haemodialysis recipients linked to national datasets for outcomes including mortality and hospitalization. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), frailty using the Clinical Frailty Scale (CFS) and quality of life using the EuroQol 5-Dimension (EQ-5D) Summary Index. Results A total of 485 prevalent haemodialysis recipients were recruited, with 111 deaths and 1241 hospitalizations during follow-up. CFS was independently associated with mortality [hazard ratio (HR) 1.31; 95% confidence interval (CI) 1.08, 1.59; P = .006], hospitalization [incidence rate ratio (IRR) 1.13; 95% CI 1.03, 1.25; P = .010] and lower quality of life (Coef. -0.401; 95% CI -0.511, -0.292; P < .001). PHQ-9 score was independently associated with lower quality of life (Coef. -0.042; 95% CI -0.063, -0.021; P < .001), but not mortality (HR 1.00; 95% CI 0.96, 1.04; P = .901) or hospitalization (IRR 0.99; 95% CI 0.97, 1.01; P = .351). In an adjusted model including CFS, moderate depression was associated with reduced hospitalization (IRR 0.72; 95% CI 0.56, 0.93; P = .013). Conclusions With the addition of frailty, depression was associated with lower hospital admissions, but poorer quality of life. The relationship between frailty and depression, and their influence on outcomes is complex, requiring further study.
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Affiliation(s)
- Benjamin M Anderson
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK,Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Muhammad Qasim
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK,Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
| | - Gonzalo Correa
- Department of Nephrology, Hospital del Salvador, Santiago, Chile
| | - Felicity Evison
- Department of Health Informatics, Queen Elizabeth Hospital, Birmingham, UK
| | - Suzy Gallier
- Department of Health Informatics, Queen Elizabeth Hospital, Birmingham, UK,PIONEER: HDR-UK hub in Acute Care, Edgbaston, Birmingham, UK
| | - Charles J Ferro
- Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK,Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Thomas A Jackson
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK,Department of Healthcare for Older People, Queen Elizabeth Hospital, Birmingham, UK
| | - Adnan Sharif
- Correspondence to: Adnan Sharif; E-mail: , Twitter: @AdnanSharif1979
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25
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Rajasekaran A, Prakash A, Hatch S, Lu Y, Cutter GR, Zarjou A. Advocating for in-center hemodialysis patients via anonymous survey. Medicine (Baltimore) 2022; 101:e30937. [PMID: 36254033 PMCID: PMC9575770 DOI: 10.1097/md.0000000000030937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We conducted an anonymous survey in 9 of our university affiliated outpatient dialysis units to address the concern that many in-center hemodialysis patients may not feel comfortable sharing their experiences. Major goals of this study: Investigating level of patient satisfaction with their care; Evaluating the subjective perception of the level of understanding of patients regarding pertinent issues of their disease and its management; Identifying potential avenues for care improvement. Survey was conducted in English, paper-based, with answer choices to individual questions for patient satisfaction and education graded using a 5-point Likert scale. Regarding potential areas of improvement, patients were asked to choose as many areas as deemed appropriate. To ensure anonymity, the completed surveys were folded and dropped into a box. Overall, 253 out of 516 (49%) screened patients were eligible and completed the survey. Patients expressed favorable responses regarding satisfaction (mean rating > 4 in each of 14 questions) and education (mean rating > 4 in 8 questions, > 3.5 in 2 questions) regarding hemodialysis. About 62% of overall study participants identified at least one area where they felt additional information would result in improvement of care. Our results indicate that patients undergoing outpatient hemodialysis were overall satisfied and had a good perceptive understanding about their health. Based on the patients' input, strategies focused on addressing pain and discomfort, privacy, providing information about palliative care/hospice, mental health resources, and the process of kidney transplantation may promote improvement in overall quality of care.
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Affiliation(s)
- Arun Rajasekaran
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, AL, USA
| | - Anand Prakash
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, AL, USA
| | - Spencer Hatch
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, AL, USA
| | - Yan Lu
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, AL, USA
| | - Gary R. Cutter
- Division of Biostatistics, University of Alabama at Birmingham, AL, USA
| | - Abolfazl Zarjou
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, AL, USA
- *Correspondence: Abolfazl Zarjou, Assistant Professor of Medicine, Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, 618 Zeigler Research Building, 703 South 19th Street Birmingham, AL 35294, USA (e-mail: )
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26
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Muacevic A, Adler JR. Sexual Dysfunction in Female Patients Undergoing Hemodialysis and Its Relationship With Anxiety and Depression. Cureus 2022; 14:e29883. [PMID: 36348849 PMCID: PMC9629872 DOI: 10.7759/cureus.29883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Hemodialysis is renal replacement therapy. However, it is associated with various complications. Sexual dysfunction is one of them. It is estimated that 25%-64% of female patients on hemodialysis have sexual dysfunction worldwide. This impaired quality of life further leads to anxiety and depression. Around 22.8%-39.3% of patients on hemodialysis are depressed while 27% have a major anxiety disorder. In Pakistan, the incidence of end-stage renal disease (ESRD) is 100 per million people. As far as we know, this is the first study conducted in Multan to assess sexual dysfunction in female patients undergoing hemodialysis. The objective of this study was to find out the prevalence of sexual dysfunction in female patients on hemodialysis and its relationship with anxiety and depression. Material and methods A cross-sectional study was conducted in Nishtar Medical University Hospital, Multan, Pakistan, from February 2021 to May 2021. Data were collected from 55 female patients in the form of an interview after having met inclusion and exclusion criteria. The questionnaire had some sociodemographic questions. The female sexual function index (FSFI) was used to evaluate sexual dysfunction in hemodialysis patients while anxiety and depression were assessed using the hospital anxiety and depression (HADS) scale. SPSS version 25.0 (IBM Corp., Armonk, NY) was used for data analysis. Pearson's correlation was used to find the association of sexual dysfunction with anxiety and depression. A p-value of <0.05 was considered statistically significant. Results Hypertension (56.4%) was the leading cause of chronic kidney disease (CKD). The most serious problem of the patients was sexual arousal suggested by the low mean score (1.77 ± 2.27) as compared to other sexual domains. Anxiety and depression were found in 20% and 30.9% of patients, respectively. There was a significant negative correlation between age ((arousal: r= -0.297, p= 0.028), (lubrication: r= -0.274, p= 0.043), (orgasm: r= -0.298, p= 0.027), and (pain: r= -0.271, p= 0.045)) and depression ((desire: r= -0.465, p= <0.001), (satisfaction: r= -0.366, p= 0.006)) with sexual function. While anxiety was not significantly associated with sexual function ((desire: r= -0.347, p= 0.069), (arousal: r= 0.053, p= 0.700), (lubrication: r= 0.061, p= 0.658), (orgasm: r= 0.047, p= 0.736), (satisfaction: r= -0.113, p= 0.410) and (pain: r= 0.045, p= 0.746)). Conclusion Sexual dysfunction is not uncommon in female hemodialysis patients. There was a significant negative correlation of different sexual domains with age and depression, respectively. The correlation of anxiety with sexual dysfunction was found to be statistically insignificant.
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27
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Pawłowski M, Fila-Witecka K, Rymaszewska JE, Kamińska D, Poznański P, Augustyniak-Bartosik H, Zielińska D, Krajewska M, Krajewski PK, Stefaniak A, Szepietowski JC, Pokryszko-Dragan A, Chojdak-Łukasiewicz J, Budrewicz S, Pawłowski T, Szcześniak D, Rymaszewska J. Psychopathological Symptoms Among Chronically Ill Patients During SARS-CoV-2 Pandemic in Poland. Psychol Res Behav Manag 2022; 15:2659-2669. [PMID: 36148283 PMCID: PMC9488602 DOI: 10.2147/prbm.s362918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/19/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had a drastic psychological and economic impact on the global population. Having a chronic disease during the pandemic is associated with numerous limitations and challenges like regular hospital visits, access to health-care units and getting specialized treatment. In addition, chronically ill patients are at great risk of acquiring the SARS-CoV-2 virus and at experiencing a more severe course of illness, due to comorbid conditions as well as more frequent encounters with health-care workers and other patients in medical facilities. The aim of this study was to examine the psychological disturbances, during the pandemic in chronically ill patients. Methods During the cross-sectional survey conducted between May and October 2020, 398 patients with four different chronic conditions (psoriasis, multiple sclerosis and patients who have undergone a kidney transplant or received dialysis). Study sample was examined regarding the occurrence of psychopathological symptoms (General Health Questionnaire 28) and their perceived stress levels (Perceived Stress Scale). Results The highest scores were found in the MS group and the lowest scores were found in the kidney transplantation group in every subscale of the GHQ-28. Close to half of the studied population (48.74%, n = 193) patients scored above the cut-off for psychopathology. Conclusion As the study was conducted during the SARS-CoV-2 pandemic in Poland, it stands to reason that the pandemic affected the psychological wellbeing of chronically ill patients. A COVID-19 infection, being quarantined and having had contact with a person who was infected, did not significantly affect the outcome measures; however, further research is needed to explore this topic.
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Affiliation(s)
- Marcin Pawłowski
- Psychiatry Department, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Dorota Kamińska
- Nephrology and Transplantology Department, Wroclaw Medical University, Wroclaw, Poland
| | - Paweł Poznański
- Nephrology and Transplantology Department, Wroclaw Medical University, Wroclaw, Poland
| | | | - Dorota Zielińska
- Nephrology and Transplantology Department, Wroclaw Medical University, Wroclaw, Poland
| | - Magdalena Krajewska
- Nephrology and Transplantology Department, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr K Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra Stefaniak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | | | | | | - Tomasz Pawłowski
- Psychiatry Department, Wroclaw Medical University, Wroclaw, Poland
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28
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Evaluation of depressive disorder in end-stage renal disease patients by proton diffusion tensor imaging. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2022.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Sallam L, Alsharif F, Abaalalaa S, Alakeely R, Abdullah Z, Alkhamis Z, Sindi N, Sharif LS. Prevalence of depression in patients with end-stage renal disease undergoing hemodialysis in Saudi Arabia: A cross-sectional study. BELITUNG NURSING JOURNAL 2022; 8:296-303. [PMID: 37546499 PMCID: PMC10401383 DOI: 10.33546/bnj.2080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/27/2022] [Accepted: 08/02/2022] [Indexed: 08/08/2023] Open
Abstract
Background A hemodialysis is a treatment option for patients with End-Stage Renal Disease (ESRD). However, patients undergoing hemodialysis three times per week may experience psychological issues, including depression, which are highly prevalent among patients. Unfortunately, most healthcare providers fail to recognize the symptoms of depression due to overlap with other somatic symptoms; thus, depression remains undiagnosed. Objective This study aimed to estimate the prevalence of depression and compare the differences in depression symptoms according to the sociodemographic characteristics of patients with ESRD undergoing hemodialysis. Method A descriptive, cross-sectional study was conducted from August to October 2021 with a total of 132 hemodialysis patients using the Beck Depression Inventory (BDI II) questionnaire to examine symptoms of depression at multiple health centers in Jeddah. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis, Post-hoc analysis using Conover tests were used for data analysis. Results The prevalence of depression in hemodialysis patients was 51.5%, 25.8%, 15.9%, and 6.8%, with minimal, mild, moderate, and severe symptoms, respectively. Depression exhibited a significant relationship with sex (p = 0.034), with females showing higher mean depression scores than males. Additionally, depression scores were statistically significant across the different levels of education (p = 0.019), with the mean depression scores significantly highest in subjects who had only primary school level of education. Furthermore, the most common symptoms associated with depression were found to be energy loss and fatigue. Conclusion Depression prevalence was relatively low among patients with ESRD undergoing hemodialysis, and a loss of energy and fatigue were the most common symptoms correlated with depression. Hence, nurses should be trained on how to routinely use psychological screening scales among patients with ESRD undergoing hemodialysis.
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Affiliation(s)
- Lujain Sallam
- Medical Surgical Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Fatmah Alsharif
- Medical Surgical Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Sarah Abaalalaa
- Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Rawan Alakeely
- Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Zahraa Abdullah
- Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Zahra Alkhamis
- Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
| | - Najla Sindi
- King Fahad Hospital, Jeddah 23325, Saudi Arabia
| | - Loujain S Sharif
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, King Abdulaziz University, Jeddah 21551, Saudi Arabia
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30
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Douglass-Molloy H, Law MM, Le B, Katz N. Spiritual distress in dialysis: A case report. PROGRESS IN PALLIATIVE CARE 2022. [DOI: 10.1080/09699260.2022.2090052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | | | - Brian Le
- Royal Melbourne Hospital, Victoria, Australia
- Peter MacCallum Cancer Centre, Victoria, Australia
| | - Naomi Katz
- Peter MacCallum Cancer Centre, Victoria, Australia
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31
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Self-care self-efficacy and depression associated with quality of life among patients undergoing hemodialysis in Vietnam. PLoS One 2022; 17:e0270100. [PMID: 35709232 PMCID: PMC9202875 DOI: 10.1371/journal.pone.0270100] [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: 03/12/2022] [Accepted: 06/04/2022] [Indexed: 11/19/2022] Open
Abstract
Background Hemodialysis impacts the quality of life of patients with end-stage renal disease. Particularly, depression is the most common psychological condition among patients. Self-care self-efficacy might play an important role in quality of life of patients with hemodialysis. Objective This study was designed to explore the relationships among self-care self-efficacy, depression, and quality of life. The second aim was to explore the extent to which self-care self-efficacy and depression explain the variance in quality of life of patients on hemodialysis. Methods This cross-sectional study included 127 patients receiving hemodialysis and used the Short Form 36 Health Survey, the Strategies Used by People to Promote Health, and the Patient Health Questionnaire 9 to evaluate quality of life, self-care self-efficacy, and depression. Data was analyzed using independent t-test, analysis of variance, Pearson’s correlation and hierarchical multiple regression. Results The findings indicated that self-care self-efficacy was significantly positively correlated (PCS r = .533, p < 0.001, MCS r = .47, p < .001) and depression was significantly negatively correlated (PCS r = −.446, p < .001, MCS r = −.605, p < .001) with the two quality of life components. Self-care self-efficacy and depression were significant predictors of the physical (R2inc = 0.09, β = -0.38, p<0.001, R2inc = 0.12, β = -0.22, p<0.001) and mental (R2inc = 0.04%, β = -0.25, p<0.001, R2inc = 0.33, β = -0.51, p<0.001) quality of life of hemodialysis patients. Conclusions Health professionals may target improving self-care self-efficacy and reducing depressive symptoms to enhance patient quality of life.
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Zhang N, Lai F, Guo Y, Wang L. Status of and Factors Influencing the Stigma of Chinese Young and Middle-Aged Maintenance Hemodialysis Patients: A Preliminary Study. Front Psychol 2022; 13:873444. [PMID: 35645865 PMCID: PMC9130852 DOI: 10.3389/fpsyg.2022.873444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
Many young and middle-aged maintenance hemodialysis patients suffer a poor prognosis, experience a series of problems during long-term treatment and are thus prone to stigma. This study was designed to analyze stigma in young and middle-aged maintenance hemodialysis patients and explore its influencing factors. This study was conducted as a cross-sectional descriptive study with a convenience sampling method and included 97 patients from Shanghai Jiao Tong University Affiliated Sixth People’s Hospital between November 2020 and February 2021. The Social Impact Scale, a demographic questionnaire, and hemodialysis indicators were used in the investigation. Patient biochemical indexes from hemodialysis were compared. Young and middle-aged maintenance hemodialysis patients had a medium level of stigma. Patients who had low income, were younger, were male, had long-term hemodialysis and were unemployed had significantly higher stigma scores than other patients (P < 0.05). Age, gender, occupational status, annual household income and the duration of hemodialysis were found to be the main factors related to stigma in young and middle-aged maintenance hemodialysis patients by multiple regression analysis. Perceptions of hemodialysis-related stigma were common in our sample. Patients who had low income, were younger, were male, had long-term hemodialysis and were employed had a higher level of stigma, which deserves attention from clinical medical workers. Replication studies are needed to confirm these findings.
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Affiliation(s)
- Nina Zhang
- Department of Nursing, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Fengxia Lai
- School of Nursing, Medical College of Soochow University, Suzhou, China
| | - Yong Guo
- Department of Critical Care Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lan Wang
- Department of Nursing, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Martin KE, Thomas BS, Greenberg KI. The expanding role of primary care providers in care of individuals with kidney disease. J Natl Med Assoc 2022; 114:S10-S19. [DOI: 10.1016/j.jnma.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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34
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Feng J, Lu X, Li H, Wang S. High neutrophil-to-lymphocyte ratio is a significant predictor of depressive symptoms in maintenance hemodialysis patients: a cross-sectional study. BMC Psychiatry 2022; 22:313. [PMID: 35505395 PMCID: PMC9063198 DOI: 10.1186/s12888-022-03963-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is one of the most important psychiatric disorders in chronic kidney disease patients who undergo maintenance hemodialysis (MHD). Previous studies have shown that low-grade inflammation is involved in the progression of depressive symptoms. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker that is inexpensive and easy to measure. However, the association between NLR and depression symptoms in MHD patients has not been examined. METHODS In this single-center, cross-sectional study, we included 160 patients undergoing MHD. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. NLR was calculated as the ratio of neutrophils to lymphocytes. Multinomial logistic regression and multivariate linear regression analyses were used to examine the association between NLR and depressive symptoms in MHD patients. RESULTS Depressive symptoms were detected in 36.7% of the 160 MHD patients. Multinomial logistic regression showed that NLR was a significant predictor of mild (odds ratio [OR]: 1.383, 95% confidence interval [CI]: 1.015-1.884, p = 0.04) and moderate/moderately severe depressive symptoms (OR: 1.441, 95% CI: 1.017-2.042, p = 0.04) in MHD patients, adjusted for age, sex, Kt/V, dialysis duration, history of kidney transplantation, history of hypertension, and Charlson comorbidity index score. In addition, multivariate linear regression analysis showed that NLR was an independent influencing factor for PHQ-9 score in MHD patients, after adjusting for confounding factors. CONCLUSIONS These findings suggest that NLR can be used as a biomarker for predicting depressive symptoms in MHD patients.
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Affiliation(s)
- Jianan Feng
- grid.411607.5Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing, 100020 China
| | - Xiangxue Lu
- grid.411607.5Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing, 100020 China
| | - Han Li
- Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing, 100020, China.
| | - Shixiang Wang
- grid.411607.5Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing, 100020 China
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35
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Chen JHC, Lim WH, Howson P. Changing landscape of dialysis withdrawal in patients with kidney failure: Implications for clinical practice. Nephrology (Carlton) 2022; 27:551-565. [PMID: 35201646 PMCID: PMC9315017 DOI: 10.1111/nep.14032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/09/2022] [Accepted: 02/19/2022] [Indexed: 11/29/2022]
Abstract
Dialysis withdrawal has become an accepted treatment option for patients with kidney failure and is one of the leading causes of death in patients receiving dialysis in high-income countries. Despite its increasing acceptance, dialysis withdrawal currently lacks a clear, consistent definition. The processes and outcomes of dialysis withdrawal have wide temporal and geographical variability, attributed to dialysis patient selection, influence from cultural, religious and spiritual beliefs, and availability of kidney replacement therapy and conservative kidney management. As a complex, evolving process, dialysis withdrawal poses an enormous challenge for clinicians and healthcare teams with various limitations precluding a peaceful and smooth transition between active dialysis and end-of-life care. In this review, we examine the current definitions of dialysis withdrawal, the temporal and geographical patterns of dialysis withdrawal, international barriers in the decision-making process (including dialysis withdrawal during the COVID-19 pandemic), and gaps in the current dialysis withdrawal recommendations for clinical consideration and future studies.
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Affiliation(s)
- Jenny H C Chen
- Faculty of Medicine, University of Wollongong, Wollongong, Australia.,Wollongong Hospital, Wollongong, Australia
| | - Wai H Lim
- Department of Nephrology, Sir Charles Gairdner Hospital, Perth, Australia.,Faculty of Medicine, University of Western Australia, Perth, Australia
| | - Prue Howson
- Department of Nephrology, Sir Charles Gairdner Hospital, Perth, Australia
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36
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Tian X, Xia X, Yu H, Chen H, Jiang A, Xin L. Cognitive Dysfunction and Its Risk Factors in Patients Undergoing Maintenance Hemodialysis. Neuropsychiatr Dis Treat 2022; 18:2759-2769. [PMID: 36452115 PMCID: PMC9704003 DOI: 10.2147/ndt.s380518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Cognitive impairment (CI) in Maintenance hemodialysis (MHD) is attracting increasing attention. This study aims to clarify the prevalence and risk factors for cognitive dysfunction in patients on MHD who have no history of stroke. METHODS A total of 99 patients with no history of stroke undergoing MHD were enrolled. Global cognitive function was evaluated using the Montreal Cognitive Assessment scale. Attention and executive functions were evaluated by the Digital Span (DS) test and the Color Trail Test (CTT). The Hamilton Depression and Anxiety scales were used to assess depression and anxiety status. The effects of patient background factors, laboratory indicators, anxiety, and depression on cognitive dysfunction were examined by regression analysis. RESULTS There were 69.70% of the patients had general CI, 65.65% had depression, and 57.57% had anxiety. The forward and backward DS in the cognitively impaired (CI) group were shorter than in the normal cognitive function (NCF) group (P<0.05). Times required for CTT-I, CTT-II, and CTT II - CTT I were longer in the CI group than in the NCF group (P<0.05). Hemoglobin levels were lower, and parathyroid hormone (PTH) and uric acid levels were higher in the CI group than in the NCF group (P<0.05). Hemoglobin levels were negatively correlated with CI in these patients (odds ratio [OR] 0.634, P<0.05) and PTH, and uric acid levels were positively correlated with CI (OR 1.028, P<0.05; and OR 1.011, P<0.05). The proportions of patients with diabetes and depression were higher in the CI group (P<0.05). CONCLUSION There was a high prevalence of CI with significant impairment of attention and executive ability in MHD patients who had no stroke history. Hemoglobin may protect cognitive function, while diabetes, PTH, and uric acid levels may be risk factors. Depressive and anxiety states may aggravate CI in MHD patients.
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Affiliation(s)
- Xiaolin Tian
- Department of Rehabilitation Medicine, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Haibo Yu
- Blood Purification Center, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Haiyan Chen
- Blood Purification Center, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Aili Jiang
- Blood Purification Center, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Li Xin
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
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37
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Chen X, Han P, Song P, Zhao Y, Zhang H, Niu J, Yu C, Ding W, Zhao J, Zhang L, Qi H, Shao X, Su H, Guo Q. Mediating Effects of Malnutrition on the Relationship between Depressive Symptoms Clusters and Muscle Function Rather than Muscle Mass in Older Hemodialysis Patients. J Nutr Health Aging 2022; 26:461-468. [PMID: 35587758 DOI: 10.1007/s12603-022-1778-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the association and mediation pathways among muscle mass, muscle function (muscle strength and physical performance), and malnutrition with depressive symptoms clusters in the older hemodialysis patients. DESIGN A multi-center cross-sectional study. SETTING AND PARTICIPANTS A total of 499 patients aged ≥ 60 on hemodialysis from seven facilities in Shanghai of China from 2020 to 2021. MEASUREMENTS Muscle mass was assessed by skeletal muscle index(SMI). Muscle strength was measured by handgrip strength, and physical performance was measured via gait speed and Timed Up and Go Test (TUGT). Nutritional status was assessed by Malnutrition Inflammation Score (MIS). Depressive symptoms were evaluated by the Patient Health Questionnaire-9 (PHQ-9). Logistic regression and mediation analyses fully adjusted for all potential confounding factors. RESULTS Among 499 participants (312 men, mean age 69.2±6.6 years), 108 (21.6%) had depressive symptoms. The muscle strength, physical performance and malnutrition were associated with depressive symptoms. Furthermore, malnutrition significantly mediated the association of muscle function with total, cognitive-affective symptoms. The association of the muscle function with somatic symptoms were mediated by the nutritional status. The mediated proportions of malnutrition in the relationship between physical performance and depressive symptoms clusters were stronger in somatic symptoms than in cognitive-affective symptoms. CONCLUSIONS Our findings suggest that muscle function rather than muscle mass may contribute substantially to the development of depressive symptoms clusters in the hemodialysis via malnutrition. The malnutrition mediated stronger in the association of muscle function with somatic symptoms. These findings may help guide clinicians to better diagnose and manage depression in the context of concomitant muscle function and malnutrition.
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Affiliation(s)
- X Chen
- Qi Guo, M.D., Ph.D. Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Pudong New District, Shanghai, 201318, China, Phone: 86-22-8333-6977, Fax: 86-22-8333-6977, E-mail:
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Alzayer H, Geraghty AM, Sebastian KK, Panesar H, Reddan DN. Dialysis Patients’ Preferences on Resuscitation: A Cross-Sectional Study Design. Can J Kidney Health Dis 2022; 9:20543581221113383. [PMID: 35923181 PMCID: PMC9340425 DOI: 10.1177/20543581221113383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background: End-stage kidney disease is associated with a 10- to 100-fold increase in
cardiovascular mortality compared with age-, sex-, and race-matched
population. Cardiopulmonary resuscitation (CPR) in this cohort has poor
outcomes and leads to increased functional morbidity. Objective: The aim of this study is to assess patients’ preferences toward CPR and
advance care planning (ACP). Design: cross-sectional study design. Setting: Two outpatient dialysis units. Patients: Adults undergoing dialysis for more than 3 months were included. Exclusion
criteria were severe cognitive impairment or non-English-speaking
patients. Measurements: A structured interview with the use of Willingness to Accept Life-Sustaining
Treatment (WALT) tool. Methods: Demographic data were collected, and baseline Montreal Cognitive Assessment,
Patient Health Questionnaire–9, Duke Activity Status Index, Charlson
comorbidity index, and WALT instruments were used. Descriptive analysis,
chi-square, and t test were performed along with
probability plot for testing hypotheses. Results: Seventy participants were included in this analysis representing a 62.5%
response rate. There was a clear association between treatment burden,
anticipated clinical outcome, and the likelihood of that outcome with
patient preferences. Low-burden treatment with expected return to baseline
was associated with 98.5% willingness to accept treatment, whereas
high-burden treatment with expected return to baseline was associated with
94.2% willingness. When the outcome was severe functional or cognitive
impairment, then 45.7% and 28.5% would accept low-burden treatment,
respectively. The response changed based on the likelihood of the outcome.
In terms of resuscitation, more than 75% of the participants would be in
favor of receiving CPR and mechanical ventilation at their current health
state. Over 94% of patients stated they had never discussed ACP, whereas
59.4% expressed their wish to discuss this with their primary
nephrologist. Limitations: Limited generalizability due to lack of diversity. Unclear decision stability
due to changes in health status and patients’ priorities. Conclusions: ACP should be incorporated in managing chronic kidney disease (CKD) to
improve communication and encourage patient involvement.
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Affiliation(s)
- Husam Alzayer
- Department of Nephrology, University Hospital Galway, Ireland
- Royal College of Surgeons in Ireland, Dublin
| | | | - Kuruvilla K. Sebastian
- Department of Renal Medicine, Cork University Hospital, Ireland
- Department of Medicine, National University of Ireland, Galway
- Royal College of Physicians of Ireland, Dublin
| | - Hardarsh Panesar
- Department of Renal Medicine, Cork University Hospital, Ireland
- Western University, London, ON, Canada
| | - Donal N. Reddan
- Department of Nephrology, University Hospital Galway, Ireland
- Royal College of Physicians of Ireland, Dublin
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Intradialytic nutrition and quality of life in Chilean older patients in hemodialysis with protein-energy wasting. Int Urol Nephrol 2021; 54:1947-1955. [PMID: 34860339 PMCID: PMC9262769 DOI: 10.1007/s11255-021-03077-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 11/22/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE The study assessed the impact of intradialytic oral nutritional supplementation on the quality of life in patients receiving hemodialysis and diagnosed with protein energy wasting. METHODS A pre-test post-test quasi-experimental study was conducted before and after 3 months of intradialytic oral nutritional supplementation on 109 older hemodialysis patients. We measured before and after 3 months of intradialytic oral nutritional supplementation, the quality of life score, the burden of kidney disease, three quality of life scales and the mental and physical health status using KDQoL-SF™ 1.3, body composition and biochemical parameters of nutritional condition. RESULTS The mean age of the patients was 69.4 ± 3.4 years, 59% were male, and the time on dialysis was 63.5 ± 52.6 months. Comparing the baseline with month 3 of intradialytic oral nutritional supplementation, we observed to better quality of life. In contrast to malnutrition, score, specifically increased significantly score of symptoms/problems list related to hemodialysis, sexual function, social and cognitive function, sleep, pain, energy/fatigue and general state of health. Significant changes were also found in nutritional status, energy intake and body composition indicators. After 3 months of intradialytic oral nutritional supplementation, we observed a nutritional status recovery in one or more indicators in 92% of the patients. CONCLUSION Our findings indicate that 3 months of intradialysis oral nutritional supplementation improves the components of physical and mental quality of life and nutritional status in older patients receiving hemodialysis diagnosed with loss of protein energy. These results are relevant to improve the experience of patients with protein energy loss receiving hemodialysis.
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Crowe K, Quinn TJ, Mark PB, Findlay MD. "Is It Removed During Dialysis?"-Cognitive Dysfunction in Advanced Kidney Failure-A Review Article. Front Neurol 2021; 12:787370. [PMID: 34925220 PMCID: PMC8674209 DOI: 10.3389/fneur.2021.787370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/08/2021] [Indexed: 12/02/2022] Open
Abstract
Cognitive impairment is independently associated with kidney disease and increases in prevalence with declining kidney function. At the stage where kidney replacement therapy is required, with dialysis or transplantation, cognitive impairment is up to three times more common, and can present at a younger age. This is not a new phenomenon. The cognitive interactions of kidney disease are long recognized from historical accounts of uremic encephalopathy and so-called "dialysis dementia" to the more recent recognition of cognitive impairment in those undergoing kidney replacement therapy (KRT). The understanding of cognitive impairment as an extra-renal complication of kidney failure and effect of its treatments is a rapidly developing area of renal medicine. Multiple proposed mechanisms contribute to this burden. Advanced vascular aging, significant multi-morbidity, mood disorders, and sleep dysregulation are common in addition to the disease-specific effects of uremic toxins, chronic inflammation, and the effect of dialysis itself. The impact of cognitive impairment on people living with kidney disease is vast ranging from increased hospitalization and mortality to decreased quality of life and altered decision making. Assessment of cognition in patients attending for renal care could have benefits. However, in the context of a busy clinical service, a pragmatic approach to assessing cognitive function is necessary and requires consideration of the purpose of testing and resources available. Limited evidence exists to support treatments to mitigate the degree of cognitive impairment observed, but promising interventions include physical or cognitive exercise, alteration to the dialysis treatment and kidney transplantation. In this review we present the history of cognitive impairment in those with kidney failure, and the current understanding of the mechanisms, effects, and implications of impaired cognition. We provide a practical approach to clinical assessment and discuss evidence-supported treatments and future directions in this ever-expanding area which is pivotal to our patients' quality and quantity of life.
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Affiliation(s)
- Kirsty Crowe
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Terence J. Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Patrick B. Mark
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Mark D. Findlay
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom
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Diffusion Tensor Imaging Features of Watershed Segmentation Algorithm for Analysis of the Relationship between Depression and Brain Nerve Function of Patients with End-Stage Renal Disease. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7036863. [PMID: 34733456 PMCID: PMC8560248 DOI: 10.1155/2021/7036863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/26/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
The aim of this research was to explore the relationship between depression and brain nerve function in patients with end-stage renal disease (ESRD) and long-term maintenance hemodialysis (MHD) based on watershed segmentation algorithm using diffusion tensor imaging (DTI) technology. A total of 29 ESRD patients with depression who received MHD treatment in the hemodialysis center of hospital were included as the research subjects (case group). A total of 29 healthy volunteers were recruited as the control group, and a total of 29 ESRD patients with depression and brain lesions were recruited as the control group (HC group). Within 24 h after hemodialysis, the blood biochemical indexes were collected before this DTI examination. All participants completed the neuropsychological scale (MoCA, TMT A, DST, SAS, and SDS) test. The original DTI data of all subjects were collected and processed based on watershed segmentation algorithm, and the results of automatic segmentation according to the image were evaluated as DSC = 0.9446, MPA = 0.9352, and IOU = 0.8911. Finally, the average value of imaging brain neuropathy in patients with depression in the department of nephrology was obtained. The differences in neuropsychological scale scores (PSQI, MoCA, TMTA, DST, SAS, and SDS) between the two groups were statistically significant (P < 0.05). The differences of FA values in all the white matter partitions of Fu organs, except the cingulum of hippocampus (CgH) between the two groups, were statistically significant (P < 0.05). ESRD and DTI quantitative detection under the guidance of watershed segmentation algorithm in MHD patients showed that ESRD patients can be early identified, so as to carry out psychological nursing as soon as possible to reduce the occurrence of depression, and then protect the brain nerve to reduce brain neuropathy.
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Abstract
PURPOSE OF REVIEW The aim of this study was to examine updated prevalence rates, risk factors and the prognosis, diagnosis and treatments for depression among dialysis patients. RECENT FINDINGS Depression influences prognosis, complications, quality of life (QOL), treatment and costs for dialysis patients worldwide. Reported prevalence of depression is 13.1-76.3%; it is higher for dialysis than transplant and higher post than predialysis. Reported depression rates with peritoneal dialysis (PD) compared with in-centre haemodialysis (HD) are inconsistent. Related medical factors are known, but suspected associated patient characteristics including gender and race remain unexplored. Associations between depression in dialysis and QOL, mortality, pathophysiological mechanisms of increased mortality, infection and pathways of inflammation-mediated and psychosocial factors require clarification. Several depression screening instruments are validated for dialysis patients - the Structured Clinical Interview for DSM disorders (SCID) remains the gold standard - but authors suggest the diagnostic standard should be higher than for the general population. Short-term studies indicate nonpharmacological therapy achieves clinical effects for depression in dialysis patients, but research on long-term effects is needed. SUMMARY Depression management through early screening and continuous care models emphasizing dynamic relationships between healthcare teams, patients and families should be encouraged. Large-scale studies of short-term and long-term benefits of pharmacological and nonpharmacological depression management are warranted.
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Affiliation(s)
- Na Tian
- Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia
| | - Na Chen
- Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia
| | - Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol and Richard Yu Peritoneal Dialysis Research Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
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Shirai N, Yamamoto S, Osawa Y, Tsubaki A, Morishita S, Igarashi K, Narita I. Comparison of muscle strength between hemodialysis patients and non-dialysis patients with chronic kidney disease. J Phys Ther Sci 2021; 33:742-747. [PMID: 34658517 PMCID: PMC8516613 DOI: 10.1589/jpts.33.742] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/26/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Muscle weakness in patients with chronic kidney disease is
associated with several disease-related factors, and this study aimed to examine whether
hemodialysis is one of risk factors for muscle weakness in patients with chronic kidney
disease. [Participants and Methods] We conducted a cross-sectional study with 74
non-dialysis and 84 hemodialysis patients. Muscle strength evaluations were performed by
measuring isometric knee extensor muscle strength and grip strength. Each evaluation item
was compared between the hemodialysis and non-dialysis groups, and multiple regression
analysis was performed to determine the factors associated with muscle strength. In
addition, the correlation between lower-extremity muscle strength and grip strength was
examined in each group. [Results] Isometric knee extensor muscle strength was
significantly lower in the hemodialysis group than in the non-dialysis group. Grip
strength was also significantly lower in the hemodialysis group than in the non-dialysis
group. Hemodialysis was determined to be an independent risk factor associated with lower
limb muscle strength as well as grip strength. The positive correlation between isometric
knee extensor muscle strength and grip strength was almost the same in the groups.
[Conclusion] Hemodialysis treatment was an independent risk factor for muscle weakness.
Regular monitoring of grip strength may facilitate better management with physical therapy
in hemodialysis patients.
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Affiliation(s)
- Nobuyuki Shirai
- Department of Rehabilitation, Niigata Rinko Hospital, Japan.,Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences: 1-757 Asahimachi-dori, Niigata, Niigata 951-8510, Japan
| | - Suguru Yamamoto
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences: 1-757 Asahimachi-dori, Niigata, Niigata 951-8510, Japan
| | - Yutaka Osawa
- Internal Medicine, Niigata Rinko Hospital, Japan
| | - Atsuhiro Tsubaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Science, Fukushima Medical University, Japan
| | | | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences: 1-757 Asahimachi-dori, Niigata, Niigata 951-8510, Japan
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Cho OH, Cho YH, Chung MY. Burden, Depression, and Awareness of Information on Safety Behavior in Korean Hemodialysis Patients during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910348. [PMID: 34639648 PMCID: PMC8507864 DOI: 10.3390/ijerph181910348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/17/2021] [Accepted: 09/27/2021] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to investigate the relationships among burden, depression, awareness of information (AIC), and safety behavior among hemodialysis patients in Korea during the COVID-19 pandemic. The study participants included 149 patients who received hemodialysis at seven general hospitals in Korea between January and February 2021. A structured questionnaire was used to survey their levels of burden, depression, AIC, adherent safety behavior (ASB), and dysfunctional safety behavior (DSB). The study results showed that the influencing factors of ASB for COVID-19 were AIC (β = 0.265, p < 0.001), the burden of “not receiving hemodialysis on time” (β = 0.233, p = 0.008), and the burden of “social exclusion of hemodialysis patients” (β = 0.186, p = 0.032). The influencing factors of DSB were the burden of “social exclusion of hemodialysis patients” (β = 0.258, p = 0.003) and AIC (β = 0.217, p = 0.004). As the COVID-19 pandemic continues, the latest evidence-based information must be provided to hemodialysis patients to promote self-care and prevention behavior that encourages ASB and discourages DSB.
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Affiliation(s)
- Ok-Hee Cho
- Department of Nursing, College of Nursing and Health, Kongju National University, 56 Gongjudeahak-ro, Gongju-si 32588, Chungcheongnam-do, Korea;
| | - Yun-Hee Cho
- Department of Nursing, Daejeon Sun Hospital, 29 Mokjung-ro, Jung-gu, Daejeon 34811, Korea;
| | - Mi-Young Chung
- Department of Nursing Science, Sunmoon University, 70 Sunmoon-ro 221beon-gil, Tangjeong-myeon, Asan-si 31460, Chungcheongnam-do, Korea
- Correspondence: ; Tel.: +82-41-530-2752; Fax: +82-41-530-2725
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Use of Sertraline in Hemodialysis Patients. MEDICINA-LITHUANIA 2021; 57:medicina57090949. [PMID: 34577872 PMCID: PMC8470022 DOI: 10.3390/medicina57090949] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/29/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022]
Abstract
Depression and anxiety are the most common psychiatric disorders in end-stage renal disease (ESRD) patients treated with hemodialysis (HD) and may correlate with lower quality of life and increased mortality. Depression treatment in HD patients is still a challenge both for nephrologists and psychiatrists. The possible treatment of depressive disorders can be pharmacological and non-pharmacological. In our article, we focus on the use of sertraline, the medication which seems to be relatively safe and efficient in the abovementioned population, taking under consideration several limitations regarding the use of other selective serotonin reuptake inhibitors (SSRIs). In our paper, we discuss different aspects of sertraline use, taking into consideration possible benefits and side effects of drug administration like impact on QTc (corrected QT interval) prolongation, intradialytic hypotension (IDH), chronic kidney disease-associated pruritus (CKD-aP), bleeding, sexual functions, inflammation, or fracture risk. Before administering the medication, one should consider benefits and possible side effects, which are particularly significant in the treatment of ESRD patients; this could help to optimize clinical outcomes. Sertraline seems to be safe in the HD population when provided in proper doses. However, we still need more studies in this field since the ones performed so far were usually based on small samples and lacked placebo control.
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46
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Jain G, Weiner DE. Value-Based Care in Nephrology: The Kidney Care Choices Model and Other Reforms. KIDNEY360 2021; 2:1677-1683. [PMID: 35372980 PMCID: PMC8785791 DOI: 10.34067/kid.0004552021] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/13/2021] [Indexed: 02/04/2023]
Abstract
The Advancing American Kidney Health (AAKH) initiative has reinvigorated the focus on improving the care of patients with advanced CKD. Multiple interventions have been planned, focusing on education campaigns for both clinicians and patients, delaying the progression of kidney disease and improving utilization of home dialysis modalities and kidney transplantation. Value-based care models for patients with advanced kidney disease are being rolled out, with the ESKD treatment choices model starting in January 2021, and the Kidney Care Choices model planned to start in January 2022. There is increasing emphasis on the role of the nephrologist as the "captain of the ship," leading efforts in care coordination as physician leaders. The transplant reforms have focused on changes to organ procurement organizations aiming to increase availability of organs, and transplants performed, both deceased and living donor, and removing financial disincentives from live organ donation. The American Society of Nephrology (ASN) and the National Kidney Foundation (NKF) are partnering with the Department of Health and Human Services to develop educational material for clinicians and patients. In this review, we discuss these reforms, potential challenges that have arisen, and potential solutions, with emphasis on the Kidney Care Choices model.
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Affiliation(s)
- Gaurav Jain
- Division of Nephrology, Department of Medicine, University of Alabama in Birmingham, Birmingham, Alabama
| | - Daniel E. Weiner
- Department of Nephrology, Tufts Medical Center, Boston, Massachusetts
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Novais T, Pongan E, Gervais F, Coste MH, Morelon E, Krolak-Salmon P, Vernaudon J. Pretransplant Comprehensive Geriatric Assessment in Older Patients with Advanced Chronic Kidney Disease. Nephron Clin Pract 2021; 145:692-701. [PMID: 34261074 DOI: 10.1159/000517342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/13/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In older patients with advanced chronic kidney disease (CKD), the decision of kidney transplantation (KT) is a challenge for nephrologists. The use of comprehensive geriatric assessment (CGA) is increasingly gaining interest into the process of decision-making about treatment modality choice for CKD. The aim of this study was to assess the prevalence of geriatric impairment and frailty in older dialysis and nondialysis patients with advanced CKD using a pretransplant CGA model and to identify geriatric impairments influencing the geriatricians' recommendations for KT. METHODS An observational study was conducted with retrospective data from July 2017 to January 2020. Patients aged ≥65 years with advanced CKD, treated or not with dialysis, and referred by the nephrologist were included in the study. The CGA assessed comorbidity burden, cognition, mood, nutritional status, (instrumental) activities of daily living, physical function, frailty, and polypharmacy. Geriatric impairments influencing the geriatricians' recommendations for KT were identified using univariate and multivariate logistic regressions. RESULTS 156 patients were included (74.2 ± 3.5 years and 62.2% on dialysis). Geriatric conditions were highly prevalent in both dialysis and nondialysis groups. The rate of geriatric impairments was higher in dialysis patients regarding comorbidity burden, symptoms of depression, physical function, autonomy, and frailty. Geriatrician's recommendations for KT were as follows: favorable (79.5%) versus not favorable or multidisciplinary discussion needed with nephrologists (20.5%). Dependence for Instrumental Activities of Daily Living (IADL) (odds ratio [OR] = 3.01 and 95% confidence interval [CI] = 1.30-7.31), physical functions (OR = 2.91 and 95% CI = 1.08-7.87), and frailty (OR = 2.66 and 95% CI = 1.07-6.65) were found to be independent geriatric impairments influencing geriatrician's recommendations for KT. CONCLUSIONS Understanding the burden of geriatric impairment provides an opportunity to direct KT decision-making and to guide interventions to prevent functional decline and preserve quality of life.
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Affiliation(s)
- Teddy Novais
- Pharmaceutical Unit, Lyon Institute for Elderly, Charpennes Hospital, University Hospital of Lyon, Lyon, France.,EA-7425 HESPER, Health Services and Performance Research, University Lyon, Lyon, France.,Claude Bernard Lyon 1 University, University Lyon 1, Lyon, France
| | - Elodie Pongan
- Day-Care Unit, Lyon Institute for Elderly, Charpennes Hospital, University Hospital of Lyon, Lyon, France
| | - Frederic Gervais
- Pharmaceutical Unit, Lyon Institute for Elderly, Charpennes Hospital, University Hospital of Lyon, Lyon, France
| | - Marie-Hélène Coste
- Day-Care Unit, Lyon Institute for Elderly, Charpennes Hospital, University Hospital of Lyon, Lyon, France.,Clinical and Research Memory Centre of Lyon, Lyon Institute for Elderly, Charpennes Hospital, University Hospital of Lyon, Lyon, France
| | - Emmanuel Morelon
- Nephrology, Transplantation and Clinical Immunology Department, RTRS « Centaure », Edouard Herriot Hospital, University Hospital of Lyon, Lyon, France
| | - Pierre Krolak-Salmon
- Day-Care Unit, Lyon Institute for Elderly, Charpennes Hospital, University Hospital of Lyon, Lyon, France.,Clinical and Research Memory Centre of Lyon, Lyon Institute for Elderly, Charpennes Hospital, University Hospital of Lyon, Lyon, France.,INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Brain Dynamics and Cognition Team, Lyon, France
| | - Julien Vernaudon
- Day-Care Unit, Lyon Institute for Elderly, Charpennes Hospital, University Hospital of Lyon, Lyon, France.,Clinical and Research Memory Centre of Lyon, Lyon Institute for Elderly, Charpennes Hospital, University Hospital of Lyon, Lyon, France
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Guerra F, Ranieri J, Passafiume D, Lupi D, Maccarone D, Pisani F, Ferri C, Di Giacomo D. Psychosomatic interactions in kidney transplantation: role of personality dimensions in mental health-related quality of life. Ther Adv Chronic Dis 2021; 12:20406223211024359. [PMID: 34290848 PMCID: PMC8274123 DOI: 10.1177/20406223211024359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background and aims: The increase in innovative and personalized medicine solutions in kidney surgery can improve patients’ chances of survival; however, during the transplantation process, patients are exposed to many psychological challenges. This study aimed to evaluate the role and impact of personality dimensions on the behaviour of waiting-list patients towards the post-surgery adaptation process. Method: The participants were 113 out-patients aged 18–70 years (mean age 54.7 years, SD ± 9.9) who had received a kidney transplant at least 3 years prior to the study. Results: The results of the study revealed that personality dimensions can predict mental health-related quality of life after kidney transplantation; in particular, the dimensions play an important role in patients’ behavioural ability to manage their quality of life both during end-stage renal disease and after kidney transplantation. Psychological distress and anxiety were associated with a low level of the conscientiousness dimension, while a high level of the openness dimension was associated with a high level of psychological distress and stress. In addition, body self-perception was associated with personality dimensions. Conclusion: Personality dimensions were found to predict behavioural reactions when emotional traits and body self-perception for each patient were combined; clinical psychologists could apply personalized intervention by modeling the treatments step by step and mitigating the negative effects of the whole kidney transplantation disease, thus helping the individual to adapt to a new life.
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Affiliation(s)
- Federica Guerra
- MESVA Department, University of L'Aquila, L'Aquila, Abruzzo, Italy
| | - Jessica Ranieri
- MESVA Department, University of L'Aquila, L'Aquila, Abruzzo, Italy
| | | | - Diana Lupi
- Regional Centre for Transplantation (Abruzzo-Molise), L'Aquila, Italy
| | - Daniela Maccarone
- Regional Centre for Transplantation (Abruzzo-Molise), L'Aquila, Italy
| | - Francesco Pisani
- ASL AQ Abruzzo, S. Salvatore Hospital, L'Aquila, Italy DISCAB Department, University of L'Aquila, Italy
| | - Claudio Ferri
- MESVA Department, University of L'Aquila, L'Aquila, Abruzzo, Italy S. Salvatore Hospital, ASL AQ Abruzzo, L'Aquila, Italy
| | - Dina Di Giacomo
- MESVA Department, University of L'Aquila, L'Aquila, Abruzzo, Italy
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49
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Feasibility of an Intradialytic Combined Exercise Program Targeting Older Adults With End-Stage Renal Disease. J Aging Phys Act 2021; 29:905-914. [PMID: 34111843 DOI: 10.1123/japa.2020-0359] [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: 09/08/2020] [Revised: 11/10/2020] [Accepted: 12/01/2020] [Indexed: 11/18/2022]
Abstract
Intradialytic exercise is feasible and yields substantial clinical benefits in middle-aged patients. However, evidence is scarce in older hemodialysis patients. OBJECTIVE To assess the feasibility and clinical benefits of supervised, intradialytic exercise in older patients. METHODS Multicenter one-arm feasibility study. The main outcome was feasibility (ease of recruitment, dropout rate, adherence, affective valence, and adverse events). The secondary outcomes were physical capacity (five-repetition sit-to-stand, 60-s sit-to-stand tests, and grip strength), quality of life (36-Item Short-Form Health Survey), quality of sleep (Pittsburgh Sleep Quality Index), depressive symptoms (Beck Depression Inventory), and dialysis efficacy (Kt/V and urea reduction ratio). RESULTS About 79% of the screened patients agreed to participate (n = 25, 73 [66-77] years). The dropout rate was high (32%), but adherence remained high among the participants who completed the study (94%). Improvements were found in the five-repetition sit-to-stand (p < .001), 60-s sit-to-stand tests (p = .028), 36-Item Short-Form Health Survey mental component score (p = .008), depressive symptoms (p = .006), and quality of sleep (p = .035). CONCLUSION Supervised intradialytic exercise seems safe and beneficial in older patients.
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50
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Chen J, Liu L, Chen J, Ng MSN, Lou VWQ, Wu B, Jiang W, Jie Y, Zhu J, He Y. The cross-lagged association between depressive symptoms and health-related quality of life in patients receiving maintenance hemodialysis: a three-wave longitudinal study. Qual Life Res 2021; 30:3463-3473. [PMID: 33977414 DOI: 10.1007/s11136-021-02866-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To examine the cross-lagged relationship between depressive symptoms and health-related quality of life (HRQoL) in patients receiving maintenance hemodialysis. METHODS A longitudinal, observational study was conducted in two public hospitals in Shanghai, China. The sample consisted of 204 patients at baseline (T1). Of these, 144 completed the 12-month follow-up survey (T2), and 135 completed the 24-month follow-up survey (T3). Depressive symptoms were assessed using the depression subscale of the Hospital Anxiety and Depression Scale, and HRQoL was assessed using the Kidney Disease Quality of Life 36 short form. Cross-lagged path analysis was used to examine the temporal relationship between depressive symptoms and domains of health-related quality of life. RESULTS Lower levels of three out of five domains of HRQoL (physical functioning, burden of kidney disease, and symptoms of kidney disease) at T1 were associated with increases in depressive symptoms at T2. Moreover, higher depressive symptoms at T2 were associated with decreases in four domains of HRQoL (mental functioning, burden of kidney disease, symptoms of kidney disease, and effects of kidney disease) at T3. CONCLUSIONS Patients who had poor HRQoL were more likely to report more subsequent depressive symptoms, which in turn predict lower HRQoL over time. It indicates a need to break this cycle in patients receiving maintenance hemodialysis.
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Affiliation(s)
- Jieling Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lingling Liu
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Marques S N Ng
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Bibo Wu
- Department of Nephrology, Zha Bei District Center Hospital of Shanghai, Shanghai, China
| | - Weijie Jiang
- Department of Nephrology, Shanghai Shi Bei Hospital, Shanghai, China
| | - Yanqing Jie
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200025, China
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200025, China.
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