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Pereira-Céspedes A, Jiménez-Morales A, Polo-Moyano A, Spruce-Esparza E, Palomares-Bayo M, Martínez-Martínez F, Calleja-Hernández MÁ. Health-Related Quality of Life and Associated Factors in Patients Undergoing Kidney Replacement Therapies. FARMACIA HOSPITALARIA 2024:S1130-6343(24)00143-0. [PMID: 39294036 DOI: 10.1016/j.farma.2024.08.008] [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: 05/06/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 09/20/2024] Open
Abstract
OBJECTIVE Characterize the health-related quality of life among patients undergoing kidney replacement therapy and to explore associated factors. METHOD A descriptive observational study was conducted using the Kidney Disease Quality of Life Short Form questionnaire to assess health-related quality of life. The Dader Method was employed to evaluate negative outcomes associated with medications. Face-to-face interviews and clinical records were utilized to collect sociodemographic and clinical data from patients undergoing kidney replacement therapy at the Nephrology Department of Virgen de las Nieves University Hospital (Granada, Spain). We explored the association between independent variables (clinical and demographic factors) and dependent variables (Mental Component Score and Physical Component Score) using the linear regression method. RESULTS Ninety-one participants were included, 47 (48.35%) were females. The mean age was 62 years, 52 patients (57.14%) were on hemodialysis, 13 patients (14.29%) on peritoneal dialysis, and 26 patients (28.57%) on other forms of kidney replacement therapy. The study revealed a mean Physical Component Score of 40.89 and a Mental Component Score of 47.19. Additionally, 98.90% of the patients experienced negative outcomes associated with medications. Influential factors include age, comorbid conditions, the number of medications, and clinical parameters such as vitamin D and calcium levels. CONCLUSIONS This study underscores significant findings in patients undergoing kidney replacement therapy, indicating low Mental Component Score and Physical Component Score, accompanied by negative outcomes associated with medications.
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Affiliation(s)
- Alfonso Pereira-Céspedes
- Pharmaceutical Care Research Group, Pharmacy Faculty, University of Granada, 18071 Granada, Spain; Pharmacy Department, Hospital Universitario Virgen de las Nieves, 18014, Granada, Spain; Centro Nacional de Información de Medicamentos, Instituto de Investigaciones Farmacéuticas, Pharmacy Faculty, University of Costa Rica, 11501-2060, San José, Costa Rica.
| | - Alberto Jiménez-Morales
- Pharmaceutical Care Research Group, Pharmacy Faculty, University of Granada, 18071 Granada, Spain; Pharmacy Department, Hospital Universitario Virgen de las Nieves, 18014, Granada, Spain
| | - Aurora Polo-Moyano
- Nephrology Department, Hospital Universitario Virgen de las Nieves, 18014, Granada, Spain
| | | | | | | | - Miguel Ángel Calleja-Hernández
- Pharmaceutical Care Research Group, Pharmacy Faculty, University of Granada, 18071 Granada, Spain; Pharmacy Department, Hospital Universitario Virgen Macarena, 41009, Seville, Spain
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Chung YK, Lim JH, Jeon YN, Jeon YH, Jung HY, Choi JY, Park SH, Kim CD, Kim YL, Cho JH. The impact of quality of life on the survival of elderly patients with end-stage renal disease: a prospective multicenter cohort study in Korea. Clin Kidney J 2024; 17:sfae241. [PMID: 39228997 PMCID: PMC11367168 DOI: 10.1093/ckj/sfae241] [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: 12/14/2023] [Indexed: 09/05/2024] Open
Abstract
Background Quality of life (QOL) is associated with mortality in dialysis patients. However, the impact of QOL index or score on elderly patients undergoing maintenance dialysis is unclear. We analyzed the relationship between QOL domains and survival in elderly end-stage renal disease (ESRD) patients on dialysis. Methods We included 492 incident ESRD patients aged ≥65 years from a Korean nationwide prospective cohort study who were assessed for QOL with a follow-up duration of 67.3 ± 34.6 months after dialysis initiation. Their QOL was evaluated using the Kidney Disease Quality of Life (KDQOL) instrument, and the effect of each QOL domain on mortality was analyzed. Multivariable Cox regression analysis was performed to identify independent risk factors for death after adjusting for confounding factors. Results Low physical component summary (PCS) and Short Form-36 score were significantly associated with low survival rate (P < .001 and P = .017, respectively), whereas the mental component summary and ESRD-targeted item scores were not correlated with survival rate. Multivariable Cox regression analysis confirmed that only a high PCS score was associated with better survival (hazard ratio 0.71; 95% confidence interval 0.52-0.97; P = .031). Linear regression analysis revealed that age, sex, modified Charlson comorbidity index, albumin and intact parathyroid hormone were associated with PCS. Among the PCS items, only the physical functioning score was significantly associated with mortality (P = .017). Conclusion PCS was an independent risk factor for death in elderly ESRD patients. A higher physical functioning score was associated with a better outcome, suggesting the importance of physical condition in elderly dialysis patients.
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Affiliation(s)
- Yu-Kyung Chung
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
- Clinical Research Center for End-Stage Renal Disease, South Korea
| | - Jeong-Hoon Lim
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
- Clinical Research Center for End-Stage Renal Disease, South Korea
| | - Ye-na Jeon
- Clinical Research Center for End-Stage Renal Disease, South Korea
- Department of Epidemiology & Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - You Hyun Jeon
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
- Clinical Research Center for End-Stage Renal Disease, South Korea
| | - Hee-Yeon Jung
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Ji-Young Choi
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Sun-Hee Park
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Chan-Duck Kim
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Yong-Lim Kim
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
| | - Jang-Hee Cho
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea
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Ethier I, Hayat A, Pei J, Hawley CM, Johnson DW, Francis RS, Wong G, Craig JC, Viecelli AK, Htay H, Ng S, Leibowitz S, Cho Y. Peritoneal dialysis versus haemodialysis for people commencing dialysis. Cochrane Database Syst Rev 2024; 6:CD013800. [PMID: 38899545 PMCID: PMC11187793 DOI: 10.1002/14651858.cd013800.pub2] [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] [Indexed: 06/21/2024]
Abstract
BACKGROUND Peritoneal dialysis (PD) and haemodialysis (HD) are two possible modalities for people with kidney failure commencing dialysis. Only a few randomised controlled trials (RCTs) have evaluated PD versus HD. The benefits and harms of the two modalities remain uncertain. This review includes both RCTs and non-randomised studies of interventions (NRSIs). OBJECTIVES To evaluate the benefits and harms of PD, compared to HD, in people with kidney failure initiating dialysis. SEARCH METHODS We searched the Cochrane Kidney and Transplant Register of Studies from 2000 to June 2024 using search terms relevant to this review. Studies in the Register were identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal, and ClinicalTrials.gov. MEDLINE and EMBASE were searched for NRSIs from 2000 until 28 March 2023. SELECTION CRITERIA RCTs and NRSIs evaluating PD compared to HD in people initiating dialysis were eligible. DATA COLLECTION AND ANALYSIS Two investigators independently assessed if the studies were eligible and then extracted data. Risk of bias was assessed using standard Cochrane methods, and relevant outcomes were extracted for each report. The primary outcome was residual kidney function (RKF). Secondary outcomes included all-cause, cardiovascular and infection-related death, infection, cardiovascular disease, hospitalisation, technique survival, life participation and fatigue. MAIN RESULTS A total of 153 reports of 84 studies (2 RCTs, 82 NRSIs) were included. Studies varied widely in design (small single-centre studies to international registry analyses) and in the included populations (broad inclusion criteria versus restricted to more specific participants). Additionally, treatment delivery (e.g. automated versus continuous ambulatory PD, HD with catheter versus arteriovenous fistula or graft, in-centre versus home HD) and duration of follow-up varied widely. The two included RCTs were deemed to be at high risk of bias in terms of blinding participants and personnel and blinding outcome assessment for outcomes pertaining to quality of life. However, most other criteria were assessed as low risk of bias for both studies. Although the risk of bias (Newcastle-Ottawa Scale) was generally low for most NRSIs, studies were at risk of selection bias and residual confounding due to the constraints of the observational study design. In children, there may be little or no difference between HD and PD on all-cause death (6 studies, 5752 participants: RR 0.81, 95% CI 0.62 to 1.07; I2 = 28%; low certainty) and cardiovascular death (3 studies, 7073 participants: RR 1.23, 95% CI 0.58 to 2.59; I2 = 29%; low certainty), and was unclear for infection-related death (4 studies, 7451 participants: RR 0.98, 95% CI 0.39 to 2.46; I2 = 56%; very low certainty). In adults, compared with HD, PD had an uncertain effect on RKF (mL/min/1.73 m2) at six months (2 studies, 146 participants: MD 0.90, 95% CI 0.23 to 3.60; I2 = 82%; very low certainty), 12 months (3 studies, 606 participants: MD 1.21, 95% CI -0.01 to 2.43; I2 = 81%; very low certainty) and 24 months (3 studies, 334 participants: MD 0.71, 95% CI -0.02 to 1.48; I2 = 72%; very low certainty). PD had uncertain effects on residual urine volume at 12 months (3 studies, 253 participants: MD 344.10 mL/day, 95% CI 168.70 to 519.49; I2 = 69%; very low certainty). PD may reduce the risk of RKF loss (3 studies, 2834 participants: RR 0.55, 95% CI 0.44 to 0.68; I2 = 17%; low certainty). Compared with HD, PD had uncertain effects on all-cause death (42 studies, 700,093 participants: RR 0.87, 95% CI 0.77 to 0.98; I2 = 99%; very low certainty). In an analysis restricted to RCTs, PD may reduce the risk of all-cause death (2 studies, 1120 participants: RR 0.53, 95% CI 0.32 to 0.86; I2 = 0%; moderate certainty). PD had uncertain effects on both cardiovascular (21 studies, 68,492 participants: RR 0.96, 95% CI 0.78 to 1.19; I2 = 92%) and infection-related death (17 studies, 116,333 participants: RR 0.90, 95% CI 0.57 to 1.42; I2 = 98%) (both very low certainty). Compared with HD, PD had uncertain effects on the number of patients experiencing bacteraemia/bloodstream infection (2 studies, 2582 participants: RR 0.34, 95% CI 0.10 to 1.18; I2 = 68%) and the number of patients experiencing infection episodes (3 studies, 277 participants: RR 1.23, 95% CI 0.93 to 1.62; I2 = 20%) (both very low certainty). PD may reduce the number of bacteraemia/bloodstream infection episodes (2 studies, 2637 participants: RR 0.44, 95% CI 0.27 to 0.71; I2 = 24%; low certainty). Compared with HD; It is uncertain whether PD reduces the risk of acute myocardial infarction (4 studies, 110,850 participants: RR 0.90, 95% CI 0.74 to 1.10; I2 = 55%), coronary artery disease (3 studies, 5826 participants: RR 0.95, 95% CI 0.46 to 1.97; I2 = 62%); ischaemic heart disease (2 studies, 58,374 participants: RR 0.86, 95% CI 0.57 to 1.28; I2 = 95%), congestive heart failure (3 studies, 49,511 participants: RR 1.10, 95% CI 0.54 to 2.21; I2 = 89%) and stroke (4 studies, 102,542 participants: RR 0.94, 95% CI 0.90 to 0.99; I2 = 0%) because of low to very low certainty evidence. Compared with HD, PD had uncertain effects on the number of patients experiencing hospitalisation (4 studies, 3282 participants: RR 0.90, 95% CI 0.62 to 1.30; I2 = 97%) and all-cause hospitalisation events (4 studies, 42,582 participants: RR 1.02, 95% CI 0.81 to 1.29; I2 = 91%) (very low certainty). None of the included studies reported specifically on life participation or fatigue. However, two studies evaluated employment. Compared with HD, PD had uncertain effects on employment at one year (2 studies, 593 participants: RR 0.83, 95% CI 0.20 to 3.43; I2 = 97%; very low certainty). AUTHORS' CONCLUSIONS The comparative effectiveness of PD and HD on the preservation of RKF, all-cause and cause-specific death risk, the incidence of bacteraemia, other vascular complications (e.g. stroke, cardiovascular events) and patient-reported outcomes (e.g. life participation and fatigue) are uncertain, based on data obtained mostly from NRSIs, as only two RCTs were included.
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Affiliation(s)
- Isabelle Ethier
- Department of Nephrology, Centre hospitalier de l'Université de Montréal, Montréal, Canada
- Health innovation and evaluation hub, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada
| | - Ashik Hayat
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Juan Pei
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
- Department of Nephrology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Carmel M Hawley
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
| | - Ross S Francis
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Germaine Wong
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Jonathan C Craig
- Cochrane Kidney and Transplant, Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Andrea K Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
| | - Htay Htay
- Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore
| | - Samantha Ng
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Saskia Leibowitz
- Department of Nephrology, Logan Hospital, Meadowbrook, Australia
| | - Yeoungjee Cho
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Australia
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
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Zhang LP, Li MT, Pan MJ, Ou YT, Gao M, Wu M. The association between vascular access satisfaction and all-cause mortality in maintenance hemodialysis patients. J Vasc Access 2024:11297298241244483. [PMID: 38682422 DOI: 10.1177/11297298241244483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND The mortality is significantly higher in patients undergoing maintenance hemodialysis (MHD) than in the general population. It is well-known that vascular access (VA) is critical for MHD patients. But the association between VA satisfaction and all-cause mortality in MHD patients is still not clear. The aim of this study was to explore the relationship between VA satisfaction and all-cause mortality in MHD patients with a 30-month follow-up. METHODS Two hundred twenty-nine MHD patients in two dialysis centers were enrolled in this observational prospective study. VA satisfaction was assessed using the Short Form Vascular Access Questionnaire (VAQ). Health-related quality of life (HRQoL) score was calculated with Short Form 36 (SF-36) questionnaire. Multiple logistic regression analysis was used to evaluate the influencing factors of all-cause mortality. RESULTS During the 30-month follow-up period, 35 patients dropped out of the study. Among them, 31 patients died, and 4 patients stopped MHD treatment after renal transplantation. Multivariable analyses showed that the age, VAQ total score, social functioning score and dialysis-related complication score of the VAQ, the total score and MCS of the SF-36 were factors influencing all-cause mortality in MHD patients. The Kaplan-Meier curve further showed that the cumulative survival probability was significantly higher in the MHD patients with VAQ scores <7 at baseline than in patients with VAQ scores ⩾7 (p = 0.031). INCLUSION The present study showed that VA satisfaction was significantly associated with all-cause mortality in MHD patients. These findings suggest that a holistic approach is required for VA choice.
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Affiliation(s)
- Liu-Ping Zhang
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Meng-Ting Li
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Meng-Jiao Pan
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Yu-Tong Ou
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Min Gao
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
| | - Min Wu
- Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu, China
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Campos PC, Silva ACRD, Fleury Cardoso R, Rodrigues VGB, Alves FL, Maciel EHB, Prates MCSM, Costa HS, Figueiredo PHS, Lima VP. Reliability and validity of the Patient Generated Index (PGI) in patients with chronic kidney disease (CKD) on dialysis, a new approach to quality of life. Disabil Rehabil 2024; 46:773-782. [PMID: 36705255 DOI: 10.1080/09638288.2023.2173314] [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: 05/13/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
PURPOSE To evaluate the test-retest reliability and validity of the Patient Generated Index (PGI) in individuals with Chronic Kidney Disease (CDK) undergoing hemodialysis. METHODS Through a non-experimental study with repeated measures, PGI was applied twice to assess internal consistency and test-retest reliability. Correlations with the Kidney Disease Quality of Life Short Form (KDQOL-SF), the Human Activity Profile (HAP) questionnaire, the Social Participation Scale, and the Glittre ADL Test were used. RESULTS 91 individuals with CKD were evaluated. There was high reliability for the PGI (ICC= 0.97) PGI correlated with KQDOL - SF in Functional Capacity r = 0.38 (p < 0.001), Emotional Well-Being r = 0.31 (p = 0.003), Social Aspect r = 0.22 (p = 0.036), Emotional Function r = 0.22 (p = 0.038) and Effect of Kidney Disease r = 0.21 (p = 0.042), and Physical scores r = 0.24 (p = 0.021)), Mental r = 0.21 (p = 0.05) and General r = 0.22 (p = 0.037) summarized. There was a significant correlation between PGI and HAP r = 0.40 (p < 0.001) and the Social Participation Scale r = -0.36 (p < 0.001). There was no correlation between the PGI and Glittre ADL scores r = 0.12 (p = 0.247). CONCLUSION In adults receiving hemodialysis, the PGI proved to be an accurate and reliable instrument for the assessment of the quality of life from the perspective of the patient.IMPLICATIONS FOR REHABILITATIONAlthough hemodialysis treatment is associated with increased survival and symptom control, there is a significant change in the patient's lifestyle.In order to provide a more focused view of the individual, the Patient Generated Index (PGI) was created to evaluate the quality of life.PGI is reliable and correlates with KQDOL - SF and the Social Participation Scale in this population.
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Affiliation(s)
- Patrícia Cardoso Campos
- Postgraduate Program in Rehabilitation and Functional Performance, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | - Ana Caiane Rocha da Silva
- Postgraduate Program in Rehabilitation and Functional Performance, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | - Renato Fleury Cardoso
- Postgraduate Program in Rehabilitation and Functional Performance, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | - Vanessa Gomes Brandão Rodrigues
- Postgraduate Program in Rehabilitation and Functional Performance, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina, Diamantina, Brazil
- School of Medicine, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | - Frederico Lopes Alves
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina, Diamantina, Brazil
- School of Medicine, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | - Emílio Henrique Barroso Maciel
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina, Diamantina, Brazil
- School of Medicine, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | - Maria Cecília Sales Mendes Prates
- Postgraduate Program in Rehabilitation and Functional Performance, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
- Hemodialysis Unit of the Santa Casa de Caridade de Diamantina, Diamantina, Brazil
- School of Medicine, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | - Henrique Silveira Costa
- Postgraduate Program in Rehabilitation and Functional Performance, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
- Department of Physiotherapy, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- Postgraduate Program in Rehabilitation and Functional Performance, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
- Department of Physiotherapy, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | - Vanessa Pereira Lima
- Postgraduate Program in Rehabilitation and Functional Performance, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
- Department of Physiotherapy, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
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Liu S, Wang F, Sha S, Cai H, Ng CH, Feng Y, Xiang YT. A comparison of quality of life between older adults living in high and low altitude areas. Front Public Health 2023; 11:1184967. [PMID: 38074716 PMCID: PMC10699141 DOI: 10.3389/fpubh.2023.1184967] [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: 03/16/2023] [Accepted: 06/23/2023] [Indexed: 12/18/2023] Open
Abstract
Background High altitude is known to have a significant impact on human physiology and health, therefore, understanding its relationship with quality of life is an important research area. This study compared the quality of life (QOL) in older adults living in high and low altitude areas, and examined the independent correlates of QOL in those living in a high altitude area. Methods Older adults living in three public nursing homes in Xining (high altitude area) and one public nursing home in Guangzhou (low altitude area) were recruited. The WHOQOL-BREF was used to measure the QOL. Results 644 older adults (male: 39.1%) were included, with 207 living in high altitude and 437 living in low altitude areas. After controlling for the covariates, older adults living in the high altitude area had higher QOL in terms of physical (P = 0.035) and social domains (P = 0.002), but had lower QOL in psychological (P = 0.009) domain compared to their counterparts living in the low altitude area. For older adults living in the high altitude area, smoking status was associated with higher social QOL (P = 0.021), good financial status was associated with higher physical QOL (P = 0.035), and fair or good health status was associated with higher physical (p < 0.001) and psychological QOL (P = 0.046), while more severe depressive symptoms were associated with lower QOL. Conclusion Appropriate interventions and support to improve depressive symptoms and both financial and health status should be developed for older adults living in high altitude areas to improve their QOL.
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Affiliation(s)
- Shou Liu
- Department of Public Health, Medical College, Qinghai University, Xining, Qinghai, China
| | - Fei Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macau, China
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macau, China
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Sharma S, Kalra D, Rashid I, Mehta S, Maity MK, Wazir K, Gupta S, Ansari SA, Alruqi OS, Khan R, Khan I, Anwar S. Assessment of Health-Related Quality of Life in Chronic Kidney Disease Patients: A Hospital-Based Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1788. [PMID: 37893506 PMCID: PMC10608694 DOI: 10.3390/medicina59101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/26/2023] [Accepted: 09/30/2023] [Indexed: 10/29/2023]
Abstract
Background: Health-related quality of life is rapidly becoming recognized as an important indicator of how a disease affects patient lives and for evaluating the quality of care, especially for chronic conditions such as chronic kidney disease (CKD). Objectives: This study is an attempt to assess the quality of life in patients with chronic kidney disease at MMIMSR and also identify characteristics that may be associated with their worsening quality of life. Materials and Methods: This cross-sectional investigation was conducted at the in-patient department (IPD) of the MMIMSR hospital. This study included 105 CKD patients and used a systematic random sampling method for quantitative analysis. This study utilized a 36-item short-form SF-36 (v1.3) questionnaire to assess HRQoL in CKD patients. Descriptive statistics were employed at the baseline. Chi square and ANOVA were used to draw comparisons between two groups or more than two groups, respectively. Logistic regression analysis was utilized to identify the potential QoL determinants. A p value of 0.05 or lower was used to determine statistical significance. Results: Among a total of 105 participants, the mean (±standard deviation) age was found to be 54.53 ± 13.47 years; 48 were male patients, and 57 were female patients. Diabetes Mellitus (61.9%), hypertension (56.2%), chronic glomerulonephritis (7.6%), chronic pyelonephritis (6.7%), and polycystic kidney disease (5.7%) were identified to be the most frequent disorders associated with CKD. The current study also demonstrated that the HRQoL score domains such as symptom problem list, the effect of kidney disease, and the burden of kidney disease decline significantly and progressively as the patient advances into higher stages of CKD (p = 0.005). A similar pattern was observed in work status, sleep, and general health (p < 0.005). Additionally, a statistically significant difference was noted for cognitive function, quality of social interaction, overall health, dialysis staff encouragement, patient satisfaction, social support, physical functioning, role of physical health, pain, emotional well-being, role of emotional health, social functioning, and energy fatigue (p < 0.005). The mean difference for PCS and MCS based on CKD stages was found to be statistically significant (p < 0.005). The PCS and MCS showed a positive correlation with GFR (r = 0.521), and Hb (r = 0.378), GFR (r = 0.836), and Hb (r = 0.488), respectively. Conclusions: The findings of this study demonstrated that a significant decrease in HRQoL was observed among CKD patients, with a progressive deterioration of HRQoL dimensions as the patient advances to end-stage renal disease. This study also revealed that CKD imposes various restrictions on patients' day-to-day lives, particularly in terms of their physical and mental functioning, even in the initial stages of the disease.
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Affiliation(s)
- Shivam Sharma
- Department of Pharmacy Practice, M.M. College of Pharmacy, Maharishi Markandeshwar University, Ambala 133207, India; (S.S.); (D.K.)
| | - Darpan Kalra
- Department of Pharmacy Practice, M.M. College of Pharmacy, Maharishi Markandeshwar University, Ambala 133207, India; (S.S.); (D.K.)
| | - Ishfaq Rashid
- Department of Pharmacy Practice, M.M. College of Pharmacy, Maharishi Markandeshwar University, Ambala 133207, India; (S.S.); (D.K.)
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, 30S 2000E, Salt Lake City, UT 84112, USA
| | - Sudhir Mehta
- Department of Nephrology, M.M. Institute of Medical Sciences and Research, Maharishi Markandeshwar University, Ambala 133207, India
| | - Manish Kumar Maity
- Department of Pharmacy Practice, M.M. College of Pharmacy, Maharishi Markandeshwar University, Ambala 133207, India; (S.S.); (D.K.)
| | - Khushi Wazir
- Department of Pharmacy Practice, M.M. College of Pharmacy, Maharishi Markandeshwar University, Ambala 133207, India; (S.S.); (D.K.)
| | - Sumeet Gupta
- Department of Pharmacology, M.M. College of Pharmacy, Maharishi Markandeshwar University, Ambala 133207, India;
| | - Siddique Akber Ansari
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (S.A.A.)
| | - Obaid S. Alruqi
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (S.A.A.)
| | - Roohi Khan
- Department of General Medicine, King Khaled Hospital, Hail 55421, Saudi Arabia
| | - Imran Khan
- Department of General Medicine, King Khaled Hospital, Hail 55421, Saudi Arabia
| | - Sirajudheen Anwar
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Hail, Hail 55476, Saudi Arabia
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AlRowaie F, Alaryni A, AlGhamdi A, Alajlan R, Alabdullah R, Alnutaifi R, Alnutaifi R, Aldakheelallah A, Alshabanat A, Bin Shulhub A, Moazin O, Qutob R, Alsolami E, Hakami O. Quality of Life among Peritoneal and Hemodialysis Patients: A Cross-Sectional Study. Clin Pract 2023; 13:1215-1226. [PMID: 37887085 PMCID: PMC10605737 DOI: 10.3390/clinpract13050109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/16/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The quality of life (QoL) of patients with end-stage kidney disease (ESKD) who undergo dialysis is a reliable predictor of their long-term survival. Hemodialysis is the most common form of kidney replacement therapy for ESKD, followed by peritoneal dialysis. This study aimed to identify the factors affecting QoL in ESKD patients treated with peritoneal dialysis (PD) or hemodialysis (HD) in Riyadh, Saudi Arabia. METHODS A cross-sectional study was conducted between June and July 2021 to assess the QoL of patients with ESKD who underwent peritoneal dialysis and hemodialysis. Patients who had been on dialysis for at least one year were included. The Arabic version of the Quality of Life Index-Dialysis (QLI-D) version III was used to measure the QoL. RESULTS A total of 210 patients completed the questionnaire. The overall QLI score was 21.73 ± 4.2, with subscales for health and functioning (20.35 ± 5.2), social and economic (20.20 ± 4.8), psychological/spiritual (23.94 ± 4.9), and family (24.95 ± 4.5). The QLI scores for PD and HD patients were 21.80 ± 4.4 and 21.72 ± 4.1, respectively. SOCSUB (p = 0.031) was significantly associated with group and income, whereas QLI (p = 0.003), HFSUB (p = 0.013), SOCSUB (p = 0.002), and PSPSUB (p = 0.003) were significantly correlated with group and years of dialysis. CONCLUSION The study found that patients were most satisfied with their family, health and functioning, and social/economic subscales. Income and years of dialysis were found to be predictive factors of QoL. Overall, peritoneal patients in this study demonstrated a better QoL than HD patients.
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Affiliation(s)
- Fadel AlRowaie
- Nephrology Department, King Fahad Medical City, Riyadh 12231, Saudi Arabia;
| | - Abdullah Alaryni
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Abdullah AlGhamdi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Renad Alajlan
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Razan Alabdullah
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Raed Alnutaifi
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Raneem Alnutaifi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Amani Aldakheelallah
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Alanoud Alshabanat
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Abdullah Bin Shulhub
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Othillah Moazin
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Rayan Qutob
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Enad Alsolami
- Department of Internal Medicine, College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia;
| | - Osamah Hakami
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
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Silveira-Silva PC, Silva RE, Santos EC, Justino PB, Santos MP, Gonçalves RV, Novaes RD. Advanced glycosylation end products as metabolic predictors of systemic pro-inflammatory and prooxidant status in patients with end-stage renal disease. Cytokine 2023; 166:156189. [PMID: 37004469 DOI: 10.1016/j.cyto.2023.156189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/07/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023]
Abstract
Controlling systemic proinflammatory and prooxidant effectors is essential for mitigating cardiovascular risk and mortality in patients with end-stage renal disease (ESRD). However, monitoring these processes is still challenging due to the high uncertainty about their determinants and predictors. Thus, we investigated the relationship between advanced glycosylation end products (AGE), proinflammatory and prooxidant effectors in ESRD patients undergoing hemodialysis (HD). In addition to nutritional profile and dialysis efficiency, AGE, cytokines, chemokines, C-reactive protein (CRP), total (TAC) and non-protein (npAC) antioxidant capacity, lipid and protein oxidation were analyzed in blood samples from 43 HD patients. AGE, CRP, cytokines, chemokines, protein carbonyl (PCn), and malondialdehyde (MDA) were upregulated, while TAC and npAC were down-regulated in HD patients compared to heath subjects. Dialysis efficiency, TAC and npAC were reduced, while leucocytes counting, pre- and post-HD urea, TNF, IL-6, IL-10, CCL-2, MIP-1β, PCn, and MDA were increased in patients with higher AGE accumulation compared to those with lower AGE levels. Serum levels of CRP, protein carbonyl, malondialdehyde, and all cytokines and chemokines analyzed were correlated with AGE circulating levels for patients with higher AGE accumulation. AGE was inversely correlated with IL-10, TAC and npAC in patients with higher AGE accumulation. AGE exhibited predictive value (determination coefficient) to explain CRP, cytokines, chemokines, PCN, MDA, TAC and npAC variability in patients with higher AGE levels. Taken together, our findings provide evidence that AGE accumulation is associated with important proinflammatory and prooxidant effectors in patients with ESRD undergoing hemodialysis. Thus, AGE monitoring may be relevant to predict systemic inflammatory stress and the balance between oxidant and antioxidant status in these patients.
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Correia de Carvalho M, Nunes de Azevedo J, Azevedo P, Pires C, Machado JP, Laranjeira M. Effectiveness of Acupuncture on Health-Related Quality of Life in Patients Receiving Maintenance Hemodialysis. Healthcare (Basel) 2023; 11:1355. [PMID: 37174896 PMCID: PMC10178503 DOI: 10.3390/healthcare11091355] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
Patients with kidney failure (KF) receiving maintenance hemodialysis (HD) experience numerous symptoms that impair their health-related quality of life (HRQOL) and contribute to high mortality rates. Acupuncture is often used for symptom enhancement and HRQOL. This blinded, randomized, controlled patient-assessor trial evaluated the effectiveness of acupuncture compared with sham acupuncture on patients' HRQOL receiving maintenance HD as a secondary analysis. Seventy-two participants were randomly assigned to verum acupuncture (VA), sham acupuncture (SA), or waiting-list (WL) groups. The outcome was an improvement in HRQOL, assessed using the Kidney Disease Quality of Life-Short Form, version 1.3 (KDQOL-SF™ v1.3) at baseline, after treatment, and at 12-week follow-up. Non-parametric tests were used for statistical analysis. Of the 72 randomized patients, 67 were included in the complete analysis set. As for the changes between baseline and after treatment, the VA group showed significantly increased scores on most of the KDQOL-SF™ v1.3 scales compared to SA or WL groups (p < 0.05). No statistically significant differences between groups were observed in the changes from baseline to follow-up (p > 0.05). Compared to the sham treatment, acupuncture improved the HRQOL in patients receiving maintenance HD after treatment but not at follow-up.
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Affiliation(s)
| | | | - Pedro Azevedo
- TECSAM-Tecnologia e Serviços Médicos SA, 5370-530 Mirandela, Portugal
| | - Carlos Pires
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Jorge Pereira Machado
- ICBAS, School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- CBSin, Center of BioSciences in Integrative Health, 4000-105 Porto, Portugal
| | - Manuel Laranjeira
- ICBAS, School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- INC, Instituto de Neurociências, 4100-141 Porto, Portugal
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Moeinzadeh F, Shahidi S, Shahzeidi S. Evaluating the effect of intradialytic cycling exercise on quality of life and recovery time in hemodialysis patients: A randomized clinical trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:84. [PMID: 36685021 PMCID: PMC9854908 DOI: 10.4103/jrms.jrms_866_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/24/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
Abstract
Background The aim of this study was to assess the effect of intradialytic cycling exercise on quality of life (QOL) and recovery time in patients who underwent hemodialysis. Materials and Methods Hemodialysis patients were recruited from the referral dialysis centers affiliated with Isfahan University of Medical Sciences, Isfahan, Iran. Patients were randomly assigned into the intervention and the control groups. Patients in the intervention group exercised on a stationary bike for 12 weeks (3 times per week for 30 min); however, patients in the control group received usual hemodialysis. The kidney disease QOL (KDQOL)-short-form version 1.3 was used to assess QOL. Patients were asked to answer the question "How long does it take to recover from a dialysis session?" to assess recovery time. Results A total of 110 hemodialysis patients, including 60 in the intervention group and 50 in the control group were analyzed. A significant increase was observed in the generic (mean difference ± SE: 1.50 ± 0.44, P = 0.001), kidney disease (mean difference ± SE: 0.84 ± 0.28, P = 0.004), and overall QOL (mean difference ± SE: 1.18 ± 0.33, P = 0.001) scores after 12 weeks of intradialytic cycling exercise in the intervention group. Furthermore, a significant difference was noted between the intervention and the control group regarding the mean difference of all QOL scores after the intervention (P < 0.05). We also found a significant difference in the mean difference of recovery time between the intervention and the control group after the intervention (P < 0.001). Conclusion KDQOL and recovery time could improve in hemodialysis patients after 12-week intradialytic exercise.
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Affiliation(s)
- Firouzeh Moeinzadeh
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Shahidi
- Isfahan Kidney Diseases Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Safoora Shahzeidi
- Department of Internal Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Safoora Shahzeidi, Department of Internal Medicine, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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12
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So S, Li K, Hoffman AT, Josland E, Brown MA. Quality of Life in Patients with Chronic Kidney Disease Managed with or without Dialysis: An Observational Study. KIDNEY360 2022; 3:1890-1898. [PMID: 36514416 PMCID: PMC9717644 DOI: 10.34067/kid.0001602022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/11/2022] [Indexed: 01/12/2023]
Abstract
Background Emerging research suggests that quality of life (QOL) outcomes, such as maintenance of independence, rather than length of life, are the main priority for many patients with end stage kidney disease (ESKD). There is therefore a need to focus on whether QOL for older patients on dialysis differs significantly from conservative kidney management (CKM). This study aimed to describe the QOL trajectory for patients with ESKD, comparing CKM to dialysis and transplantation. Methods This retrospective, observational study included all patients who attended the Kidney Supportive Care Clinic at St. George Hospital and had one or more EuroQOL (EQ5D5L) questionnaires between July 2014 and May 2020. Kruskal-Wallis tests compared QOL scores between groups at baseline and 12 months. Wilcoxon signed rank tests compared QOL scores from baseline to 18 months within groups. Chi-squared tests compared proportions of patients reporting problems with QOL "domains" between the groups at baseline and 12 months. McNemar's tests compared changes in proportions of patients reporting problems with QOL "domains" within groups from baseline to 12 months. Results A total of 604 patients had an initial survey. At baseline, patients who were managed conservatively reported more problems with mobility, self-care, and ability to perform usual activities. However, pain/discomfort and anxiety/depression were no higher in the conservative population. CKM patients reported no significant decline in mobility, self-care, ability to perform their usual activities, pain/discomfort, or anxiety/depression after 12 months or in QOL scores after 18 months compared with the other groups. Conclusions QOL scores or symptom burdens did not change significantly in patients receiving CKM compared with dialysis, suggesting that appropriately supported CKM can maintain patients' QOL.
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Affiliation(s)
- Sarah So
- Department of Palliative Care, St. George Hospital, Kogarah, Sydney, Australia,Department of Renal Medicine, Nepean Hospital, Kingswood, Sydney, Australia,The University of New South Wales, Sydney, Australia
| | - Kelly Li
- The University of New South Wales, Sydney, Australia,Department of Renal Medicine, St. George Hospital, Kogarah, Sydney, Australia
| | - Anna T. Hoffman
- Department of Renal Medicine, St. George Hospital, Kogarah, Sydney, Australia
| | - Elizabeth Josland
- Department of Renal Medicine, St. George Hospital, Kogarah, Sydney, Australia
| | - Mark A. Brown
- The University of New South Wales, Sydney, Australia,Department of Renal Medicine, St. George Hospital, Kogarah, Sydney, Australia
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Fatigue in incident peritoneal dialysis and mortality: A real-world side-by-side study in Brazil and the United States. PLoS One 2022; 17:e0270214. [PMID: 35749444 PMCID: PMC9231740 DOI: 10.1371/journal.pone.0270214] [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: 11/18/2021] [Accepted: 06/07/2022] [Indexed: 12/01/2022] Open
Abstract
Background We tested if fatigue in incident Peritoneal Dialysis associated with an increased risk for mortality, independently from main confounders. Methods We conducted a side-by-side study from two of incident PD patients in Brazil and the United States. We used the same code to independently analyze data in both countries during 2004 to 2011. We included data from adults who completed KDQOL-SF vitality subscale within 90 days after starting PD. Vitality score was categorized in four groups: >50 (high vitality), ≥40 to ≤50 (moderate vitality), >35 to <40 (moderate fatigue), ≤35 (high fatigue; reference group). In each country’s cohort, we built four distinct models to estimate the associations between vitality (exposure) and all-cause mortality (outcome): (i) Cox regression model; (ii) competing risk model accounting for technique failure events; (iii) multilevel survival model of clinic-level clusters; (iv) multivariate regression model with smoothing splines treating vitality as a continuous measure. Analyses were adjusted for age, comorbidities, PD modality, hemoglobin, and albumin. A mixed-effects meta-analysis was used to pool hazard ratios (HRs) from both cohorts to model mortality risk for each 10-unit increase in vitality. Results We used data from 4,285 PD patients (Brazil n = 1,388 and United States n = 2,897). Model estimates showed lower vitality levels within 90 days of starting PD were associated with a higher risk of mortality, which was consistent in Brazil and the United States cohorts. In the multivariate survival model, each 10-unit increase in vitality score was associated with lower risk of all-cause mortality in both cohorts (Brazil HR = 0.79 [95%CI 0.70 to 0.90] and United States HR = 0.90 [95%CI 0.88 to 0.93], pooled HR = 0.86 [95%CI 0.75 to 0.98]). Results for all models provided consistent effect estimates. Conclusions Among patients in Brazil and the United States, lower vitality score in the initial months of PD was independently associated with all-cause mortality.
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Impact of malnutrition on health-related quality of life in persons receiving dialysis: a prospective study. Br J Nutr 2022; 127:1647-1655. [PMID: 34218825 PMCID: PMC9201831 DOI: 10.1017/s000711452100249x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Health-related quality of life (HRQoL) is severely impaired in persons receiving dialysis. Malnutrition has been associated with some measures of poor HRQoL in cross-sectional analyses in dialysis populations, but no studies have assessed the impact of malnutrition and dietary intake on change in multiple measures of HRQoL over time. We investigated the most important determinants of poor HRQoL and the predictors of change in HRQoL over time using several measures of HRQoL. We enrolled 119 haemodialysis and thirty-one peritoneal dialysis patients in this prospective study. Nutritional assessments (Subjective Global Assessment (SGA), anthropometry and 24-h dietary recalls) and HRQoL questionnaires (Short Form-36 (SF-36) mental (MCS) and physical component scores (PCS) and European QoL-5 Dimensions (EQ5D) health state (HSS) and visual analogue scores (VAS)) were performed at baseline, 6 and 12 months. Mean age was 64 (14) years. Malnutrition was present in 37 % of the population. At baseline, malnutrition assessed by SGA was the only factor independently (and negatively) associated with all four measures of HRQoL. No single factor was independently associated with decrease in all measures of HRQoL over 1 year. However, prevalence/development of malnutrition over 1 year was an independent predictor of 1-year decrease in EQ5D HSS, and 1-year decrease in fat intake independently predicted the 1-year decline in SF-36 MCS and PCS, and EQ5D VAS. These findings strengthen the importance of monitoring for malnutrition and providing nutritional advice to all persons on dialysis. Future studies are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.
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Maia Neves Menezes JI, Lopes Pereira LA. Physical exercise and peritoneal dialysis: An area yet to be explored. Nefrologia 2022; 42:265-272. [PMID: 36210121 DOI: 10.1016/j.nefroe.2021.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 02/06/2021] [Indexed: 06/16/2023] Open
Abstract
Health-related quality of life (HRQoL) of patients suffering from chronic kidney disease (CKD) is profoundly impaired by their frailty, disability and decreased physical capacity. Especially among older patients, a high prevalence of low physical activity levels and reduced functional performance has been reported. Physical exercise training has been shown to have a beneficial impact, counteracting these same hazardous consequences of inactivity and sedentarism both on CKD and end-stage kidney disease (ESKD) patients on hemodialysis (HD) treatment. The evidence-based knowledge on the effects of physical exercise on ESKD patients undergoing Peritoneal Dialysis (PD) treatment is scarce, even though this is a continually growing population that shares the same risk factors and desired clinical outcomes as the previously mentioned groups of patients. Further investigation will be necessary to clarify whether this exercise-based approach may be suitable for the PD population. This paper's purpose is to review the available literature, including randomized controlled trials, reviews and meta-analysis results that assessed the impact of physical exercise on patients under PD treatment bearing in mind their HRQoL, physical functioning and cardiovascular parameters. Furthermore, it aims to evaluate the perceived significant barriers and limitations of the PD population in what concerns physical exercise practice and how nephrologists should address them.
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Affiliation(s)
| | - Luciano Artur Lopes Pereira
- Institute of Investigation and Innovation in Health, University of Porto, Portugal; INEB - National Institute of Biomedical Engineering, University of Porto, Portugal; Department of Nephrology, São João Hospital Center, Porto, Portugal.
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Alshogran OY, Shatnawi EA, Altawalbeh SM, Jarab AS, Farah RI. Predictors of poor health-related quality of life among hemodialysis patients with anemia in Jordan. Health Qual Life Outcomes 2021; 19:272. [PMID: 34952599 PMCID: PMC8709968 DOI: 10.1186/s12955-021-01905-7] [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: 05/13/2021] [Accepted: 12/06/2021] [Indexed: 12/02/2022] Open
Abstract
Objective This study examined health-related quality of life (HRQoL) and factors associated with poor HRQoL among hemodialysis (HD) patients. Methods A multicenter cross-sectional study was conducted on HD patients with anemia in Jordan (n = 168). Validated questionnaires were utilized to collect data on HRQoL using EQ-5D-5L, psychiatric symptoms using Hospital Anxiety and Depression Scale (HADS), and comorbidities score using the modified Charlson Comorbidity Index (mCCI). Multiple linear regression analysis was conducted to identify the variables which are independently associated with HRQoL among patients. Results The mean (± SD) age of study participants was 52.2 (± 14.6) years. The mean utility value of EQ-5D-5L was 0.44 (± 0.42). Participants reported extreme problems mostly in pain/discomfort domain (19.6%). Increased age, increased mCCI and patient complains, more years under dialysis, decreased exercise, and low family income were significantly associated with poor HRQoL (p < 0.05). Conclusion The study findings revealed poor HRQoL among HD patients with anemia. Various dimensions of health were negatively affected among HD patients. Development and implementation of appropriate approaches with adequate education and psychosocial support to HD patients by healthcare professionals targeting improved HRQoL and clinical outcomes would be necessary.
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Affiliation(s)
- Osama Y Alshogran
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Esraa A Shatnawi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Shoroq M Altawalbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Anan S Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Randa I Farah
- Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
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Lerma C, Lima-Zapata LI, Amaya-Aguilar JA, Leonardo-Cruz I, Lazo-Sánchez M, Bermúdez LA, Pérez-Grovas H, Lerma A, Cadena-Estrada JC. Gender-Specific Differences in Self-Care, Treatment-Related Symptoms, and Quality of Life in Hemodialysis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413022. [PMID: 34948632 PMCID: PMC8701918 DOI: 10.3390/ijerph182413022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/27/2021] [Accepted: 12/08/2021] [Indexed: 12/25/2022]
Abstract
Gender and sex differences affect women with kidney failure (KF) negatively at all stages of the disease. This study assessed gender differences in self-care, hemodialysis symptoms, and quality of life in a sample of 102 adult KF patients treated with hemodialysis, from two clinical centers in Mexico. Self-care agency, quality of life, and the symptoms related to hemodialysis were evaluated through questionnaires, and sociodemographic and laboratory variables were obtained from the clinical records. Compared to male patients, female patients reported similar self-care, lower quality of life subscales (symptoms, physical functioning, pain, and overall health), and higher prevalence and intensity of hemodialysis symptoms. There were gender differences regarding the correlation between self-care and quality of life, symptoms intensity, and symptoms prevalence. In conclusion, women with KF treated with hemodialysis perceived a higher impact of hemodialysis and reported a lower quality of life than men. Despite having a similar self-care agency, the self-care correlations with quality of life and hemodialysis symptoms appeared different between men and women treated with chronic hemodialysis. Such differences may be important in future nursing interventions to improve self-care and quality of life among KF patients.
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Affiliation(s)
- Claudia Lerma
- Department of Electromechanical Instrumentation, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico; (C.L.); (L.I.L.-Z.)
| | - Larissa I. Lima-Zapata
- Department of Electromechanical Instrumentation, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico; (C.L.); (L.I.L.-Z.)
| | - Jorge A. Amaya-Aguilar
- Department of Nursing Research, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico; (J.A.A.-A.); (I.L.-C.); (M.L.-S.)
| | - Itzel Leonardo-Cruz
- Department of Nursing Research, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico; (J.A.A.-A.); (I.L.-C.); (M.L.-S.)
| | - Monica Lazo-Sánchez
- Department of Nursing Research, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico; (J.A.A.-A.); (I.L.-C.); (M.L.-S.)
| | - Luis A. Bermúdez
- Centro Estatal de Hemodiálisis, Instituto Estatal de Cancerología, Colima 28000, Mexico;
| | - Héctor Pérez-Grovas
- Department of Nephrology, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico;
| | - Abel Lerma
- Institute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, San Juan Tilcuautla, Pachuca 42160, Mexico;
| | - Julio César Cadena-Estrada
- Department of Nursing Research, National Institute of Cardiology Ignacio Chávez, Mexico City 14080, Mexico; (J.A.A.-A.); (I.L.-C.); (M.L.-S.)
- Correspondence: ; Tel.: +52-55-5573-2911 (ext. 23300)
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18
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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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19
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Skoumalova I, Madarasova Geckova A, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Health-Related Quality of Life Profiles in Dialyzed Patients With Varying Health Literacy. A Cross-Sectional Study on Slovak Haemodialyzed Population. Int J Public Health 2021; 66:585801. [PMID: 34744558 PMCID: PMC8565259 DOI: 10.3389/ijph.2021.585801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/05/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives: Chronic kidney disease (CKD) strongly affects patients’ health-related quality of life (HRQoL), mostly in the advanced stages of CKD. Health literacy (HL) may affect this association, in particular for some aspects of HRQoL. The aim of this study is to compare the profiles of HRQoL in dialyzed patients with varying HL. Methods: We obtained data on HL using the Health Literacy Questionnaire (HLQ) and on HRQoL using the Kidney Disease Quality of Life – Short Form (KDQoL-SF 1.3) in a multicentre cross-sectional study in 20 dialysis clinics in Slovakia (n = 542; mean age = 63.6 years; males: 60.7%). We compared HRQoL for three HL groups using ANOVA and the Kruskal-Wallis test. Results: Patients with low HL reported worse HRQoL than patients with moderate and high HL. The greatest differences between HL groups were found in the scales Effect of kidney disease, Cognitive function, Quality of social interaction, Social support, Dialysis staff encouragement, Patient satisfaction, Physical functioning, Pain, Emotional well-being and Social function. p-values in all cases were <0.001. Conclusion: Patients with low HL have a worse HRQoL in several domains than patients with a higher HL. Increasing HL capacities and better supporting patients with low HL should thus be given priority to support their HRQoL and at least maintain its level.
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Affiliation(s)
- Ivana Skoumalova
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands.,Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Andrea Madarasova Geckova
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands.,Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic.,FMC-Dialysis Services Slovakia, Kosice, Slovakia
| | | | - Peter Kolarcik
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands.,Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Andrea F de Winter
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Jitse P van Dijk
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Sijmen A Reijneveld
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands
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20
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Association of Health-Related Quality of Life with Atherosclerotic Cardiovascular Disease: Lifetime Risk Pooling Project. Am J Prev Cardiol 2021; 7:100222. [PMID: 34611648 PMCID: PMC8387281 DOI: 10.1016/j.ajpc.2021.100222] [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: 03/11/2021] [Revised: 06/23/2021] [Accepted: 06/27/2021] [Indexed: 11/22/2022] Open
Abstract
Objective The Pooled Cohort Equations (PCE) serve as the platform for quantitative risk assessment for atherosclerotic cardiovascular disease (ASCVD). Data are sparse regarding the benefit of adding health-related quality of life (HRQoL) measures to the PCE. We sought to estimate the association of HRQoL with ASCVD events and evaluate the potential utility of adding HRQoL to the PCE in refining quantitative risk assessment for primary prevention decisions. Methods Three multi-ethnic longitudinal cohorts were included in the study. HRQoL was measured using the SF-12 physical component summary (PCS) and mental component summary (MCS); higher PCS or MCS scores indicate better HRQoL. We constructed a four-level HRQoL status variable: MCS <50 and PCS <50; MCS <50 and PCS ≥50; MCS ≥50 and PCS <50; MCS ≥50 and PCS ≥50. Harrell's C statistics and net reclassification improvement (NRI) analyses were used to assess the added predictive ability of HRQoL for incident ASCVD. Results A total of 9,904 individuals were included in the analysis, of whom 4,743 were in the low risk subgroup (<5% predicted 10-year risk). HRQoL status, PCS and its subscale scores were independent predictors of ASCVD events. HRQoL improved both discrimination (delta C: 0.004, p = 0.05) and reclassification (cNRI: 0.15, p<0.01) modestly when added to PCE; 3% and 6% of individuals with events were correctly reclassified to higher risk in the overall sample and low risk subgroup, respectively. Conclusion HRQoL is an independent predictor of ASCVD events, and improves ASCVD risk prediction significantly, though modestly, overall and in low-risk individuals. HRQoL may be a cost-effective risk-enhancing factor for refining quantitative risk assessment for primary prevention decisions.
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21
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Maia Neves Menezes JI, Lopes Pereira LA. Physical exercise and peritoneal dialysis: An area yet to be explored. Nefrologia 2021; 42:S0211-6995(21)00116-8. [PMID: 34419333 DOI: 10.1016/j.nefro.2021.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/27/2020] [Accepted: 02/06/2021] [Indexed: 12/25/2022] Open
Abstract
Health-related quality of life (HRQoL) of patients suffering from chronic kidney disease (CKD) is profoundly impaired by their frailty, disability and decreased physical capacity. Especially among older patients, a high prevalence of low physical activity levels and reduced functional performance has been reported. Physical exercise training has been shown to have a beneficial impact, counteracting these same hazardous consequences of inactivity and sedentarism both on CKD and end-stage kidney disease (ESKD) patients on hemodialysis (HD) treatment. The evidence-based knowledge on the effects of physical exercise on ESKD patients undergoing Peritoneal Dialysis (PD) treatment is scarce, even though this is a continually growing population that shares the same risk factors and desired clinical outcomes as the previously mentioned groups of patients. Further investigation will be necessary to clarify whether this exercise-based approach may be suitable for the PD population. This paper's purpose is to review the available literature, including randomized controlled trials, reviews and meta-analysis results that assessed the impact of physical exercise on patients under PD treatment bearing in mind their HRQoL, physical functioning and cardiovascular parameters. Furthermore, it aims to evaluate the perceived significant barriers and limitations of the PD population in what concerns physical exercise practice and how nephrologists should address them.
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Affiliation(s)
| | - Luciano Artur Lopes Pereira
- Institute of Investigation and Innovation in Health, University of Porto, Portugal; INEB - National Institute of Biomedical Engineering, University of Porto, Portugal; Department of Nephrology, São João Hospital Center, Porto, Portugal.
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22
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Ren Q, Shi S, Yan C, Liu Y, Han W, Lin M, He H, Shen Q. Self-Management Micro-Video Health Education Program for Hemodialysis Patients. Clin Nurs Res 2021; 31:1148-1157. [PMID: 34282644 DOI: 10.1177/10547738211033922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Self-management in hemodialysis patients is critical; however, is generally low. This study aimed to examine the effects of a theory-based micro-video health education program on the improvement of self-management, hemodialysis knowledge, and self-efficacy in hemodialysis patients. A pre-test post-test control group quasi-experimental design was used to recruit 80 hemodialysis patients in a dialysis center. The participants were assigned in a 1:1 ratio to receive routine care or a 3-month micro-video health education program. Between-group comparison showed that patients in the intervention group had significantly greater improvement in hemodialysis knowledge than those in the control group (p < .05). However, no significant group differences were observed in terms of self-management and self-efficacy. Within-group comparison showed that the overall self-management level of patients in both groups improved significantly, particularly in problem-solving skills and self-care dimensions. Therefore, micro-video health education can improve the self-management and hemodialysis knowledge in Chinese patients undergoing hemodialysis.Trial Registration: Registered at ClinicalTrials.gov with study number (ChiCTR1800018172; http://www.chictr.org.cn/index.aspx).
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Affiliation(s)
- Qingli Ren
- Xiamen University, Fujian, China.,Shanxi Medical University, Taiyuan, China
| | - Suhua Shi
- Xiamen University Affiliated Chenggong Hospital, Fujian, China
| | - Chen Yan
- Xiamen University, Fujian, China
| | - Yang Liu
- Xiamen University, Fujian, China
| | - Wei Han
- Zhongshan Hospital Xiamen University, Fujian, China
| | - Min Lin
- Xiamen University Affiliated Chenggong Hospital, Fujian, China
| | - Honggu He
- National University of Singapore, Singapore
| | - Qu Shen
- Xiamen University, Fujian, China
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Shokrpour N, Sheidaie S, Amirkhani M, Bazrafkan L, Modreki A. Effect of positive thinking training on stress, anxiety, depression, and quality of life among hemodialysis patients: A randomized controlled clinical trial. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:225. [PMID: 34395662 PMCID: PMC8318152 DOI: 10.4103/jehp.jehp_1120_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 10/10/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Given the relationship between positivity interventions and psychological problems, this study aimed to investigate the effect of positive thinking training on stress, anxiety, depression, and quality of life of hemodialysis patients. MATERIALS AND METHODS This is a quasi-experimental and interventional study conducted on 70 hemodialysis patients referred to Fasa hemodialysis centers, Iran, between April 2019 and October 2019. Patients were selected using a simple sampling method and randomly divided into control (n = 35) and intervention (n = 35) groups. The intervention group was trained on positive thinking skills in eight sessions of a workshop. Before and after the intervention, stress, anxiety, depression, and quality of life in both the groups were measured using the Depression, Anxiety, and Stress Scale-21 and Short Form-36 Questionnaire. Data were analyzed using paired t-test, independent t-test, Kolmogorov-Smirnov, and Chi-square tests. RESULTS There was no significant difference in the mean scores of stress, anxiety, depression, and quality of life in the two groups before the intervention.(P > 0.05), and in the control group, there was no statistically significant difference before and after the intervention (P = 0.092, P = 0.228, 0.280, respectively). In the intervention group, the mean score of stress and anxiety decreased from 23.65 ± 4.12 to 16.68 ± 4.41 (P < 0.001) and from 17.77 ± 5.15 to 14.57 ± 4.18 (P = 0.002), respectively, and that of the patients' quality of life also increased from 35.19 ± 10.07 to 55.98 ± 11.71 (P < 0.001). However, the mean score of depression did not change significantly after the intervention (P = 0.689). CONCLUSION According to the results of this study, the use of positive thinking intervention programs with other methods for hemodialysis patients' care and treatment is recommended as a nonpharmacological, cost-effective, and uncomplicated method.
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Affiliation(s)
- Nasrin Shokrpour
- Department of English, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- IJCBNM research Center, Nursing School, Shiraz University of Medical Sciences, Shiraz, Iran
- Center for Interdisciplinary Research in Islamic Education and Health Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shima Sheidaie
- Department of Education, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehdi Amirkhani
- Department of Health in Disasters and Emergencies, Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Bazrafkan
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ameneh Modreki
- Department of Clinical Psychology, Fasa University of Medical Sciences, Fasa, Iran
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Windahl K, Irving GF, Almquist T, Lidén MK, Stenvinkel P, Chesnaye NC, Drechsler C, Szymczak M, Krajewska M, Fu EL, Torino C, Porto G, Roderick P, Caskey FJ, Wanner C, Dekker FW, Jager KJ, Evans M. Patient-Reported Measures and Lifestyle Are Associated With Deterioration in Nutritional Status in CKD Stage 4-5: The EQUAL Cohort Study. J Ren Nutr 2021; 32:161-169. [PMID: 33931314 DOI: 10.1053/j.jrn.2021.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 03/21/2021] [Accepted: 03/23/2021] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The aim of this study was to explore the changes in nutritional status before dialysis initiation and to identify modifiable risk factors of nutritional status decline in older adults with advanced renal disease. DESIGN AND METHODS The European Quality Study on treatment in advanced chronic kidney disease (EQUAL) is a prospective, observational cohort study involving six European countries. We included 1,103 adults >65 years with incident estimated glomerular filtration rate <20 mL/min/1.73 m2 not on dialysis, attending nephrology care. Nutritional status was assessed with the 7-point Subjective Global Assessment tool (7-p SGA), patient-reported outcomes with RAND-36 and the Dialysis Symptom Index. Logistic regression was used to estimate the associations between potential risk factors and SGA decline. RESULTS The majority of the patients had a normal nutritional status at baseline, 28% were moderately malnourished (SGA ≤5). Overall, mean SGA decreased by -0.18 points/year, (95% confidence interval -0.21; -0.14). More than one-third of the study participants (34.9%) deteriorated in nutritional status (1 point decline in SGA) and 10.9% had a severe decline in SGA (≥2 points). The proportion of patients with low SGA (≤5) increased every 6 months. Those who dropped in SGA also declined in estimated glomerular filtration rate and mental health score. Every 10 points decrease in physical function score increased the odds of decline in SGA by 23%. Lower physical function score at baseline, gastrointestinal symptoms, and smoking were risk factors for impaired nutritional status. There was an interaction between diabetes and physical function on SGA decline. CONCLUSIONS Nutritional status deteriorated in more than one-third of the study participants during the first year of follow-up. Lower patient-reported physical function, more gastrointestinal symptoms, and current smoking were associated with decline in nutritional status.
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Affiliation(s)
- Karin Windahl
- Renal unit, Department of clinical intervention and technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Division of Clinical Nutrition and Dietetics, Department of Orthopedics, Danderyds Hospital, Stockholm, Sweden.
| | | | - Gerd Faxén Irving
- Division of Clinical Geriatrics, Department of NVS, Karolinska Institutet, Stockholm, Sweden
| | - Tora Almquist
- Division of Nephrology, Department of Clinical Sciences, Danderyds Hospital, Stockholm, Sweden
| | - Maarit Korkeila Lidén
- Renal unit, Department of clinical intervention and technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Peter Stenvinkel
- Renal unit, Department of clinical intervention and technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Nicholas C Chesnaye
- ERA-EDTA Registry, Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research Institute, Amsterdam, the Netherlands
| | - Christiane Drechsler
- Division of Nephrology, Department of Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Maciej Szymczak
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Edouard L Fu
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Claudia Torino
- 4CNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy
| | - Gaetana Porto
- 4CNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy
| | - Paul Roderick
- Department of renal medicine, North Bristol NHS Trust, Bristol, UK
| | - Fergus J Caskey
- Department of renal medicine, North Bristol NHS Trust, Bristol, UK; Population Health Sciences, University of Bristol, Bristol, UK
| | - Christoph Wanner
- Division of Nephrology, Department of Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Kitty J Jager
- ERA-EDTA Registry, Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health research Institute, Amsterdam, the Netherlands
| | - Marie Evans
- Renal unit, Department of clinical intervention and technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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Physical performance and health-related quality of life among older adults on peritoneal dialysis: a cross-sectional study. Int Urol Nephrol 2021; 53:1033-1042. [PMID: 33392883 DOI: 10.1007/s11255-020-02737-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 12/02/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Identifying performance-based tests that meaningful for patients may facilitate the implementation of rehabilitation programs. The primary aim of this study was to determine the independent associations between different performance-based tests and health-related quality of life (HRQoL) among elderly peritoneal dialysis (PD) patients. METHODS This cross-sectional study was conducted in China. Patients on PD who were 60 years of age or above were included. HRQoL was assessed using the Medical Outcomes Study Short Form 36. Physical function was determined by handgrip strength, timed up and go (TUG) test, 5-repetition sit-to-stand test, and comfortable gait speed. Depressive symptoms were measured using the self-reported Geriatric Depression Scale (GDS-15). Multiple linear regression analyses were performed to examine the factors influencing HRQoL. RESULTS In total, 115 participants with a mean age of 69.7 were included (46 women and 69 men). TUG (β =- 0.460, p < 0.001), prealbumin (β = 0.223, p = 0.014), and education level (β = 0.183, p = 0.042) were associated with physical health. GDS score (β = - 0.475, p < 0.001), serum albumin level (β = 0.264, p = 0.003), and sex (β = 0.217, p = 0.012), were associated with mental HRQoL. CONCLUSION TUG could be a valuable test for use in clinical practice and research aiming at facilitating tailed exercise programs, as it was associated with self-perceived physical HRQoL and could be meaningful to elderly PD patients. Depressive symptoms and nutrition were another two important rehabilitation areas for optimizing the overall HRQoL of older adults on PD.
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Hussien H, Apetrii M, Covic A. Health-related quality of life in patients with chronic kidney disease. Expert Rev Pharmacoecon Outcomes Res 2020; 21:43-54. [PMID: 33213186 DOI: 10.1080/14737167.2021.1854091] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction: In the last three decades, health systems have continued to pay increasing attention to the quality of life (QOL) due to definitional changes in the concept of health and disease. The health-related quality of life (HRQOL) in patients with chronic kidney disease (CKD) is significantly affected, regardless of the stage of CKD. Areas covered: We attempt to thoroughly explore how CKD affects HRQOL domains with a quick primer on HRQOL assessment instruments in patients with CKD. Also, we pointed out the factors affecting HRQOL in patients with CKD as well as the clinical application of HRQOL in CKD management. Expert opinion: The general population enjoys higher HRQOL than patients with CKD in all domains. Similarly, pre-dialysis and kidney-transplant patients have better HRQOL than dialysis population. There are many factors which negatively impact HRQOL in CKD which include for example depression, anxiety, and cognitive impairment for the social domain, inactivity, and frailty for the physical domain as well as lack of social support and extroversion in the social domain. Additionally, social disparities and CKD-related factors would influence HRQOL. Of note, there is no global standard HRQOL assessment tool. Finally, HRQOL should be included in future CKD management guidelines.
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Affiliation(s)
- Hani Hussien
- Department of Nephrology, Grigore T Popa University of Medicine and Pharmacy, Faculty of Medicine , Iasi, Romania.,Department of Nephrology Dr C I Parhon University Hospital , Iasi, Romania
| | - Mugurel Apetrii
- Department of Nephrology, Grigore T Popa University of Medicine and Pharmacy, Faculty of Medicine , Iasi, Romania.,Department of Nephrology Dr C I Parhon University Hospital , Iasi, Romania
| | - Adrian Covic
- Department of Nephrology, Grigore T Popa University of Medicine and Pharmacy, Faculty of Medicine , Iasi, Romania.,Department of Nephrology Dr C I Parhon University Hospital , Iasi, Romania
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Sousa H, Ribeiro O, Costa E, Frontini R, Paúl C, Amado L, Miranda V, Ribeiro F, Figueiredo D. Being on hemodialysis during the COVID-19 outbreak: A mixed-methods' study exploring the impacts on dialysis adequacy, analytical data, and patients' experiences. Semin Dial 2020; 34:66-76. [PMID: 32939844 DOI: 10.1111/sdi.12914] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/28/2020] [Accepted: 08/16/2020] [Indexed: 12/17/2022]
Abstract
For individuals with end-stage renal disease (ESRD), the novel coronavirus can present several additional challenges in disease self-management. This study aimed to explore the impacts of the COVID-19 pandemic in non-COVID-19 patients with ESRD undergoing in-center hemodialysis (HD). A mixed-methods study was conducted with a purposive sample recruited from one dialysis unit in Portugal. Quantitative data were collected retrospectively from patients' medical records from February 2020 (T1-before the outbreak) and from April 2020 (T2-during lockdown). Semi-structured interviews were conducted with 20 patients (66.9 ± 11.9 years old) undergoing HD for an average of 46.1 months (±39.5) in April 2020. Overall results suggested that dialysis adequacy and serum albumin levels decreased significantly at T2, while phosphorus levels increased. The findings from thematic analysis suggested several psychosocial negative impacts and impacts on disease and treatment-related health behaviors (eg, difficulties managing dietary restrictions during the lockdown and diminished physical activity), which can partially explain these quantitative results. However, some patients were also able to find positive impacts in this experience and problem-focused and emotional strategies were identified to cope with the demands of COVID-19. Several recommendations have been made to mitigate patients' emotional, relational, and educational unmet needs during the current pandemic and in the event of new outbreaks.
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Affiliation(s)
- Helena Sousa
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS.UA), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Elísio Costa
- Research Unit on Applied Molecular Biosciences (UCIBIO - REQUIMTE), Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Roberta Frontini
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Constança Paúl
- Center for Health Technology and Services Research (CINTESIS), Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | | | | | - Fernando Ribeiro
- Institute for Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
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Olivera LMD, Okuno MFP, Barbosa DA, Sesso RDCC, Scherrer Júnior G, Pessoa JLE, Fonseca CDD, Belasco AGS. Quality of life and spirituality of patients with chronic kidney disease: pre- and post-transplant analysis. Rev Bras Enferm 2020; 73 Suppl 5:e20190408. [PMID: 32785446 DOI: 10.1590/0034-7167-2019-0408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/15/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to compare the quality of life (QoL) of patients under dialysis and after kidney transplant; correlate the QoL of transplant patients to sociodemographic, morbid and spirituality/religiosity variables. METHOD prospective study with a quantitative approach, with a sample of 27 patients who underwent peritoneal dialysis or dialysis undergoing kidney transplant. QoL and spirituality were assessed by the KDQOL-SF and WHOQOL-SRPB tools, being correlated with sociodemographic and economic variables. RESULTS the dimensions of total mental component, kidney disease effects and kidney disease burden showed significant improvement in the post-transplant period, with p <0.0004. There was a significant correlation between four dimensions of spirituality and seven dimensions of QoL; p ranged from 0.04 to 0.006. CONCLUSION there was a significant improvement in QoL in the post-transplant period. The dimensions of spirituality: wholeness and integration, spiritual connection, wonder and inner peace were positively correlated with seven dimensions of QoL.
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Moore C, Carter LA, Mitra S, Skevington S, Wearden A. Quality of life improved for patients after starting dialysis but is impaired, initially, for their partners: a multi-centre, longitudinal study. BMC Nephrol 2020; 21:185. [PMID: 32423378 PMCID: PMC7236460 DOI: 10.1186/s12882-020-01819-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 04/19/2020] [Indexed: 02/07/2023] Open
Abstract
Background Quality of life (QOL) is important to patients with end stage renal disease and their partners. Despite the first 12 weeks being a critical time in the treatment pathway, limited research exists which examines how the transition onto dialysis impacts QOL. In this study we measured QOL in patients and their partners at pre-dialysis and over the first 12 weeks on dialysis to investigate QOL during this crucial period. Methods Patients and their partners, recruited from 10 renal units in England, completed questionnaires at pre-dialysis (n = 166 participants, 83 couples), 6 weeks (n = 90 participants, 45 couples) and 12 weeks (n = 78, 39 couples) after starting dialysis. On each occasion participants completed a QOL questionnaire (WHOQOL-BREF). Multilevel modelling accommodated the nested structure of couples with repeated measures within participants. Three-level random intercept models estimated changes in WHOQOL general QOL and its four domains (Physical, Psychological, Social and Environment). Two-level random intercept models assessed the relationship between baseline clinical and socio-demographic variables with changes in general QOL. Results Patients reported positive changes in general QOL from pre-dialysis to 6 weeks (β = 0.42, p < 0.001, 95% CI 0.19, 0.65) and from pre-dialysis to 12 weeks (β = 0.47, p < 0.001, 95% CI 0.24, 0.71). Partners’ general QOL decreased significantly from pre-dialysis to 6 weeks (β = − 0.24, p = 0.04, 95% CI -0.47, − 0.01) but returned to its original level at 12 weeks. Patients reported improvements in the physical domain between pre-dialysis and 12 weeks (β = 6.56, p < 0.004, 95% CI 2.10, 11.03). No other domains changed significantly in patients or partners. Only in patients were there significant associations between moderator variables and general QOL. High comorbidity risk level and diabetes were associated with poorer QOL at pre-dialysis whereas being female and having an arteriovenous fistula were linked with improvements in general QOL. Conclusions Patients reported significant improvements in their general and physical QOL after starting dialysis. Partners’ general QOL worsened after patients started dialysis but improved by 12 weeks. Both patients and partners may benefit from additional educational and counselling services in the lead up to, and immediately after starting dialysis, which could facilitate the transition onto dialysis and improve QOL in both. Study registration This study was adopted on the NIHR Clinical Research Network (UK). The details of this study are registered on the Research Registry website (www.researchregistry.com). The identifier for this study is researchregistry2574.
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Affiliation(s)
- Currie Moore
- School of Health Sciences, Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK. .,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
| | - Lesley-Anne Carter
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Sandip Mitra
- Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,Manchester University NHS Foundation Trust, Manchester, UK.,NIHR Devices for Dignity MedTech Cooperative, Sheffield, UK
| | - Suzanne Skevington
- School of Health Sciences, Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Alison Wearden
- School of Health Sciences, Division of Psychology and Mental Health, Manchester Centre for Health Psychology, University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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30
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Luo L, Chen Q. Effect of CKD-MBD phenotype on health-related quality of life in patients receiving maintenance hemodialysis: A cross-sectional study. J Int Med Res 2020; 48:300060519895844. [PMID: 32054360 PMCID: PMC7105727 DOI: 10.1177/0300060519895844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 11/27/2019] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to investigate the factors influencing health-related quality of life (HRQoL) in patients with different chronic kidney disease–mineral and bone disorder (CKD–MBD) phenotypes. Methods Patients undergoing maintenance hemodialysis (MHD) at our center from 1 July to 31 August 2017 were enrolled. Patients who received hemodialysis for less than 3 months or displayed poor compliance, or those with incomplete clinical data were excluded. QoL was evaluated using the Kidney Disease Quality of Life–Short Form (KDQOL-SF™) 1.3 scale. The influential factors were stratified based on different CKB–MBD phenotypes. Results There were 296 patients enrolled. The serum intact parathyroid hormone (iPTH) concentration was 436.40 ± 490.99 pg/mL, serum calcium (Ca) concentration was 2.14 ±0.27 mmol/L, serum phosphorus (P) concentration was 1.81 ± 0.56 mmol/L, the kidney disease and dialysis-related QoL (KDTA) score was 57.07 ± 10.40, and the SF-36 score was 51.45 ± 17.62. Among patients with different CKD–MBD phenotypes, HRQoL was highest in the group with an iPTH concentration of 150 to 300 pg/mL, serum Ca concentration of <2.10 mmol/L, and serum P concentration of >1.78 mmol/L. Conclusions CKD−MBD phenotypes significantly affected HRQoL. Comprehensive management of serum iPTH, Ca, and P levels is important to improve QoL in patients receiving hemodialysis.
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Affiliation(s)
- Laimin Luo
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, P.R. China
| | - Qinkai Chen
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, P.R. China
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Oliveira LM, Sari D, Schöffer C, Santi SS, Antoniazzi RP, Zanatta FB. Periodontitis is associated with oral health‐related quality of life in individuals with end‐stage renal disease. J Clin Periodontol 2020; 47:319-329. [DOI: 10.1111/jcpe.13233] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/04/2019] [Accepted: 12/08/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Leandro M. Oliveira
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Daniélli Sari
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Caroline Schöffer
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Samantha S. Santi
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Raquel P. Antoniazzi
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
| | - Fabrício B. Zanatta
- Postgraduate Program in Dentistry Emphasis on Periodontics Department of Stomatology Universidade Federal de Santa Maria (UFSM) Santa Maria Brazil
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