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Bakker WM, Theunissen M, Öztürk E, Litjens E, Courtens A, van den Beuken-van Everdingen MHJ, Hemmelder MH. Educational level and gender are associated with emotional well-being in a cohort of Dutch dialysis patients. BMC Nephrol 2024; 25:179. [PMID: 38778249 PMCID: PMC11112868 DOI: 10.1186/s12882-024-03617-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Patients undergoing dialysis have an impaired health-related quality of life (HRQOL). There are conflicting data from small series on whether patient-related factors such as educational level have an impact on experienced HRQOL. The aim of this study was to investigate the association between educational level and HRQOL in dialysis patients. METHODS In a single-center retrospective cross-sectional study HRQOL was measured using the Kidney Disease Quality of Life Short Form-36 (KDQOL-SF36) in prevalent chronic dialysis patients. Educational level was categorized into low, intermediate and high subgroups. Univariate and multivariate regression analyses were performed to assess the effects of age, gender, ethnicity, and dialysis vintage on the association between HRQOL and educational level. RESULTS One hundred twenty-nine chronic dialysis patients were included. Patients with an intermediate educational level had significantly higher odds of a higher emotional well-being than patients with a low educational level 4.37 (1.-89-10.13). A similar trend was found for a high educational level (OR 4.13 (1.04-16.42), p = 0.044) The odds for women compared to men were 2.83 (1.32-6.06) for better general health and 2.59 (1.15-5,84) for emotional well-being. There was no interaction between gender and educational level for both subdomains. Each year of increasing age significantly decreased physical functioning (OR 0.94 (0.91-0.97)). CONCLUSIONS Educational level and sex were associated with emotional well-being, since patients with intermediate and high educational level and females had better emotional well-being in comparison to patients with low educational level and males. Physical functioning decreased with increasing age.
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Affiliation(s)
- Wisanne M Bakker
- Department of Internal Medicine, Maastricht University Medical Center+, P. Debyelaan 25, Maastricht, 6229 HX, the Netherlands
| | - Maurice Theunissen
- Center of Expertise for Palliative Care, Maastricht University Medical Center+, (MUMC+), Maastricht, the Netherlands
| | - Elife Öztürk
- Department of Internal Medicine, Maastricht University Medical Center+, P. Debyelaan 25, Maastricht, 6229 HX, the Netherlands
- CARIM Cardiovascular Research Institute Maastricht, University Maastricht, Maastricht, the Netherlands
| | - Elisabeth Litjens
- Department of Internal Medicine, Maastricht University Medical Center+, P. Debyelaan 25, Maastricht, 6229 HX, the Netherlands
| | - Annemie Courtens
- Center of Expertise for Palliative Care, Maastricht University Medical Center+, (MUMC+), Maastricht, the Netherlands
| | | | - Marc H Hemmelder
- Department of Internal Medicine, Maastricht University Medical Center+, P. Debyelaan 25, Maastricht, 6229 HX, the Netherlands.
- CARIM Cardiovascular Research Institute Maastricht, University Maastricht, Maastricht, the Netherlands.
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Zahirian Moghadam T, Powell J, Sharghi A, Zandian H. Economic evaluation of dialysis and comprehensive conservative care for chronic kidney disease using the ICECAP-O and EQ-5D-5L; a comparison of evaluation instruments. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2023; 21:81. [PMID: 37924060 PMCID: PMC10625205 DOI: 10.1186/s12962-023-00491-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Chronic Kidney Disease (CKD) patients often require long-term care, and while Hemodialysis (HD) is the standard treatment, Comprehensive Conservative Care (CCC) is gaining popularity as an alternative. Economic evaluations comparing their cost-effectiveness are crucial. This study aims to perform a cost-utility analysis comparing HD and CCC using the EQ-5D-5L and ICECAP-O instruments to assessing healthcare interventions in CKD patients. METHODS This short-term economic evaluation involved 183 participants (105 HD, 76 CCC) and collected data on demographics, comorbidities, laboratory results, treatment costs, and HRQoL measured by ICECAP-O and EQ-5D-5L. Incremental Cost-Effectiveness Ratios (ICERs) and Net Monetary Benefit (NMB) were calculated separately for each instrument, and Probabilistic Sensitivity Analysis (PSA) assessed uncertainty. RESULTS CCC demonstrated significantly lower costs (mean difference $8,544.52) compared to HD. Both EQ-5D-5L and ICECAP-O indicated higher Quality-Adjusted Life Years (QALYs) for both groups, but the difference was not statistically significant (p > 0.05). CCC dominated HD in terms of HRQoL measures, with ICERs of -$141,742.67 (EQ-5D-5L) and -$4,272.26 (ICECAP-O). NMB was positive for CCC and negative for HD, highlighting its economic feasibility. CONCLUSION CCC proves a preferable and more cost-effective treatment option than HD for CKD patients aged 65 and above, regardless of the quality-of-life measure used for QALY calculations. Both EQ-5D-5L and ICECAP-O showed similar results in cost-utility analysis.
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Affiliation(s)
- Telma Zahirian Moghadam
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Jane Powell
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Afshan Sharghi
- Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamed Zandian
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
- Centre for Public Health and Wellbeing, School of Health and Social Wellbeing, College of Health, Science and Society, University of the West of England, Bristol, UK.
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Berhe T, Tegegne GT, Berha AB. Quality of life and associated factors among chronic kidney disease patients at Zewditu Memorial and Tikur Anbessa Specialised Hospitals, Ethiopia: a cross-sectional study design. BMJ Open 2023; 13:e069712. [PMID: 37263701 DOI: 10.1136/bmjopen-2022-069712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is associated with significant morbidity, mortality, healthcare cost and reduced health-related quality of life (HRQoL). This study aimed to assess HRQoL and associated factors among patients with CKD at both Zewditu Memorial and Tikur Anbessa Specialised Hospitals, Ethiopia. METHOD A cross-sectional study design was performed. All patients who visited the renal clinics in both hospitals from March to July 2019 were targeted, and data were collected using interviews and medical records. HRQoL was assessed using the Kidney Disease and Quality of Life-36 tool. Normality assessment was done for HRQoL subscales. Descriptive statistics, logistic regression, t-test and one-way analysis of variance were performed. RESULT A total of 300 patients with CKD were included. Around 62% of them were in either stage 3 or 4 CKD. The mean domain scores of physical component summary (PCS), mental component summary (MCS), burden of kidney disease, effect of kidney disease and symptoms and problems of kidney disease (SPKD) subscales were 50.4, 59.5, 63.1, 74.6 and 80.4, respectively. The lowest HRQoL was seen in the PCS scale, while the highest was in SPKD. In addition, the study revealed that a lower level of education, elevated serum creatinine and a history of smoking were significantly associated with poor PCS score. Further, the presence of three or more comorbidities, CKD-related complications and a lower haemoglobin level were significantly associated with poor MCS. CONCLUSION The overall mean scores of PCS and MCS were low, below the standard level. Level of education, serum creatinine and smoking history were significantly associated with PCS, while the presence of comorbidity, complications and haemoglobin level were significantly associated with MCS. Stakeholders working on CKD management should design a relevant strategy targeting patients, patients' care providers and healthcare professionals to improve HRQoL of patients.
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Affiliation(s)
- Teshome Berhe
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gobezie T Tegegne
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemseged Beyene Berha
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Alshelleh S, Alhawari H, Alhouri A, Abu-Hussein B, Oweis A. Level of Depression and Anxiety on Quality of Life Among Patients Undergoing Hemodialysis. Int J Gen Med 2023; 16:1783-1795. [PMID: 37193250 PMCID: PMC10183175 DOI: 10.2147/ijgm.s406535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023] Open
Abstract
Background Despite the growing concern worldwide regarding the quality of life (QoL) and mental well-being among chronic kidney disease (CKD), a few research has been done to address this issue. The study aims to measure depression, anxiety, and QoL prevalence among Jordanian patients with End Stage Renal Disease (ESRD) on hemodialysis and how all of these variables are correlated. Methods This is a cross-sectional, interview-based study on patients at the Jordan University Hospital (JUH) dialysis unit. Sociodemographic factors were collected, and the prevalence of depression, anxiety disorder, and QOL was assessed using the Patient Health Questionnaire 9 (PHQ9), the Generalized Anxiety Disorder 7-item (GAD7), and the WHOQOL-BREF, respectively. Results In a study of 66 patients, 92.4% had depression, and 83.3% had generalised anxiety disorder. Females had significantly higher depression scores than males (mean = 6.2 ± 3.77 vs 2.9 ± 2.8, p < 0.001), and single patients had significantly higher anxiety scores than married patients (mean = 6.1 ± 6 vs 2.9 ± 3.5, p = 0.03). Age was positively correlated with depression scores (rs= 0.269, p = 0.03), and QOL domains showed an indirect correlation with GAD7 and PHQ9 scores. Males had higher physical functioning scores than females (mean = 64.82 vs 58.87, p = 0.016), and patients who studied in universities had higher physical functioning scores than those with only school education (mean of College/University = 78.81 vs mean of School Education = 66.46, p = 0.046). Patients taking <5 medications had higher scores in the environmental domain (p = 0.025). Conclusion The high prevalence of depression, GAD, and low QOL in ESRD patients on dialysis highlights the need for caregivers to provide psychological support and counselling for these patients and their families. This can promote psychological health and prevent the onset of psychological disorders.
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Affiliation(s)
- Sameeha Alshelleh
- Division of Nephrology, Department of Medicine, The University of Jordan, Amman, Jordan
| | - Hussein Alhawari
- Division of Nephrology, Department of Medicine, The University of Jordan, Amman, Jordan
| | - Abdullah Alhouri
- Department of Medicine, Division of Gastroenterology, Royal Berkshire Hospital, Reading, UK
- Correspondence: Abdullah Alhouri, Department of Medicine, Division of Gastroenterology, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK, Email
| | | | - Ashraf Oweis
- Division of Nephrology, Department of Medicine, Jordan University of Science and Technology, Amman, Jordan
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Floria I, Kontele I, Grammatikopoulou MG, Sergentanis TN, Vassilakou T. Quality of Life of Hemodialysis Patients in Greece: Associations with Socio-Economic, Anthropometric and Nutritional Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215389. [PMID: 36430108 PMCID: PMC9696256 DOI: 10.3390/ijerph192215389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 05/13/2023]
Abstract
Chronic kidney disease (CKD) is a serious public health problem that, in recent decades, has taken on significant dimensions with serious effects on the quality of life (QoL) of patients. The purpose of this cross-sectional study is to evaluate the QoL of a sample of hemodialysis patients in Greece and the possible correlations with socio-economic and anthropometric factors, as well as with adherence to the Mediterranean Diet (MD). During September-November 2019, one-hundred and five (n = 105) patients with end-stage CKD (63.4 ± 13.09 years of age) who were regularly monitored in five public and private hemodialysis units in the region of Attica, completed a demographic questionnaire, the MedDietScore questionnaire, and the KDQOL-SF questionnaire. Females presented worse QoL than males (p < 0.05), and older patients presented worse QoL than younger patients (p < 0.01). Patients of higher educational status presented better QoL scores than those of lower educational status (p < 0.01), while those with low financial status presented lower QoL scores than patients of middle and high financial status (p < 0.01). Obese patients had lower QoL scores than overweight patients (p < 0.05), and overweight males scored higher than normal weight males (p < 0.05). Age was negatively correlated to the total and most of the scales of QoL (p < 0.01). A majority of the patients (90.5%) showed a moderate adherence to MD, although "work status" was the only QoL scale that was correlated to MD. Age, educational status and financial status accounted for 28.1% of the variance in the KDQOL-SF total score. Hemodialysis patients need support in various levels, such as social, financial and educational, as well as nutritional counseling to adopt a balanced diet and maintain a healthy weight, in order to achieve a better quality of life.
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Affiliation(s)
- Ioanna Floria
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
| | - Ioanna Kontele
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
| | - Maria G. Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41110 Larissa, Greece
| | - Theodoros N. Sergentanis
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece
- Correspondence:
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Elgendy A, Abdelsalam AI, Mansour M, Nassar MK. Can residual kidney function affect quality of life and cognitive function in hemodialysis patients? BMC Nephrol 2022; 23:263. [PMID: 35870885 PMCID: PMC9308911 DOI: 10.1186/s12882-022-02892-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Residual kidney function (RKF) may provide many benefits to patients on permanent renal replacement therapy that are reflected in better control of biochemical parameters. In hemodialysis patients, quality of life (QOL) and cognitive function are often impaired. This study aimed to assess the predictors of RKF and its impact on QOL and cognitive function in chronic hemodialysis patients. PATIENTS AND METHODS The study involved seventy-eight patients suffering from end-stage renal disease on regular hemodialysis. The patients were divided into two groups according to the presence or absence of RKF (24-hour urine volume ≥ 100 ml). Beside basic laboratory investigations, all patients were subjected to Kidney Disease Quality of Life-Short Form (KDQOL-SF) version 1.3 for assessing the quality of life and Montreal cognitive assessment (MoCA) score for assessing cognitive function. RESULTS There was a significantly higher score for KDQOL domains and MoCA score in patients with RKF compared to patients without RKF. There was a significant positive correlation between RKF and both of MoCA score and the physical composite score (PCS) of QOL. Moreover, there were statistically significant positive correlations between the MoCA score and both PCS and mental composite score (MCS). On multivariate analysis, hemodialysis duration was the only predictor for RKF; whereas age was a significant predictor for PCS; and MoCA score could be significantly predicted by the measured RKF and patients' age. CONCLUSION HD patients with maintained RKF had better QOL and cognitive function. The duration of HD and the age of the patients were found to be related to RKF and PCS in this study. RKF was associated with the cognitive performance of hemodialysis patients.
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Affiliation(s)
- Asmaa Elgendy
- Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Mansoura University, Mansoura, Egypt
| | - Adel I Abdelsalam
- Rheumatology and Immunology Unit, Internal Medicine Department, Mansoura University, Mansoura, Egypt
| | - Mostafa Mansour
- Clinical Pathology Department, Mansoura faculty of medicine, Mansoura, Egypt
| | - Mohammed K Nassar
- Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Mansoura University, Mansoura, Egypt.
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Sethi S, Menon A, Dhooria HPS, Makkar V, Dhooria GS, Chaudhary R. Evaluation of Health-Related Quality of Life in Adult Patients on Hemodialysis. Int J Appl Basic Med Res 2021; 11:221-225. [PMID: 34912684 PMCID: PMC8633691 DOI: 10.4103/ijabmr.ijabmr_237_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/20/2021] [Accepted: 07/09/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Hemodialysis in end-stage renal disease patients causes disability in different domains of patient's lives, leading to impaired (quality of life [QOL]). Studies measuring the QOL in patients on renal replacement therapy are limited in the Indian scenario. Aims: To evaluate the QOL in adult patients on maintenance hemodialysis by applying the World Health Organization QOL (WHOQOL)-BREF scale. Material and Methods and Study Design: Health-related QOL was evaluated in 100 adult patients on maintenance haemodialysis for 3 months or more in Dayanand Medical College and Hospital, Ludhiana. The WHOQOL-BREF was applied in these patients and the physical, psychological, social, and environmental health domains were assessed. Results: Most common age group was 31–60 years (56%) with a mean age of 54.44 years, male: 74%. Patients with age more than 60 years had better QOL scores in the social domain which was statistically significant (P = 0.005). Male patients had better scores in all four domains and was significant in the social domain (P = 0.025). Married patients had better QOL scores in social domain. Duration of dialysis had a reverse correlation with QOL scores in physical domain with better scores in dialysis duration of <12 months. Frequency of dialysis did not significantly affect the QOL scores. QOL scores were directly related to the monthly family income in all four domains with the highest income group showing better scores (P < 0.05). Conclusion: The present study provided an insight into the factors that affect the QOL in hemodialysis patients. Patients with age >60 years had better QOL scores in the social domain. Female gender, low serum proteins, HD duration of more than 1 year, and low monthly income were found to be associated with impaired QOL domains in patients undergoing maintenance hemodialysis.
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Affiliation(s)
- Suman Sethi
- Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | | | | | - Vikas Makkar
- Department of Nephrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Gurdeep Singh Dhooria
- Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Rupesh Chaudhary
- Department of Psychiatry, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Hakeem Ismael N, Omer Rashid A. Health-Related Quality of Life in End-Stage Renal Disease Patients and Healthy Individuals. Galen Med J 2021; 9:e1987. [PMID: 34466621 PMCID: PMC8343940 DOI: 10.31661/gmj.v9i0.1987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/18/2020] [Accepted: 08/28/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Health-related quality of life (HRQOL) is an important outcome measure in patients with end-stage renal disease (ESRD). HRQOL is assumed to improve with kidney transplantation and compared to hemodialysis. However, there is no evidence regarding HRQOL to support the optimal treatment choice for patients on hemodialysis who hesitate opting for transplantation. Therefore, this study aims to compare HRQOL between patients with ESRD and healthy individuals. Materials and Methods: This case-control study was performed of 50 patients with ESRD under hemodialysis and 100 healthy participants as controls. HRQOL was assess using the SF-36 questionnaire. Data was analysis by using linear regression to compared HRQOL between groups, and adjusted for age, gender, dialysis duration. Results: Most of the patients were males (62%) and aged 21 to 60 years old (82%). The patients and healthy subjects were significantly different in terms of the presence of chronic diseases (P<0.05). ESRD patients had a significantly lower level of satisfaction with health and function, family and friends, and social and psychological functions. The patients’ quality of life was not significantly affected by their demographic characteristics, including age, gender, educational level, marital status, and financial status. However, there was a significant association between chronic disease and HRQOL among ESRD (P=0.0001). Conclusion: ESRD has a remarkably negative effect on the patients’ quality of life and satisfaction with important domains of life. HRQOL among patients with end-stage renal disease can be affected by the associated chronic diseases.
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Affiliation(s)
- Niyan Hakeem Ismael
- Faculty of Medical Sciences, College of Nursing, University of Sulaimani, Urological Department. Sulaymaniyah, Iraq
| | - Aso Omer Rashid
- Faculty of Medical Sciences, College of Medicine, University of Sulaimani Urological Department, Sulaymaniyah, Iraq
- Correspondence to: Aso Omer Rashid, Assistant Lecturer, PhD. Faculty of Medical Sciences, College of Nursing, University of Sulaimani, Urological department. Sulaymaniyah, Iraq Telephone Number: 00964(0)7701930039 Email Address:
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Reyes M, Fuertes JN, Moore MT, Punnakudiyil GJ, Calvo L, Rubinstein S. Psychological and relational factors in ESRD hemodialysis treatment in an underserved community. PATIENT EDUCATION AND COUNSELING 2021; 104:149-154. [PMID: 32591256 DOI: 10.1016/j.pec.2020.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/23/2020] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The researchers investigated the association of depression with treatment adherence, and examined the possible moderating roles of social support and of the physician-patient working alliance (PPWA) on treatment adherence, satisfaction with treatment, and quality of life. METHODS The current study sampled ninety-five patients with End Stage Renal Disease who were receiving outpatient hemodialysis (HD) treatment. RESULTS Findings indicated that higher levels of depression were significantly associated with lower ratings of adherence, quality of life, and social support. In contrast, higher levels of social support and of the PPWA were significantly associated with higher ratings of adherence, satisfaction with treatment, and quality of life. Analyses of moderation showed no effect for PPWA between depression and adherence, satisfaction, or quality of life; however, there was a significant moderation effect for social support. CONCLUSION There are mild but significant associations between PPWA and social support. Positive associations between the PPWA and social support on adherence, satisfaction, and quality of life indicate that each one, PPWA and social support, plays its own role on patients' experiences of and behavior in treatment. Affective social support significantly limits the negative influence of depression on adherence. PRACTICE IMPLICATIONS Assessment of depression and social support is essential in hemodialysis treatment.
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Affiliation(s)
- Mariela Reyes
- Derner School of Psychology, Adelphi University, Garden City, NY 11530, USA
| | - Jairo N Fuertes
- Derner School of Psychology, Adelphi University, Garden City, NY 11530, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, 11549 USA.
| | - Michael T Moore
- Derner School of Psychology, Adelphi University, Garden City, NY 11530, USA
| | | | - Luis Calvo
- Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA
| | - Sofia Rubinstein
- Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA
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D'Souza MS, Labrague LJ, Karkada SN, Kamble P. Relationship between socio-demographic, clinical factors, and quality of life in adults living with diabetic nephropathy. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Romano-Zelekha O, Golan E, Ifrah A, Weinstein T, Shohat T. Differences in quality of life between Jewish and Arab patients on hemodialysis. Qual Life Res 2017; 26:3343-3352. [PMID: 28791563 DOI: 10.1007/s11136-017-1661-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE Higher health-related quality of life (HRQOL) in dialysis patients has been associated with fewer hospitalizations and lower mortality. Since Arab patients on dialysis have better survival rates than Jewish patients, we hypothesized that they would have higher HRQOL. We also studied the impact of several risk factors on HRQOL in each population. METHODS Based on a national dialysis registry, patients from 64 hemodialysis units were recruited to participate. Patients who consented were interviewed face-to-face, using the Kidney Disease Quality of Life Short Form (KDQOL-SF36) questionnaire. RESULTS Five hundred and fifty-eight (50.6%) Jewish and 544 (49.4%) Arab patients participated in the study. For Arab patients mean crude scores for the "mental component summary" and KDQOL scores were significantly lower than for Jewish patients [31.6 (95% Cl 30.0-33.3) vs. 38.0 (95% Cl 36.1-39.9), p < 0.0001 and 55.6 (95% Cl 54.5-56.7) vs. 59.8 (95% Cl 58.6-60.9), p < 0.0001, respectively]. Much lower scores were observed for Arabs in the "emotional role" and "work status" subscales. The two populations had similar general health assessments and albumin level. For both, HRQOL was positively associated with higher educational level, higher albumin level, and dialysis connection by fistula or graft; and negatively associated with low income and diabetes. HRQOL was negatively associated with previous cerebrovascular accident among Arabs and with female gender among Jews. CONCLUSIONS Differences between Jews and Arabs in subscales related to psychosocial factors suggest that cultural differences in the perceptions of sickness and health may be relevant here. Future studies should explore such possibility and focus on the large gap in the "work status" subscale.
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Affiliation(s)
- Orly Romano-Zelekha
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, 52621, Israel.
| | - Eliezer Golan
- Hemodialysis Unit, Meir Medical Center, Kfar Saba, Israel
- Israel Renal Registry, ISNH, Tel Hashomer, Israel
- Sourasky Medical Center Tel-Aviv, Tel-Aviv, Israel
| | - Anneke Ifrah
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, 52621, Israel
| | - Talia Weinstein
- Sourasky Medical Center Tel-Aviv, Tel-Aviv, Israel
- The Israeli Society of Nephrology and Hypertension, Tel-Aviv, Israel
| | - Tamy Shohat
- Israel Center for Disease Control, Ministry of Health, Tel Hashomer, 52621, Israel
- Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel
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SF36 Quality of Life and Mortality across Different Levels of Serum Albumin in Patients with Hemodialysis. Nephrourol Mon 2017. [DOI: 10.5812/numonthly.45319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Rebollo Rubio A, Morales Asencio JM, Eugenia Pons Raventos M. Depression, anxiety and health-related quality of life amongst patients who are starting dialysis treatment. J Ren Care 2017; 43:73-82. [PMID: 28239953 DOI: 10.1111/jorc.12195] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) has a severe impact on patients' health-related quality of life (HRQL). The start of renal replacement therapy (RRT) significantly influences psychological, physical and social aspects of life. OBJECTIVES To analyse the HRQL and psychological status (anxiety and depression) at the start of RRT. METHODS We undertook an observational descriptive cross-sectional study. A total of 152 patients starting RRT were recruited for the study. HRQL was measured by the Kidney Disease and Quality of Life Short Form questionnaire. Levels of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale questionnaire. Comorbidities and sociodemographic and clinical factors were also evaluated. FINDINGS HRQL in patients with end-stage kidney disease (ESKD) is significantly affected by the initiation of RRT in all respects. States of anxiety and depression were present in 26.6% and 27% of patients, respectively. These states are significantly related to the emotional component of the quality of life. CONCLUSION The initiation of RRT has a strong impact on HRQL in comparison with a reference population and with other stages of CKD. The early detection of an altered psychological state is important, as this condition should be treated from the first stages of the disease, as it can significantly affect the subsequent development of RRT and the patient's quality of life.
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Affiliation(s)
- Ana Rebollo Rubio
- Department of Nephrology, Carlos Haya Regional University Hospital and University of Málaga, Málaga, Spain
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Shayanpour S, Hayati F. Hepatitis E Virus Infection Among Chronic Hemodialysis. Jundishapur J Microbiol 2016; 9:e26645. [PMID: 27226872 PMCID: PMC4877441 DOI: 10.5812/jjm.26645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 11/03/2015] [Accepted: 01/04/2016] [Indexed: 02/02/2023] Open
Affiliation(s)
- Shokouh Shayanpour
- Department of Internal Medicine, Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Shokouh Shayanpour, Department of Internal Medicine, Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran. Tel: +98-9163114638, E-mail:
| | - Fatemeh Hayati
- Department of Internal Medicine, Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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15
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Lee SJ, Son H, Shin SK. Influence of frailty on health-related quality of life in pre-dialysis patients with chronic kidney disease in Korea: a cross-sectional study. Health Qual Life Outcomes 2015; 13:70. [PMID: 26021987 PMCID: PMC4460686 DOI: 10.1186/s12955-015-0270-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 05/20/2015] [Indexed: 12/24/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a progressive and lifelong condition with multiple medical comorbidities. Patients with CKD experience frailty more frequently and have lower health-related quality of life than do those with other chronic diseases. The purpose of this study was to examine the prevalence of frailty and investigate the contribution of frailty to quality of life in pre-dialysis CKD patients in Korea. Methods Using a cross-sectional survey design, data were collected at an outpatient CKD clinic in a general hospital in Korea. The frailty criterion was modified from previous studies. The Short Form-36 Health Survey version 2 was used to measure physical and mental component summary scores. Data were analyzed using chi-square, t-tests, and hierarchical linear regression. Results Of the 168 CKD patients, 63 (37.5 %) were frail. Frail patients were significantly older and had lower physical and mental quality of life than those who were non-frail. In hierarchical regression evaluating the influence of frailty on physical and mental quality of life, the initial model was significantly improved when frailty was included. Frail patients had lower physical and mental quality of life. Conclusions Frailty affected both physical and mental quality of life in pre-dialysis patients with CKD. More attention should be paid to the potential role of early detection and prevention of frailty to improve patients’ quality of life.
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Affiliation(s)
- Suk Jeong Lee
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, South Korea.
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, South Korea.
| | - Sug Kyun Shin
- National Health Insurance Cooperation Ilsan Hospital Clinical Professor, Yonsei University Medical College, Seoul, South Korea
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16
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Einollahi B, Motalebi M, Rostami Z, Nemati E, Salesi M. Sleep quality among Iranian hemodialysis patients: a multicenter study. Nephrourol Mon 2014; 7:e23849. [PMID: 25738125 PMCID: PMC4330687 DOI: 10.5812/numonthly.23849] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/12/2014] [Indexed: 12/20/2022] Open
Abstract
Background: Sleep disorders are prevalent complication in patients with end-stage renal disease undergoing hemodialysis (HD). The factors affecting sleep quality (SQ) of patients on HD have not been completely recognized yet. In addition, some studies have shown that poor SQ increases the risk of mortality in patients on HD. Objectives: This study aimed to identify the prevalence of poor SQ and its associated risk factors in Iranian patients on HD. Patients and Methods: This cross-sectional and multicenter study was conducted on 6878 patients on HD from 132 dialysis centers in Iran. Sleep domain of disease specific core of KDCS-SF questionnaire and generic core of this questionnaire (SF-36) were used to assess patients’ SQ and quality of life (QoL), respectively. A poor SQ was defined as a score of ≤ 61.2. Logistic and linear regression analyses were applied to assess predictors of SQ and their associations. Results: The mean age of patients was 54.4 ± 17.1 years and 39.7% of patients were > 60 years old. The majority of our patients had poor SQ (60.6%). Patients with diabetes mellitus were significantly more likely to have poor quality of sleep (63.4%). In logistic regression analysis, there were significant correlation between good SQ and younger age, shorter dialysis vintage, less muscle cramp, high QoL, high cognitive function score, and high sexual function. In addition, linear regression showed a significant association among SQ, QoL, and hospital stay as an outcome. Conclusions: With improving some factors and QoL of patients on HD, we can promote SQ in these patients that it might lead to reduction in length of hospital stay.
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Affiliation(s)
- Behzad Einollahi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohsen Motalebi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Mohsen Motalebi, Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-2181262073, Fax: +98-2181262073, E-mail:
| | - Zohreh Rostami
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Eghlim Nemati
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mahmood Salesi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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17
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Zamanian H, Taheri Kharameh Z. Translation and psychometric properties of the persian version of the dialysis symptom index in hemodialysis patients. Nephrourol Mon 2014; 7:e23152. [PMID: 25738123 PMCID: PMC4330695 DOI: 10.5812/numonthly.23152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 10/03/2014] [Accepted: 10/26/2014] [Indexed: 12/18/2022] Open
Abstract
Background: Hemodialysis patients have a high physical and psychosocial symptom burden. There is no valid and reliable tool for assessing symptoms of hemodialysis patients in Iran. Objectives: The aim of this study was to determine psychometric properties of the Persian version of the dialysis symptom index (DSI). Patients and Methods: The forward-backward procedure was applied to translate the DSI from English into Persian (Iranian language). The scale (Persian Version) was tested with a convenience sample of 95 patients with end-stage renal disease referred to main hemodialysis centers from December 2012 to June 2013. Validity was assessed using content, face and convergent validity. To test reliability, the kappa values were calculated for test-retest stability and the Cronbach alpha coefficients were also calculated for internal consistency. Results: The mean age of patients was 50.4 (SD = 15.72) years and % 61.1 of patients were male. The most commonly reported symptoms were fatigue, being irritable and nervous. Divergent validity was mostly supported by the pattern of association between DSI and SF-36 (r = -0.18– -0.48, P< 0.05). Cronbach’s alpha of the DSI was 0.90 and the weighted kappa ranged from 0.21 to 0.93, and it was greater than 0.4 for 25 of the 30 items. Conclusions: The Iranian version of the DSI had good psychometric properties and can be used to assess symptoms of hemodialysis patients.
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Affiliation(s)
- Hadi Zamanian
- Department of Health Education and Promotion, School of public health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Zahra Taheri Kharameh
- School of Paramedical Sciences, Qom University of Medical Sciences, Qom, IR Iran
- Corresponding author: Zahra Taheri Kharameh, School of Paramedical Sciences, Qom University of Medical Sciences, Qom, IR Iran. Tel: +98-9354024468, E-mail:
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18
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Bahadori M, Ghavidel F, Mohammadzadeh S, Ravangard R. The effects of an interventional program based on self-care model on health-related quality of life outcomes in hemodialysis patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2014; 3:110. [PMID: 25540783 PMCID: PMC4275608 DOI: 10.4103/2277-9531.145899] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Hemodialysis patients have lower quality of life and one of the ways to improve their quality of life is providing self-care education to them using some models including self-care model. This study aimed to determine and evaluate the effects of using self-care model on health and quality of life outcomes in hemodialysis patients. MATERIALS AND METHODS This was a quasi-experimental study conducted in 2012 on the patients who were referred to a military hospital in Tehran, Iran to be treated with hemodialysis. All 32 patients referred to this hospital in 2012 were selected and studied. Required data were collected using the Short Form-36 (SF-36) standard questionnaire and a researcher-made questionnaire. The educational intervention was implemented using self-care model. Collected data were analyzed using SPSS for Windows version 18.0 and some statistical tests including paired samples t-test, Wilcoxon and McNemar tests. RESULTS The results showed that the mean and standard deviation (SD) of patients' parameters including weight and blood pressure improved significantly after the educational intervention compared to before the intervention (P < 0.001). Also, all dimensions of the quality of life of hemodialysis patients, including physical function, role physical, bodily pain, general health, vitality, social function, mental health, and role emotional improved compared to those before the intervention (P < 0.001). CONCLUSION Implementing the self-care model increased the quality of life of hemodialysis patients. Therefore, the use of this model in hemodialysis patients is recommended.
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Affiliation(s)
- Mohammadkarim Bahadori
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ghavidel
- Department of Nursing, School of Nursing and Midwifery, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Shahla Mohammadzadeh
- Department of Nursing, School of Nursing and Midwifery, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
| | - Ramin Ravangard
- Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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19
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Einollahi B, Motalebi M. Do elderly patients benefit from renal transplantation? Indian J Nephrol 2014; 24:333-4. [PMID: 25249732 PMCID: PMC4165067 DOI: 10.4103/0971-4065.133046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- B Einollahi
- Nephrology and Urology Research Center, Department of Internal Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - M Motalebi
- Nephrology and Urology Research Center, Department of Internal Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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20
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Nobakht E, Cohen SD. Editorial Comment: Health-Related Quality of Life in Hemodialysis Patients: An Iranian Multi-Center Study. Nephrourol Mon 2014; 6:e16986. [PMID: 25032131 PMCID: PMC4090582 DOI: 10.5812/numonthly.16986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 01/21/2014] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ehsan Nobakht
- Division of Renal Diseases and Hypertension, George Washington University, Washington, DC, USA
| | - Scott D Cohen
- Division of Renal Diseases and Hypertension, George Washington University, Washington, DC, USA
- Corresponding author: Scott D Cohen, Division of Renal Diseases and Hypertension, George Washington University, Washington, DC, USA. Tel: +1-2027412283, E-mail:
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21
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Gender effect on quality of life in hemodialysis patients. J Nephrol 2014; 27:591. [PMID: 24536000 DOI: 10.1007/s40620-013-0006-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 11/19/2013] [Indexed: 10/25/2022]
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22
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Nemati E, Motalebi M. The gender effect of health-related quality of life in hemodialysis patients. Nephrourol Mon 2014; 6:e15934. [PMID: 24719818 PMCID: PMC3968987 DOI: 10.5812/numonthly.15934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 11/06/2013] [Accepted: 12/01/2013] [Indexed: 01/02/2023] Open
Affiliation(s)
- Eghlim Nemati
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohsen Motalebi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Mohsen Motalebi, Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Molla Sadra Ave, Vanak Sq., Tehran, IR Iran. Tel: +98-2181262073, Fax: +98-2181262073, E-mail:
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23
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Nemati E, Motalebi M. A Better Quality of Life in Hemodialysis Patients With Viral Hepatitis: Is it a Reality? HEPATITIS MONTHLY 2013; 13:e15525. [PMID: 24348649 PMCID: PMC3860094 DOI: 10.5812/hepatmon.15525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 10/25/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Eghlim Nemati
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohsen Motalebi
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Mohsen Motalebi, Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Molla Sadra Ave, Vanak Sq., Tehran, IR Iran. Tel: +98-2181262073, Fax: +98-2181262073, E-mail:
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24
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Einollahi B, Motalebi M. Quality of life in different geographic areas; sharing an experience. J Nephropharmacol 2013; 2:47-48. [PMID: 28197447 PMCID: PMC5297555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 06/18/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- Behzad Einollahi
- 1Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Motalebi
- 1Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
,Corresponding author: Mohsen Motallebi,
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