Life In Hemodialysis Patients Research Articles

The Correlation between Self-Efficacy of Hemodialysis Patients with Their Quality of Life

Background: Haemodialysis is often associated with decreased quality of life. Self-efficacy is a perception of patient confidence in ability activities. The correlation between self-efficacy and quality of life in the Indonesian sample is not yet explored in depth. Aim: To determine the correlation between self-efficacy and the quality of life in hemodialysis patients. Methods: Cross-sectional study. About 234 respondents were included. The General Self-Efficacy Scale (GSES) questionnaire has been used to measure self-efficacy, and the World Health Organization Quality of Life (WHOQOL-BREF) was used to measure the respondent's quality of life. Kendall's tau statistical approach was used to determine the correlation between self-efficacy and quality of life. Results: Majority of respondents with high self-efficacy as much as 68.8%, and majority of respondents with moderate and good quality of life as much as 48.3%. A significant correlation between self-efficacy and quality of life (p=0.000) with a correlation coefficient value of 0.491 was found. Conclusion: High level of self-efficacy would be a better quality of life of haemodialysis patients. Improving self-efficacy as a nursing care process is recommended as nursing outcomes in order improve the quality of life of haemodialysis patients. Identify self-efficacy predictor factors of haemodialysis patients are recommended for further research.

Association of plant and animal protein intake with sleep quality and quality of life in hemodialysis patients: a multicenter cross-sectional study

BackgroundThe current study aimed to evaluate the association between the intake of plant-based protein, animal-based protein, total protein, and the ratio of plant to animal protein with sleep quality and quality of life in patients undergoing hemodialysis.MethodsIn this cross-sectional study, 479 adult patients undergoing dialysis for a minimum of 3 months were included. The dietary intake was calculated using information from a validated 168-item semi-quantitative food frequency questionnaire. Quality of life (QOL) was assessed using the Kidney Disease Quality of Life Short Form (KDQOL-SF 1.3). and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality.ResultsIn this study, the mean age of the participants was 58.18 years (± 14.25 years), with the majority being male (58.2%). After adjusting for potential confounders, significant positive associations were observed between total protein intake (β = 0.12, p = 0.03) and quality of life (QOL). Conversely, there were significant negative associations between the ratio of plant to animal protein intake (β = −0.94, p < 0.01) and QOL. Furthermore, significant negative associations were found between total protein intake (β = −0.02, p < 0.05) and animal protein intake (β = −0.19, p < 0.05) with poor sleep quality. Additionally, there were significant positive associations between the ratio of plant to animal protein intake (β = 0.188, p < 0.05) and poor sleep quality.ConclusionIncreased consumption of animal protein is associated with improved sleep quality and Quality of Life (QOL) in patients undergoing hemodialysis (HD). Further research, especially prospective studies, is required to confirm these associations.

The Effect of Fordyce Happiness Training on Life Expectancy and Quality of Life in Hemodialysis Patients: An Intervention Study in Yazd, Iran

Background: Dialysis patients frequently experience issues such as fear, reduced social activity, and hopelessness due to lifestyle changes and treatment requirements. Objectives: This study aimed to determine the effect of Fordyce happiness training on quality of life and life expectancy in hemodialysis patients. Methods: This quasi-experimental intervention study involved 48 hemodialysis patients who were referred to Shahid Rahnemoun Hospital in Yazd, Iran, and selected through simple random sampling. Data collection tools included the Quality-of-Life Questionnaire for Kidney Patients (KDQOL-36) and the Miller Life Examination Questionnaire. Patients participated in ten 60-minute training sessions, held twice weekly. Data were collected at baseline and one month after the intervention and analyzed using SPSS 21 software. Results: Following Fordyce's happiness training, levels of potassium (K), creatinine (Cr), and blood urea nitrogen (BUN) in patients significantly decreased. Before the intervention, the mean scores for quality of life and life expectancy in dialysis patients were 51.9 ±28.27 and 169.75 ±11.95, respectively, which increased to 64.66 ±27.17 and 179.95 ±9.37 after the intervention. Paired t-test results indicated that Fordyce happiness training had a statistically significant positive effect on patients' quality of life (P < 0.05) and life expectancy (P < 0.05). Conclusions: The Fordyce happiness training program can improve quality of life and life expectancy in dialysis patients. In other words, happiness training may serve as a preventive strategy against mental disorders such as depression, anxiety, and life dissatisfaction in dialysis patients.

Blood osteoprotegerin is associated with arteriovenous access thrombosis in hemodialysis patients.

A functioning arteriovenous (AV) access is essential for hemodialysis efficiency and the quality of life in hemodialysis patients. Blood osteoprotegerin (OPG) and soluble receptor activator of nuclear factor kappa B ligand (RANKL) have been linked to cardiovascular diseases and vascular calcification. This study investigated the relationship between blood OPG, RANKL, and the occurrence of AV access thrombosis. This prospective cohort study was conducted from August 2016 to August 2021 and included patients undergoing prevalent hemodialysis in two hospital-based hemodialysis units. Cox proportional hazards models and Kaplan-Meier analysis were used to evaluate the association between blood OPG, RANKL, and AV access (AV fistula [AVF] and AV graft [AVG]) outcomes. A total of 333 hemodialysis patients were enrolled, with an AV access thrombosis rate of 22.2%. Cox regression identified several factors associated with AV access thrombosis: AV access type (AVF vs. AVG; hazard ratio [HR], 0.24; p < 0.001), C-reactive protein (HR, 1.07; p = 0.002), and log-transformed OPG (HR, 5.52; p = 0.005). Subgroup analysis revealed high log-transformed OPG and RANKL were associated with AVF thrombosis (HR, 10.77; p = 0.002 and HR, 3.26; p = 0.009, respectively), while high C-reactive protein increased the risk of AVG thrombosis (HR, 1.31; p < 0.001). Kaplan-Meier analysis showed that patients with AVF in the highest tertile of log OPG (>402 pg/mL) had the highest AVF thrombosis incidence (p = 0.03). High blood OPG was associated with AV access thrombosis, particularly in the AVF.

Social Support and Quality of Life in Hemodialysis Patients: A Comparative Study with Healthy Controls

Background and Objectives: Hemodialysis patients face significant physical and psychological challenges, including diminished quality of life and reduced social support. This study aimed to assess the levels of social support and quality of life in hemodialysis patients and identify the sociodemographic and dialysis-related factors influencing these outcomes. Materials and Methods: This study included 115 hemodialysis patients and 107 healthy controls. Social support was measured using the Modified Social Support Survey (MSSS) and its abbreviated version (MSSS-5). Quality of life was assessed using the WHOQOL-BREF questionnaire. Demographic variables (age, sex, education, marital status) and dialysis-related factors (session duration, Kt/V, vascular access type, and urea reduction ratio) were analyzed to determine their effects on social support and quality of life. Results: Hemodialysis patients reported significantly lower scores in the Physical Health and Psychological Health domains of the WHOQOL-BREF compared to healthy controls. Males on hemodialysis scored lower than the controls in the Physical Health, Psychological Health, and Environment domains of the WHOQOL-BREF and the Affectionate Support and Positive Social Interaction subscales of MSSS. Conversely, hemodialysis females reported higher scores for Tangible Support, Emotional/Informational Support, and Affectionate Support. Longer dialysis sessions negatively impacted the Social Relationships domain. Married hemodialysis patients had higher Emotional/Informational Support and Affectionate Support scores. Conclusions: Hemodialysis patients experience diminished physical and psychological quality of life, particularly males. Social support, especially emotional and informational support, is crucial for hemodialysis patients, with marital status playing a key role. Addressing these psychosocial factors may improve outcomes for hemodialysis patients.

The German Epidemiological Hemodialysis Itch Study (GEHIS) - 10-year follow-up of pruritus and health-related quality of life in hemodialysis patients.

Chronic pruritus (CP) in hemodialysis (HD) patients is a difficult to control phenomenon. While some drugs like difelikefalin showed promising results in a reduction of CP, others failed. GEHIS (German Epidemiological Hemodialysis Itch Study) is a representative, prospective cross-sectional observational cohort study of 860 HD patients started in 2013. It addresses prevalence and associated factors of CP in HD patients such as health-related quality of life (HRQOL).

Psychosocial Determinants for Self-Reported Health Status in Hemodialysis Patients: A Cohort Analysis of the CONVINCE Randomized Trial.

We investigated whether psychosocial determinants self-efficacy and social support are associated with Health-Related Quality of Life in hemodialysis patients enrolled in the CONVINCE trial. We used baseline data from the cohort of patients involved in the CONVINCE randomized trial of hemodiafiltration versus hemodialysis. Measures included age, gender, relationship status, children, housing, education, employment, comorbidities, dialysis schedules, time of first dialysis, residual kidney function, general self-efficacy and social support scores, and PROMIS measurements for health-related quality of life. Associations were analyzed using hierarchical regression. One thousand three hundred and sixty patients from CONVINCE were the cohort of interest. Mean age was 62±13.5 years (range 20-92), and 66.9% were men. Self-efficacy was a significant predictor for all health-related quality of life domains: depression (β = -0.36, p < 0.001), anxiety (β = -0.35, p < 0.001), social participation (β = 0.32, p < 0.001), cognition (β = 0.29, p < 0.001), fatigue (β = -0.29, p < 0.001), physical function (β = 0.27, p < 0.001), sleep disturbance (β = -0.23, p < 0.001), pain interference (β = 0.21, p < 0.001), pain intensity (β = -0.17, p < 0.001), interdialytic symptoms (β = -0.14, p = 0.002) and intradialytic symptoms (β = -0.14, p = 0.002). Social support was a significant predictor for cognition (β = 0.21, p < 0.001), sleep disturbance (β = -0.11, p = 0.017) and intradialytic symptoms (β =- 0.11, p = 0.02). Higher general self-efficacy scale scores are associated with improvements in cognition, depression, anxiety, social participation, fatigue, physical function, sleep disturbance, pain interference, interdialytic symptoms, pain intensity and intradialytic symptoms. Associations for self-efficacy are larger than those for social support and stronger than previously reported. It is plausible that targeted psychosocial interventions may improve health outcomes in people on hemodialysis.

Association of vitamin intake with health-related quality of life in hemodialysis patients.

It is still uncertain whether vitamin intake is associated with better quality of life in hemodialysis patients. This study aims to assess the association between the quantity of supplemented vitamins and health-related quality of life (HRQoL) in this population. This cross-sectional study included all patients on chronic hemodialysis from three units. Vitamins and micronutrients assessed were B1, B6, B12, C, D, folic acid, menaquinone, carnitine, zinc, and coenzyme Q10. Quality of life scores included the 8 domains of SF-36 and the 11 domains of the Kidney Disease Quality of Life (KDQOL). Bivariate analysis compared two groups of patients divided based on the median of vitamin intake. Spearman Rho test assessed the correlation between number of vitamins and different dimensions of HRQoL. A total of 183 patients were included. Median number of vitamins supplemented was 2 (1,3); 112 patients had an intake of ≤ 2 vitamins, and 71 patients were taking > 2 vitamins. There was a significant association between higher vitamin intake and the burden of kidney disease that remained significant in the multivariable analysis (p = 0.03), but no correlation between the number of vitamins (0 - 13) and different HRQoL scores. Sub-analyses of each category of vitamins showed no significant difference in HRQoL scores except for Vitamin B and staff encouragement (p = 0.01) and for multivitamins and quality of social interaction (p = 0.03). A higher number of vitamins in hemodialysis patients is associated with an increased perception of the burden of kidney disease. Interventional studies are needed to assess whether selective vitamin supplementation in case of deficiencies is associated with better quality of life.

Effect of manual acupressure (points SP6, SP10, ST36, and LI11) on the uremic pruritus and quality of life in hemodialysis patients: A parallel, randomized controlled trial

The present study was conducted to determine the effect of manual acupressure on uremic pruritus and quality of life (QoL) in patients undergoing hemodialysis. This randomized controlled trial was conducted with a pre-post design on 90 patients with hemodialysis in southern Iran. The patients were divided into three groups using block randomization: intervention, sham control, and passive control. The intervention group received acupressure on SP6, SP10, ST36, and LI11 points. In the sham group, pressure was exerted on sham points two Cuns away from the actual points, and the passive control group solely received routine treatment. The intervention was carried out three times a week for four weeks. The patient's QoL was evaluated before and after the intervention using the Itchy QoL scale, and the dimensions of itching were assessed before the intervention and two and five weeks after commencing the intervention using the 5-D Pruritus scale. The groups' QoL and itching parameters were the same before the intervention. The analysis of variance (ANOVA) showed significant differences among the groups in terms of QoL following intervention. This index improved significantly in the intervention group compared to the other groups (P&lt;0.001, G1=107.20 (standard deviation [SD]=5.45)). Repeated measures ANOVA showed that acupressure significantly reduced the severity and duration of itching and the number of itching points in the intervention group. Acupressure can improve hemodialysis patients' QoL and itching sensations. Being a non-pharmaceutical, risk-free, and inexpensive method, this intervention could be recommended to be used for relieving uremic pruritus.

Association of the modified creatinine index with quality of life in haemodialysis patients.

Aims/Background The evaluation of health-related quality of life in patients undergoing maintenance haemodialysis has garnered increasing attention. The modified creatinine index, a surrogate marker for muscle mass, has been linked to various clinical outcomes. However, the relationship between modified creatinine index and health-related quality of life in maintenance haemodialysis patients remains unclear. This study aims to elucidate the association between modified creatinine index and health-related quality of life in individuals receiving maintenance haemodialysis. Methods This cross-sectional study included 217 maintenance haemodialysis patients. Health-related quality of life was assessed using the Kidney Disease Quality of Life Instrument. Collected data included general patient information, laboratory results, and haemodialysis-related parameters. The modified creatinine index was calculated based on gender, age, single-pool Kt/V (spKt/V), and pre-dialysis serum creatinine levels. Multiple linear regression models and smooth curve fitting were used to investigate the relationship between modified creatinine index and health-related quality of life. Subgroup analyses and interaction tests were performed to identify potential effect modifiers. Results The 217 maintenance haemodialysis patients had a mean age of 53.66±13.15 years and a median dialysis vintage of 39 (25-84) months; 120 (55.30%) were male. The mean health-related quality of life score was 55.76±10.33, and the mean modified creatinine index was 22.72±2.95 mg/kg/day. After adjusting for confounding factors, an increase in modified creatinine index was associated with an improvement in health-related quality of life (β=0.55, 95% CI: 0.04, 1.06, p = 0.033). No nonlinear relationship was identified between modified creatinine index and health-related quality of life by smooth curve fitting. Subgroup and interaction analyses indicated that the relationship between modified creatinine index and health-related quality of life was stable and not significantly influenced by age, gender, dialysis vintage, diabetes status, or body mass index (p > 0.05). Conclusion Modified creatinine index is positively correlated with health-related quality of life in maintenance haemodialysis patients, suggesting its potential utility in evaluating patient quality of life. Modified creatinine index could be clinically useful to improve the predictability of health-related quality of life in maintenance haemodialysis patients.

Is there any association between type of dietary fat and quality of life in hemodialysis patients? A cross-sectional study.

Hemodialysis (HD) patients have a low quality of life (QOL), and dietary intakes may impact both somatic and psychosocial aspects of QOL. Nevertheless, the relationship between QOL and different dietary fats has not yet been evaluated. The purpose of this study was to assess the association between QOL and the types/quantities of dietary fats intake in HD patients. In this multi-center cross-sectional study, 251 adult patients under dialysis for at least 3 months were included. Participants' dietary intakes were collected using a validated 168-item semi-quantitative FFQ during the past year. Moreover, to assess QOL, Kidney Disease Quality of Life Short Form (KDQOL-SF 1/3) was used. The linear regression between QOL and different types of dietary fats was conducted. p < 0.05 was statistically significant. Overall, 66 women and 185 men participated in our study. Regression analysis adjusted for total calorie intake showed that there was a negative association between QOL and total fat (95% CI: -0.187, -0.043), SFA (95% CI: -0.688, -0.143), MUFA (95% CI: -0.389, -0.065) and PUFA (95% CI: -0.401, -0.056) when types of dietary fats were individually included to the regression analysis. When all types of dietary fats were simultaneously entered into the analysis, the association between QOL and MUFA (95% CI: -0.243, 1.031) and PUFA (95% CI: -1.159, 0.084) were attenuated. The regression coefficient for SFA remained significant (95% CI: -0.968, -0.138). Also, there was a marginally significant association between SFA and the risk of low QOL was observed when all types of dietary fats were simultaneously entered into the analysis (OR = 1.051, 95% CI: 0.998-1.104). Our investigation found a negative association between SFA consumption and QOL among different types of dietary fats. Furthermore, SFA mediated the relationship between QOL, MUFA, PUFA, and total fat. So, modification of dietary fat intake could enhance QOL in HD patients.

The Correlation Between Quality of Sleep and Quality of Life in Hemodialysis Patients; An Indonesian Sample

Background: Sleep quality is important clinical outcomes of hemodialysis patients. Nurse has importance role to maintains the quality of life in hemodialysis patients. Therefore, quality of sleep and quality of life in hemodialysis patients in research are needed in order to improve quality of life hemodialisys patients. Aim: To determine the correlation between quality of sleep and quality of life in hemodialysis patients. Method: Cross-sectional study. The Pittsburgh Sleep Quality Questionnaire (PSQI) and WHOQOL–BREF questionnaires were administered in this study. The Kendall Tau test was used to determine the correlation between sleep quality and quality of life. Results: Two hundred four respondents participated in this study. A total 90.2% of hemodialysis patients experienced mild sleep disturbances and, 48.3% of patients had a good quality of life category. A significant correlation between sleep quality and quality of life in hemodialysis patients was found (p=0.002). Conclusion: Lower levels of quality of sleep in hemodialysis patients have a negative effect on quality of life. Reducing sleep disruption through nursing intervention programs for hemodialysis patients is recommended during nursing care to increase quality of sleep in this vulnerable population. Identification of factors supporting sleep quality and intervention strategies are recommended for further research.

Effect of foot reflexology massage on sleep, anxiety and quality of life in hemodialysis patients: A single-blind, randomized, placebo-controlled trial

ObjectiveThe aim of this study is to investigate the effects of reflexology foot massage on sleep, anxiety, and quality of life as compared to foot massage only in patients undergoing hemodialysis treatment. MethodsThis study was conducted as a single blinded randomized placebo-controlled parallel-group trial. Data were collected using the “Demographic Characteristics Form”, “Richards-Campbell Sleep Scale”, “State-Trait Anxiety Inventory” and “Nottingham Health Profile”. Individuals in the reflexology and placebo groups received massages for three weeks; three times a week, for 15 minutes on each foot. Participants in the reflexology and placebo groups were followed-up before the massage and after the ninth massage session. ResultsIn the statistical evaluation of the sleep quality scale mean scores, after the ninth massage session, it was determined that the average sleep score of the reflexology massage group was higher than that of the placebo group. Additionally, the state anxiety level was found to be lower in the reflexology group compared to the placebo group. As for the quality of life after the ninth massage session, it was determined that there was an improvement in the reflexology massage group compared to the placebo group. ConclusionsThis study has found that foot reflexology massage is effective in reducing anxiety levels, improving sleep, and enhancing the quality of life in patients undergoing hemodialysis treatment. The findings of this study may offer nurses greater awareness of the potential benefits of reflexology. In this way, more healthcare professionals can be encouraged to use reflexology in addition to other cares.

Fatigue and Health-Related Quality of Life among Hepatitis and Non-Hepatitis Patients Undergoing Hemodialysis

Background: A common problem in hemodialysis patients, fatigue is a personal perception of extreme tiredness that impairs their quality of life, physical and mental abilities, activity levels, and performance. Study objective(s): This comprehensive study aims to assess the impact of fatigue on health-related quality of life in hemodialysis patients. Methodology: A descriptive A-non-probability (purposive sample) of (205) male and female hemodialysis patients in AL-Diwaniyah City with end-stage renal disease and undergoing hemodialysis. Most patients were diagnosed with ESRD &gt; one year ago, including those who have been on a maintenance hemodialysis programmer for more than a year. A validated and comprehensive health-related quality of life questionnaire (SF-36) tailored for individuals undergoing hemodialysis was utilized to assess fatigue and health-related quality of life among hepatitis and non-hepatitis patients undergoing hemodialysis. The study was conducted at hemodialysis centers, ensuring representation from different geographic regions and patient populations. Result: A total of 205 hemodialysis patients participated in the study. The results revealed that most participants had moderate fatigue (88 (42.9%), mild fatigue (61 (29.8%), and severe fatigue (56 (27.3%). The patient's overall health-related quality of life was found to be low, with a mean score of 19.82. conclusion: Fatigue is a prevalent symptom in hemodialysis patients, affecting their ability to engage in routine activities and self-care, negatively impacting self-confidence and health-related quality of life. Addressing fatigue is crucial for improving physical well-being and mental health.

The combined effect of leucine-enriched essential amino acid supplements and locomotion training on physical functions and quality of life in hemodialysis patients

BackgroundLocomotive syndrome (LS) is a condition of reduced mobility (locomotive organ impairment) that is associated with reduced quality of life (QOL) in patients undergoing hemodialysis (HD), and effective interventions for patients with LS undergoing HD are unclear. We conducted a clinical trial to assess the effects of exercise and oral nutritional supplementation (ONS) on QOL in this cohort.MethodsThis study was an open-label, randomized controlled trial. The participants were patients with LS undergoing HD. The intervention period was 3 months. The primary outcome was a change in the physical component summary (PCS) of QOL, and the secondary outcomes were changes in other QOL scores, physical function, body composition, and nutritional status assessed by using the geriatric nutritional risk index. Participants were divided into the locomotion training (LT) and LT + ONS groups. Both groups were instructed on LT that comprised one-leg standing and squats to be carried out four or more times per week. The ONS consisted of 3 g leucin-rich essential amino acids and 800 IU vitamin D per pack, and the participants in the LT + ONS group received one pack of the supplement per day.ResultsIn total, 40 individuals undergoing HD were included in the study; 3 patients in the LT + ONS group were excluded from the analysis because of hospitalization and incomplete assessment. The median age was 73 years (interquartile range: 62–80 years), 23 participants were men (62%), and the duration of dialysis treatment was 6 years (interquartile range: 3–16 years). The change in PCS of the LT + ONS group did not differ from that in the LT group [LT + ONS: −1.6 (−5.3, 6.8) versus LT: −0.1 (−5.3, 6.2), p = 0.94]. In contrast, the LT + ONS group showed maintenance in mental health (MH) and improvement of the two-step value.ConclusionsThe LT + ONS group did not show an effect on PCS in QOL compared with only LT in patients with LS undergoing HD. However, maintenance of MH and improvement of two-step value were confirmed in the LT + ONS group. Future research is need to confirm whether leucine-rich essential amino acids and vitamin D help mental health and physical function in patients with LS undergoing HD with larger sample sizes and long-term interventions.Clinical trial registration University Hospital Medical Information Network Center (UMIN 000032457).

Influence of self‐management, self‐efficacy, depression and social support on quality of life in patients undergoing haemodialysis by disease stage in South Korea

AbstractAimTo investigate the influence of self‐management, self‐efficacy, depression and social support by disease stage on quality of life in patients undergoing haemodialysis in South Korea.DesignA cross‐sectional survey design was used. Participants completed self‐report questionnaires.MethodsA convenience sample of 409 patients undergoing haemodialysis were recruited to complete self‐report questionnaires. T‐tests, ANOVA, multiple comparisons with Dunnett's T3 post hoc test, Pearson's correlation coefficients and hierarchical linear multiple regression were conducted using IBM SPSS version 25.0.ResultsThe crisis stage group had the highest mean quality of life score (M = 83.92). Factors influencing quality of life were social support and depression in the crisis stage and depression, self‐efficacy and self‐management in the stable stage, explaining 38.5% and 51.5% of the total variation each. In the downward stage, only depression was a significant predictor of quality of life, explaining 55.9% of it.ConclusionLong‐term intervention to decrease depression regardless of disease stage to improve quality of life in haemodialysis patients is required. Nursing interventions should include increasing social support to promote patients' quality of life in the crisis stage and improving self‐efficacy and self‐management in the stable stage.Implications for the profession and/or patient careBased on quality of life predictors, the development and implementation of patient‐centered nursing interventions considering the patient's disease stage can improve haemodialysis patients' quality of life.Impact There is minimal research on patients' quality of life considering disease stage. Depression was a significant factor of haemodialysis patients' quality of life in all stages, while social support was significant in the crisis stage and self‐efficacy and self‐management was significant in the stable stage. Reporting MethodThis study was reported according to the STROBE checklist.Patient or Public ContributionValidated interviewer‐administered questionnaires were completed by patients undergoing haemodialysis in this study.

Differences in Nutritional Status and Quality of Life in Hemodialysis Patients Compared to CAPD

Background: Patients with chronic kidney disease who undergo hemodialysis and CAPD (Continous Ambulatory Peritoneal Dialysis) modalities often experience disturbances in nutritional status and quality of life. The condition is affected by the chosen modalities and duration. Aim: This study assesses the differences in nutritional status and quality of life in individuals undergoing hemodialysis therapy with a duration of 4-hour, hemodialysis with a duration of 5-hour, and CAPD in order to determine the best modalities for patients with chronic kidney disease. Methods: Data were collected with cross-sectional from patients with chronic kidney disease at the hemodialysis polyclinic at RSUD dr. Saiful Anwar Malang, Panti Nirmala Hospital Malang, Wava Husada Kepanjen Hospital, and the CAPD polyclinic at RSUD dr. Saiful Anwar Malang. Classified into CAPD group, 4-hour hemodialysis group, and 5-hour hemodialysis group. Assessment with a questionnaire consisting of the patient’s baseline characteristics, subjective global assessment (SGA), and SF-36 are used to assess and analyze differences in nutritional status and quality of life of patients with chronic kidney disease against the selected dialysis modality. Results: The physical health of the 5-hour hemodialysis group showed significant results compared to the 4-hour hemodialysis and CAPD (p &lt;0.05). Mental health in the 5-hour hemodialysis procedure showed significant results compared to the 4-hour hemodialysis and CAPD (p &lt;0.05). The nutritional status of 5-hour of hemodialysis was better than 4-hour of hemodialysis and CAPD (p&lt;0.05). Conclusion: Hemodialysis with a duration of 5-hour has a better nutritional status and quality of life compared to a duration of 4-hour or CAPD.

#235 Quality of sleep and the quality of life in chronic kidney disease patients undergoing hemodialysis in a tertiary hospital in the Philippines

Abstract Background and Aims Sleep quality and quality of life are critical aspects of health and well-being, particularly for individuals undergoing hemodialysis. Hemodialysis is a life-sustaining treatment for individuals with end-stage kidney disease (ESKD), but it can significantly impact various dimensions of their health, including sleep quality and overall quality of life. Understanding the relationship between sleep and quality of life in hemodialysis patients is essential for developing effective interventions to improve their overall well-being. Studies have shown that hemodialysis patients often experience poor sleep quality, characterized by difficulty falling asleep, frequent awakenings during the night, and early morning awakening. Moreover, sleep disturbances experienced by hemodialysis patients can also affect their ability to perform daily activities which can have a negative impact on their overall quality of life. Factors that have been shown to be associated with quality of sleep and quality of life in hemodialysis patients include age, sex, comorbidity, mode and schedule of hemodialysis, hemoglobin, phosphorus and albumin. Physicians can provide patient-centered care more effectively when they have a better grasp of the quality of life. However, the quality of life is not thoroughly studied in individuals with chronic kidney disease, particularly those undergoing hemodialysis. To address these issues, it is essential to prioritize sleep quality and quality of life in hemodialysis patients. The aims of this study were to determine the prevalence of ‘poor sleepers’ in patients undergoing hemodialysis using a validated sleep quality questionnaire and to examine the relationship between patients’ sleep quality with the quality of life using a validated kidney-disease specific quality of life questionnaire. Method This was a descriptive cross-sectional study conducted at The Medical City Ortigas from May to July 2023. The subjects recruited were adult hemodialysis patients enrolled in The Medical City Ortigas. To get a 95% confidence level, a minimum population of 80 patients should be included based on 71% prevalence from the study of Iliescu in 2003. This study evaluated a total of 85 patients through random selection. Patients excluded were those &amp;lt;18 years of age, had been on dialysis for less than 3 months, were not competent to give informed consent, and those with diagnosed sleeping disorder prior to having chronic kidney disease. Quality of sleep and quality of life were measured using validated self-administered questionnaires; the Pittsburgh Sleep Quality Index (PSQI) and the Kidney Disease Quality of Life-Short Form v1.3 (KDQOL) respectively. Results Among the respondents 67 (78.82%) were found to be poor sleepers (PSQI &amp;gt;5) with a mean global PSQI of 9.25. Age appeared to be a significant factor as the percentage of bad sleepers belong to the 46-65 and &amp;gt;65 age groups. In contrast, sex, marital status, 150 employment, hemodialysis shift, BMI, kt/V, hemodialysis type, albumin, phosphorus, and hemoglobin levels did not have significant association with quality of sleep. There is significantly a greater number of bad sleepers that have a lower functioning due to symptoms experienced (50.65 bad sleepers vs 62.85 good sleepers). Bad sleepers also have worse quality of life in domains of cognitive function (66.67 vs 55.22), sleep (56.67 vs 46.9), patient satisfaction (57.41 vs 45.27) overall health (54.44 vs 43.28) and general health (40.83 vs 32.16). Correlations between the global PSQI score and the domains of KDQOL computed via Pearson r coefficient showing an inverse correlation between PSQI and the mental (-.392) and physical (-0.320) component summaries. Conclusion Poor sleep is common in hemodialysis patients and is associated with poorer quality of life.

#2196 Impact of intradialytic exercise on blood pressure and quality of life in hemodialysis patients: a randomized controlled trial

Abstract Background and Aims Hemodialysis is essential for end-stage renal disease (ESRD) patients, but they often face complications affecting their quality of life and cardiovascular health. Exercise has emerged as a potential adjunct therapy for improving outcomes in hemodialysis patients. This study aimed to examine the effects of exercise during dialysis on laboratory parameters, intradialytic blood pressure events, and quality of life in hemodialysis patients. Method An Egyptian dialysis center conducted a 6-month randomized controlled trial involving 80 hemodialysis patients. Patients were randomized into two groups: an intervention group (40 patients), which engaged in 30-minute exercise)in the form of 15 minutes for cycler and 15 minutes for hand grip (three times per week during dialysis sessions, and a control group (40 patients), which did not exercise. Laboratory investigations were performed before and after the intervention, measuring hemoglobin, serum sodium, potassium, calcium, phosphorus, and intact parathyroid hormone (iPTH). Intradialytic blood pressure events were recorded, and quality of life (QOL) was assessed using the Arabic version of the kidney disease and Quality of Life-Short Form 36 (KDQOL-SF™) Questionnaire. Results The intervention group exhibited a statistically significant reduction in inter-dialytic hypertension episodes compared to the control group (partial η² = .142, Cohen's f = .407). Additionally, the intervention group showed a significant increase in the physical composite score (partial η² = .178, Cohen's f = .465) accompanied by a significant decrease in the mental composite score (partial η² = .232, Cohen's f = .550) Moreover, The intervention group demonstrated a significant reduction in serum calcium levels post-intervention compared to the control group (partial η² = .069, Cohen's f = .272), with a positive correlation between the change in calcium level and the change in the physical composite score. Conclusion These findings indicate that exercise during haemodialysis may contribute to better blood pressure control and improved physical functioning. Incorporating exercise into the dialysis routine may serve as an effective approach to optimize the health and well-being of haemodialysis patients. Further research should focus on long-term effects and optimal exercise protocols to maximize these benefits.

#267 “Surprise question”, malnutrition, frailty, and health-related quality of life in predicting mortality in a cohort of haemodialysis patients

Abstract Background and Aims “Would I be surprised if this patient died in the next year (or six months)?” This question by a medical staff is called “surprise question” (SQ) and the answer “no” (SQ-No) was shown to predict a higher risk of mortality. However, it is unknown what is intuitively assessed by this question. We examined whether SQ is assessing the patient's malnutrition, frailty, or self-perceived health-related quality of life in haemodialysis patients. Method We analysed data from 994 patients on maintenance haemodialysis who participated in the Osaka Dialysis Complication Study (ODCS). Attending nurses answered to SQ. Malnutrition was evaluated by Geriatric Nutritional Risk Index (GNRI). Frailty was assessed by a modified CHS criteria. Patient-perceived health-related quality of life was examined by SF36 physical component summary (PCS). The associations of these exposures with 5-year all-cause mortality (ACM) were analysed by Cox proportional hazards model. Results Median of age and dialysis vintage was 66 and 5.9 years, 35.8% were female, and 39.6% had diabetic kidney disease. The prevalence of SQ-No and frailty was 19.7% and 46.2%. Medians of GNRI and SF36 PCS were 96.3 and 46.2, respectively. During follow-up, 250 patients died. Each of SQ-No, a low GNRI, being frail, and a low SF36 PCS was a significant predictor of a higher risk for ACM independent of potential confounders. SQ-No remained a significant predictor after further adjustment for GNRI or frailty, but SQ-No was no longer significant when adjusted for SF36 PCS. Conclusion Predictive ability of SQ was closely related to SF36 PCS in haemodialysis patients. SQ by nurses appears to assess patient-perceived health-related quality of life rather than objectively assessed malnutrition or frailty.