Life In Hemodialysis Patients Research Articles

#1476 Impact of frailty on maturation of native arteriovenous fistula in patients with end-stage kidney disease

Abstract Background and Aims Morbimortality and quality of life in hemodialysis patients is directly related to the reliability and integrity of the vascular access. Current guidelines recommend a shift from a "fistula first" approach to a patient-centered approach due to the aging dialysis population. Frailty, defined as vulnerability to adverse health states due to impaired functional status, comorbidities and psychosocial factors, conditions a worse outcome of patients with end-stage kidney disease (ESKD) undergoing dialysis. Our aim was to assess frailty status before the performance of native arteriovenous fistulas (nAVF) as a predictor of failure to mature. Method Retrospective analysis of ESKD clinic patients who underwent a first nAVF between 2020-2022 and had undergone a frailty assessment before the surgery. The Frail-VIG index, evaluating frailty through deficit accumulation (scored from 0 to 1), vas employed. Patients were categorized as either non-frail (NF-ESKD: Frail-VIG < 0.2) or frail (F-ESKD: Frail-VIG ≥ 0.2). the study evaluated early nAVF and recorded the first ultrasound maturation values 4 weeks after surgery. Results Throughout the study period, 180 patients underwent a first nAVF, 57 (31.6%) having undergone a prior frailty assessment. 27 (47.4%) patients were classified as NF-ESKD, 30 (52.6%) as F-ESKD (23 mild, 6 moderate and 1 severe frailty). In the descriptive analysis, no differences in age, sex, toxic habits, CKD etiology or medical conditions were observed between the two groups (Table 1). Regarding surgical technique, there were no differences in nAVF location and laterality between the two groups (Table 1). F-ESKD patients had a higher primary fistula failure, defined as no flow prior to the first ultrasound evaluation (36.7% vs. 3.8%; p=0.002). In patients with an initial ultrasound evaluation, the F-ESKD group had lower arterial flow (1020.76 ± 589.42 vs. 1455.56 ± 679.78 ml/min; p=0.027) and smaller fistula diameter (4.52 ± 1.51 vs. 6.4 ± 1.61 mm; p=0.018). Maturation was assessed after the first ultrasound evaluation, defined as the presence of an arterial flow greater than 500 ml/min and a diameter greater than 4 mm. A higher proportion of frail patients (88.9% vs. 33.11%; p = 0.004), a lower capacity to perform instrumental activities measured by Lawton Brody index (4.63 ± 2.2 vs. 6.55 ± 2.2; p = 0.034) and a higher percentage of diabetic patients (88.89% vs. 48.48%; p = 0.033) were found in nAVF that had not reached ultrasound-guided maturity (Table 2). In a multivariate analysis adjusted for functional status, type of vascular access and comorbidities, the presence of frailty conferred a higher risk of fistula non-maturation (OR 11.42 95%CI 1.005 - 128.74; p = 0.049). Conclusion The prevalence of frailty is notable among in ESKD patients and contributes to a higher rate of failure in native nAVF. Within this population, adopting an individual approach to the selection of a definitive vascular access may prove both feasible and beneficial in ensuring optimal dialysis access.

Measuring the perceived wellbeing of hemodialysis patients: A Mind Genomics cartography.

Chronic Kidney Disease patients under hemodialysis have high morbidity rate, which tends to considerably affect their health-related quality of life. Multiple studies that have made use of different questionnaries report the poor life quality of this patient group. The research in hand implemented the Mind Genomics Approach as a method to asses the health-related quality of life of hemodialysis patients, while relying on conjoint measurements to group individuals with similar patterns of responses to a certain mindset. The study is conducted in 3 clinics with 219 patients. It uncovers three clusters or mindsets: Mindset 1- Feels guardedly optimistic but worried about money, Mindset 2-Feels strongly positive because the state guarantees and the family supports, Mindset 3-Feels positive only about money. Based on the analysis of the collected data, the findings of this study suggest that the quality of life in hemodialysis patients is highly correlated to their financial status. The current study is one of the few first attempts to apply Mind Genomics in medical settings and the first, to our knowledge, in hemodialysis centers. This technology might enable healthcare proffesionals to provide personalized psychological treatment and additional social support to patients, which in turn could improve their clinical outcomes. The study is an example of using technology as a service.

The effect of video training on symptom burden, comfort level, and quality of life in hemodialysis patients: Clustered randomized controlled trial

ObjectiveUse of video in patient education is becoming widespread due to its low cost, time management, ease of application, and permanent learning. The study aimed to investigate the effect of video training on the symptom burden, comfort level, and quality of life of patients undergoing hemodialysis treatment. MethodsIn this clustered randomized controlled trial, the patients were randomly assigned to groups by lottery method according to hemodialysis treatment days and sessions. Individuals in the intervention group(n = 26) were screened one episode of the training video in each session for three episodes per week for 12 weeks. Individuals in the control group(n = 22) received only conventional hemodialysis without video training. ResultsAt the third and fourth measurement times, in intervention group, mean scores of symptom burden decreased compared to baseline (respectively:40,12 ± 21,63; 22,31 ± 14,08;21,54 ± 16,78), mean scores of comfort level increased (respectively:102,42 ± 13,45; 111,42 ± 8,00;115,04 ± 9,73)(p < 0.05), while there was no significant difference in control group(p > 0.05). This study observed a statistically significant difference between quality of life scale scores individuals in intervention group(p < 0,05). ConclusionIt was concluded that video training delivered to patients undergoing hemodialysis treatment decreased symptom burden of patients and increased their comfort level, and quality of life. Practice implicationsVideo training can be utilized in the educational program of hemodialysis patients.

Effect of chewing gum containing Zingiber officinale on dry mouth condition in haemodialysis patients compared to chewing gum without Zingiber officinale

IntroductionXerostomia is the most common presentation of salivary glands dysfunction affecting about 20% of the population. This study investigated the effect of ginger gum on xerostomia and quality of life in haemodialysis patients. MethodsThirty patients undergoing haemodialysis with dry mouth were randomly divided to ginger and placebo gum groups. At the beginning of the study, unstimulated and stimulated saliva samples were collected and Xerostomia Inventory (XI) and Oral Health Impact Profile (OHIP-Per14) questionnaires were administered. After 14 days, stimulated and unstimulated saliva samples were collected again and XI and OHIP-Per14 questionnaires were completed. Analysis of covariance was applied for statistical analysis. ResultsThe rate of unstimulated salivary flow (P=0.03) and oral health related quality of life (P=0.03) were significantly higher in patients that received ginger chewing gum. The amount of stimulated saliva (P=0.10) and the mean severity of dry mouth (P=0.19) were higher in patients receiving ginger gum compared to the placebo group, but the difference was not statistically significant. ConclusionWith regard to the effect of ginger gum on increasing unstimulated saliva and quality of life, it can be proposed as a safe, inexpensive, and available method to manage dry mouth.

Determinants of Nutritional Status and Quality of Life in Hemodialysis Patients

Determinants of Nutritional Status and Quality of Life in Hemodialysis Patients

WCN24-940 An assessment of the quality of life in hemodialysis patients using the IPOS-Renal Symptom Survey

WCN24-940 An assessment of the quality of life in hemodialysis patients using the IPOS-Renal Symptom Survey

Relationship between sociodemographic factors and quality of life in hemodialysis patients

Introduction: chronic kidney disease (CKD) is a progressive alteration that can lead to renal replacement therapy (hemodialysis, HD). This situation has an impact on the quality of life and is affected by the patient's sociodemographic factors.Objective: determine the relationship between sociodemographic factors and quality of life in hemodialysis patients.Methods: cross-sectional analytical study in a population of 92 patients with a diagnosis of CKD in stage V, with HD treatment. Biomedical data were collected with a dialysis record. Quality of life was estimated with the KDQOL-36 scale. Their scores were compared according to two or more groups with Mann-Whitney U tests, or Kruskal-Wallis, respectively. Spearman's correlation coefficient was used for ordinal variables. R-Studio was applied.Results: education is statistically related to “symptoms/problems” (p=0,0176), “effects of kidney disease” (p=0,0054), and “burden of kidney disease” (p=0,0200), with a tendency to observe higher scores in university studies; while economic income was the same with these last two factors (rho=0,24 and rho=0,23, respectively). Furthermore, the “symptoms/problems” score was statistically higher in men than women (74.3 versus 64.1; p=0,00417) and in the case of the “physical component” summary, patients treated in a center public hospital presented statistically higher scores compared to patients treated in private centers (38,1 versus 32,0; p=0,00607).Conclusions: there are aspects of quality of life that are linked to sociodemographic factors that health professionals can consider to focus efforts of the health team and improve this important variable

Effect of Denosumab on Bone Health, Vascular Calcification, and Health-Related Quality of Life in Hemodialysis Patients with Osteoporosis: A Prospective Observational Study.

Background: Osteoporosis is common in hemodialysis (HD) patients, contributing to cardiovascular risks. Limited research exists on denosumab's efficacy in this group. Our study explores denosumab's effects on bone turnover markers (BTMs) and vascular calcification in chronic kidney disease-mineral bone disorder (CKD-MBD) patients. Methods: In a prospective single-center study, we investigated the effects of denosumab over 2 years on 30 HD patients from a cohort of 185. Annual assessments of bone mineral density (BMD), vascular calcification, and health-related quality of life (HRQL) were conducted and compared with an untreated group. Mineral and bone parameters were analyzed at specific intervals in the treatment group. Results: Denosumab notably raised femoral BMD in the initial year. Most bone turnover markers (BTMs) decreased, except for osteocalcin. Changes in T50 correlated with BTMs. Pre-denosumab supplementation of calcium and vitamin D helped manage mineral imbalances. Post denosumab, parathyroid hormone (PTH) levels increased initially, stabilizing after 3 months. No significant changes occurred in vascular calcification or HRQL. Conclusions: Denosumab exhibited varying effects on BMD improvement, with a stronger impact in the first year that diminished in the second year. Early PTH monitoring was crucial, and extending the administrative period may enhance BMD outcomes compared to the general population.

Enhancing Nutritional Status and Quality of Life in Hemodialysis Patients: The Impact of Internet-Based Cognitive Behavioral Therapy

This study examined the effects of internet-based cognitive behavioral therapy on the nutritional status and scores from the Knowledge, Attitude, and Practice questionnaire in maintenance hemodialysis patients. Patients in the traditional therapy group received standard health education, whereas those in the experimental group participated in three months of this therapy. Clinical and nutritional indicators, including blood biomarkers and Knowledge, Attitude, and Practice questionnaire scores, were recorded for both groups before and after the treatment. Post-treatment, the group receiving internet-based cognitive behavioral therapy exhibited higher blood calcium levels, increased upper arm circumference, and reduced levels of potassium and phosphorus. They also showed comparatively lower scores in Nutritional Risk Screening 2000 and Malnutrition Inflammation, along with higher Visual Analog Scale scores (P &lt; 0.05). The internet-based cognitive behavioral therapy group exhibited higher albumin and prealbumin levels, reduced transferrin, total cholesterol, creatinine, and urea levels, and modified quantitative subjective global assessment scores than the traditional therapy group (P &lt; 0.05). They also scored higher on the Knowledge, Attitude, and Practice questionnaire (P &lt; 0.05). These results indicate that internetbased cognitive behavioral therapy can improve the nutritional status, Knowledge, Attitude, and Practice questionnaire scores, and overall quality of life in maintenance hemodialysis patients, highlighting its potential benefit in patient outcomes.

The prevalence of chronic kidney disease-associated pruritus and its impact on quality of life in hemodialysis patients: a commentary from experts from two countries.

The prevalence of chronic kidney disease-associated pruritus and its impact on quality of life in hemodialysis patients: a commentary from experts from two countries.

Combined impact of COVID-19 and renal failure on taste perception in a sample of the Egyptian population.

The present study aims to investigate the prevalence and severity of taste impairment among post-coronavirus disease 2019 (COVID-19) hemodialysis patients in a sample of the Egyptian population. This study was conducted on 272 post-COVID-19 subjects, of whom 136 were hemodialysis patients and 136 were healthy controls. History taking, clinical examination, and assessment of altered taste score, tongue coating index, salivary flow rate, and salivary pH were performed. The present study revealed a high prevalence of impaired taste function in post-COVID-19 hemodialysis patients with 72.06% affected in varying degrees; mild (25%), moderate (3.68%), severe (30.15%), and overwhelming taste impairment (13.24%). However, only 12.5% of the control group reported just a mild degree of taste impairment. The current study has shown the high prevalence and severity of taste impairment in post-COVID-19 end-stage renal disease (ESRD) patients on hemodialysis (72.06%), which indicates the combined deteriorating effect of both COVID-19 and renal failure on taste function emphasizing the importance of prompt identification and management of COVID-19 associated taste impairment to improve the quality of life in hemodialysis patients.

The Feasibility and Effects of Self-Acupressure on Symptom Burden and Quality of Life in Hemodialysis Patients: A Pilot RCT.

Symptom burden among long-term hemodialysis (HD) patients is high, and addressing symptoms has been identified as a key research priority by patients. Acupressure has shown some effectiveness in management of symptoms in patients with HD. The purpose of this study was to explore the feasibility and the effect of implementing a self-administered acupressure intervention on symptom burden and quality of life for in-center HD patients. A pilot randomized controlled study. Two outpatient community HD clinics between in Calgary, Alberta, Canada. Patients on HD for at least 3 months and with at least one symptom score rated greater than moderate were eligible for the study. Participants were randomized into either the (1) self-acupressure + usual care or (2) usual care alone group. Participants in the acupressure group were given a wooden acupressure tool and taught how to self-administer protocol on 6 acupressure sites for the 4-weeek study duration. Feasibility outcomes were assessed through satisfaction surveys and attrition. Other outcomes included quality of life and symptom scores by validated questionnaires (EQ-5D-5L and Integrated Palliative Outcome Score-Renal [IPOS-Renal]). Thirty-two participants were successfully enrolled in the study; acceptability was high with study completion at 98% in the intervention group and 82% adherence rate to the 4-week protocol. Participants in the intervention group reported an improved change score in quality of life (EQ-5D-5L Index Score change = +0.053; EQ-5D-5L visual analog scale score change = +6.7). Participants in the intervention group also reported improved symptom scores (IPOS-Renal overall change = -2.8). Small sample size and intervention duration are limitations of this pilot study. The results from this study suggest that self-acupressure was acceptable and feasible in this sample of HD patients. Self-acupressure may have a role for supporting the management of symptoms in HD patients. These pilot results can be used to inform larger more definitive investigations.

Prevalence of Intradialytic Muscle Cramps and Quality of Life in Haemodialysis Patients

Objective: The aim of this study was to find out prevalence of intradialytic muscle cramps and quality of life in hemodialysis patients. Study design and settings: This was a cross-sectional study conducted in three different hospitals in Rawalpindi and Islamabad. Methodology: Following ethical approval, a cross-sectional study was conducted on 361 patients undergoing hemodialysis through Convenience Sampling Technique. A self-structured questionnaire was used for demographic data and clinical characteristics. Numeric pain rating scale (NPRS) was used to assess severity of muscle cramps and WHOQOL- BREF was used to assess quality of life in hemodialysis patients. Result: During hemodialysis, 78% participants experienced muscle cramps, the mean severity of cramps during hemodialysis was noted to be 7.08±1.94. The most of participants i.e. 45% reported muscle cramps in leg region. The QOL of patients undergoing hemodialysis was low in physical (59.95±19.19), psychological (58.60±17.04), and environmental (33.06±10.51) domains while good in the social domain (83.26±23.75) of WHOQOL- BREF questionnaire Conclusion: The current study's findings showed that muscle cramps in patients undergoing hemodialysis is common. The most reported muscle cramps region were legs. Patients undergoing hemodialysis have a low quality of life except social domain.

Relationship between serum AGE precursor levels, oxidative stress, and quality of life in patients receiving hemodialysis

Introduction/Objective. The aim of this study was to determine the relationship between serum advanced glycation end product (AGE) precursors, oxidative stress levels, and quality of life in hemodialysis patients. Methods. A descriptive form and the Kidney Disease Quality of Life Form (KDQOL-36) were used in the study. Serum levels of AGE precursors [methylglyoxal (MGO) and glyoxal (GO)] and oxidative stress [malondialdehyde (MDA)] were determined in blood samples taken from the patients. Results. The KDQOL-36 subscale scores were 71.65 ? 17.76 for the symptoms/problems list, 66.35 ? 19.06 for the effect of kidney disease, 40.6 ? 24.01 for the kidney disease burden, 41.6 ? 9.83 SF-12 for physical health, and 37.83 ? 9.69 for SF-12 mental health. The serum levels were 3.96 ? 1.01 ?mol/L for MDA, 1029.87 ? 314.43 ng/mL for GO, and 115.2 ? 75.54 ng/mL for MGO. A positive and significant correlation was detected between serum MGO and GO (r = .285, p &lt; 0.01) and MDA (r = 0.284, p &lt; 0.01). A positive correlation was noted between serum MDA and GO (r = 1,000, p &lt; 0.05) and a negative correlation with kidney disease burden (r = -0.205, p &lt; 0.05). A negative and significant correlation was detected between GO and kidney disease burden (r = -0.204, p &lt; 0.05). Conclusion. Serum MGO, GO, and MDA levels were high in patients undergoing hemodialysis. High serum MDA levels are associated with high serum GO and MGO levels. High serum levels of MDA and GO had a negative impact on the quality of life of hemodialysis patients.

Pengaruh Kepatuhan Batasan Cairan, Dukungan Keluarga terhadap Kualitas Hidup pada Pasien Hemodialisa

Compliance of fluid limits is one of the factors that can improve the quality of life in hemodialysis patients. Success in adhering to fluid limits depends on support from the family. Patient non-compliance in restricting fluids can cause major and very serious consequences. The aim of this study was to determine the effect of family support and compliance with fluid limits on the quality of life in hemodialysis patients. The method used is quantitative research with a multivariate design using linear regression test analysis with the backward LR method. The sample in this study was 95 respondents using purposive sampling. The measuring instruments used are KDQOL SF-36, IDWG, and support from the Friedman family. The research results showed that there was a significant relationship between compliance with fluid limits and quality of life (p = 0.000) and family support with quality of life (p = 0.000), but the results of the linear regression test showed that compliance with fluid limits was the strongest factor influencing quality of life by 30.3 times compared to family support and the rest is influenced by other factors. The conclusion is that there is a significant influence between compliance with fluid limits and family support on the quality of life of hemodialysis patients

A Study on Drug Utilization Evaluation and Health-Related Quality of Life in Hemodialysis Patients

A Study on Drug Utilization Evaluation and Health-Related Quality of Life in Hemodialysis Patients

Effect of medication therapy management services on medication-burden quality of life in hemodialysis patients

BackgroundHemodialysis (HD) patients commonly receive polypharmacy leading to increased likelihood of drug related problems (DRPs) and poor quality of life. Medication Therapy Management (MTM) services discover and resolve DRPs and may specifically improve Medication-burden Quality of life (MBQoL) in HD patients. We aimed to assess the effect of MTM services on DRPs and MBQoL among HD patients.MethodsA prospective pre-post study was conducted on 104 patients in an HD unit in Alexandria, Egypt. MBQoL was assessed at baseline and after three months of MTM sessions, using the Arabic, validated version of the Patient Reported Outcomes Measure of Pharmaceutical Therapy (PROMPT) questionnaire. Cohen’s d test and multiple linear regression were used to assess the effect size of MTM and the factors affecting MBQoL, respectively. DRPs, adverse events and adherence were also monitored.ResultsMBQoL improved significantly after the implementation of MTM (Cohen’s d=0.88, p < 0.01) with the largest effect size in the “medicine information and relation with healthcare providers” domain. DRPs decreased significantly after MTM implementation (11.97 ± 4.65 versus 7.63 ± 3.85 per patient, p<0.001). The mean adverse events per patient were also reduced (9.69 ± 4.12 versus 6.56 ± 3.77, p < 0.001).ConclusionApplying MTM services presents an opportunity to improve care for HD patients by improving MBQoL, decreasing DRPs and adverse events.

Evaluation of stress intensity and its relationship with self-efficacy and quality of life of hemodialysis patients in Imam Khomeini Hospital in Shirvan in 2022

Introduction: Chronic renal failure directly and indirectly changes the quality of life of the patients. To maintain the quality of life, self-efficacy plays an effective role. Investigation of the relationship among stress, quality of life, and self-efficacy can help nurses to apply suitable ways to improve the quality of life of patients. Therefore, the present study aimed to determine the severity of stress and its relationship with self-efficacy and quality of life in hemodialysis patients in Imam Khomeini Hospital in Shirvan, Iran. Method: This cross-sectional correlational study was carried out on 77 hemodialysis patients in 2022. The research tools included demographic characteristics and quality of life questionnaire, alongside human stress and general self-efficacy measurements. The collected data were analyzed in SPSS software (version 19). Results: Mean age and weight of the participants were 56.5 ± 14.73 years and 66.48 ± 17.15 Kg, respectively. Moreover, 59.7% of the patients were male and 41.6% of them performed dialysis for 1-3 years. There was a significant relationship between the mean stress score and score of some dimensions of quality of life (P&lt;0.05). However, there was no significant relationship between the mean score of stress and self-efficacy. In addition, there was no significant relationship between the average of self-efficacy score and some dimensions of quality of life (P≥0.05). Conclusion: According to the results, the quality of life of hemodialysis patients improves by reducing the stress intensity. Meanwhile, people who have a higher level of self-efficacy experience less stress. Therefore, the effort of the treatment staff is to identify the aggravating factors and use suitable interventions to reduce them with the aim of improving the quality of life of patients.

Effect of Low and High Sodium Dialysate on Functional Capacity and Health Related Quality of Life in Hemodialysis Patients

Abstract Background Patients on dialysis have low health related quality of life (HRQOL) and an annual mortality rate many-fold greater than the general population. There is uncertainty about whether low sodium in dialysis fluid improves overall health and wellbeing for people on haemodialysis, since there are mixtures of probably good and bad effects. Aim To assess the effect of low sodium and high sodium dialysate on functional capacity and HRQOL in hemodialysis patients. Patients and Methods comparative case-control study conducted on 60 ESRD patients on maintenance hemodialysis receiving their treatment at the Nephrology hemodialysis unit in Luxor International Hospital from June 2021 till November 2021. The study population was divided into 2 groups: Group 1: included 30 patients on low sodium dialysate (130 mmol/l). Group 2: included 30 patients on high sodium dialysate (138 mmol/l). Results Our data revealed a significant increase in the percentage of hypertensive patients recruited to be among the low sodium dialysate group as compared with high sodium group (P value &amp;lt;0.001). At the end of the study, there were a significant decrease in DBP, IDWG and UF among low sodium group compared with high sodium group, there were a significant increase in 6MWT and SF-36 in Low sodium group when compared with High sodium group. No statistical significant difference between the studied groups as regard each of the laboratory data, ECG, and ECHO at the end of the study (P value&amp;gt;0 Conclusion Low sodium dialysate is effective in improving the health related quality of life of hypertensive hemodialysis patients, however, it did not reduce left ventricular mass relative to control despite improving fluid status.

Effects of physical activity by the teach-back educational method on the physical ability and quality of life in hemodialysis patients: a clinical trial†

Abstract Objective To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’ quality of life (QOL) and physical ability. Methods This is a single-blind clinical trial study involving a control group. A total of 90 patients who admitted to the dialysis centers of Beheshti and Besat hospitals in Hamadan were selected using a convenience sampling method and were randomly assigned to intervention (n = 45) and control (n = 45) groups. Data were collected using a demographic information checklist, a kidney disease QOL questionnaire, and a 6-minute-walk distance (6MWD) checklist. The patients’ QOL questionnaire was completed, and the 6MWD was recorded before and at the end of the 2nd, 4th, 6th, 8th, and 12th weeks of the intervention. In the intervention group, the patients were taught to perform physical activities with Pilates stretches in different resistances using the teach-back educational method during dialysis sessions for 12 weeks. Data were analyzed by using the independent t-test and chi-square test using SPSS-22 software. Results Before the intervention, no differences were observed between the experimental and control groups in terms of demographic characteristics, QOL, and physical ability (P &gt; 0.05). The physical ability and QOL levels of patients exercising in the test group were higher than those in the control group after the intervention (P &lt; 0.05). Based on the results, the 2 groups significantly differed with regard to the scores of various dimensions of QOL and physical ability after the intervention (P &lt; 0.05). Conclusions Physical activity by using the teach-back method can effectively increase physical ability and improve QOL of hemodialysis patients. Therefore, the recommendations and inclusion of exercise in the dialysis care plan can effectively promote patients’ health.