Life In Maintenance Hemodialysis Patients Research Articles

Physical activity, exercise habits and health-related quality of life in maintenance hemodialysis patients: a multicenter cross-sectional study.

Although exercise has the potential to yield numerous benefits for maintenance hemodialysis patients, the relationship between physical activity, exercise habits, and health-related quality of life (HRQOL) has not been thoroughly investigated. This study aimed to characterize the physical activity, exercise habits, and HRQOL of maintenance hemodialysis patients while examining the associations between these factors. A convenience sampling was used to recruit 827 patients from 74 dialysis units in China. The structured questionnaire included sociodemographics, the International Physical Activity Questionnaire, exercise habits, and the Kidney Disease Quality of Life Short Form 1.3. An independent samples t-test, multivariable logistic regression analysis, and multivariable linear regression analysis were used. The physical activity levels of 69% of participants were found to be below the recommendation of the World Health Organization. Despite 62.4% of participants reporting regular exercise, 73.8% reported light exercise intensity, and 92.6% engaged in walking or jogging. Participants' HRQOL was higher in the low-intensity exercise group compared with the moderate-to-hard-intensity exercise group. Moderate-to-high physical activity was associated with better HRQOL in 13 of the 19 domains and regular exercise was linked to higher HRQOL in four of the 19 domains. This study identified a low level of physical activity, light exercise intensity, and walking as the primary exercise type among the participants. A significant correlation was found between higher physical activity levels, regular exercise, and better HRQOL for maintenance hemodialysis patients. It is advisable to implement strategies to enhance physical activity levels and design exercise programs for maintenance hemodialysis patients based on their real-world physical activity levels and exercise habits.

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 < 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 < 0.05). They also scored higher on the Knowledge, Attitude, and Practice questionnaire (P < 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.

Influences of trans-theoretical model-based diet nursing intervention on sarcopenia and quality of life in maintenance hemodialysis patients.

to explore the influences of a trans-theoretical model-based diet nursing intervention on sarcopenia and quality of life in maintenance hemodialysis patients. the clinical data of 243 patients with maintenance hemodialysis (MHD) admitted to our hospital from January 2019 to August 2020 were retrospectively analyzed. A 1:1 orientation score matching (PSM) method was adopted, and patients with different intervention methods were matched based on gender, age, education time, dialysis age, body mass index, underlying diseases, annual income, and whether they were malnourished. Finally, 82 cases were included in the control group (routine nursing and dietary guidance) and 80 cases in the intrevention group (dietary nursing intervention based on the trans-theoretical model), respectively. After PSM, 82 cases in the control group and 80 cases in the intrevention group were included in the study. After the intervention, the incidence of sarcopenia, the extracellular water rate (ECF/TBF) value, and the malnutrition rate of the intrevention group were lower than those of the control group (p < 0.05); the scores of self-care, facing difficulties, potassium intake management, salt intake management, fluid restriction management, the levels of serum albumin, prealbumin and transferrin were all higher than those of the control group (p < 0.05); the SF-36 Concise Health Scale score of the intrevention group was higher than that of the control group (p < 0.05). The 1-year survival rate in the intrevention group (95.00 %) was higher than that in the control group (85.37 %) (p < 0.05). a TTM-based diet nursing intervention can help improve the dietary management behavior of MHD patients, prevent malnutrition, reduce the incidence of sarcopenia, and improve their quality of life and survival rate.

Effects of Different Exercises on Physical Function, Dialysis Adequacy, and Health-Related Quality of Life in Maintenance Hemodialysis Patients: A Systematic Review and Network Meta-Analysis

Background: Clinical guidelines recommend exercise training for patients undergoing maintenance hemodialysis (MHD). However, the effectiveness of different types of exercise remains uncertain. Objectives: The aims of the study were to compare and rank the effect of different types of exercise on walking capacity, cardiorespiratory fitness, dialysis adequacy, and health-related quality of life (HRQOL) in patients undergoing MHD. Methods: Eight databases (four English and four Chinese) were searched from inception to January 1, 2022. Randomized controlled trials evaluating the efficacy of different exercises for patients undergoing MHD were included. Two independent reviewers screened the literature, extracted data, assessed the risk of bias, and evaluated the certainty of evidence. A frequentist random-effect network meta-analysis was conducted. Results: Ninety trials with 4,084 participants comparing 15 types of exercise were included, reporting on the six-minute walking test (45 trials), peak oxygen uptake (22 trials), dialysis adequacy (30 trials), and HRQOL (23 trials). Network meta-analysis showed that the most effective intervention for walking capacity was intradialytic aerobic exercise combined with blood flow restriction with a mean difference and 95% confidence interval of 97.35 (11.89–182.81), for peak oxygen uptake it was non-intradialytic combined aerobic and resistance exercise with a value of 4.35 (2.25–6.44), for dialysis adequacy it was intradialytic combined aerobic and resistance exercise with a value of 0.17 (0.06–0.28), for the physical component summary of HRQOL it was intradialytic aerobic exercise with a value of 4.93 (2.31–7.54), and for the mental component summary of HRQOL it was non-intradialytic combined aerobic and resistance exercise with a value of 6.36 (0.45–12.27). Ultimately, intradialytic combined aerobic and resistance exercise could improve all the above outcomes compared to usual care. Conclusions: This study concluded that intradialytic combined aerobic and resistance exercise is optimal for MHD patients due to its significant positive effects on multiple outcomes. Walking capacity can be further enhanced by combining blood flow restriction with exercise. For improving dialysis adequacy, intradialytic exercise proves to be more effective than non-intradialytic exercise. Further well-designed clinical trials are needed to investigate the effects of exercise with varying durations, intensities, and frequencies.

Effect of aromatherapy on quality of life in maintenance hemodialysis patients: a systematic review and meta-analysis

Objective Aromatherapy has been used for patients on maintenance hemodialysis (MHD), but the outcomes are still controversial. Thus, we conducted this study to systematically evaluate the effect of aromatherapy on the quality of life of patients on MHD. Methods We searched the PubMed, Embays, Scopus, Web of Science, and CNKI databases for randomized controlled trials that evaluated the use of aromatherapy in dialysis patients and reported at least one outcome of interest. Results Twenty-two relevant studies were included in the meta-analysis. The meta-analysis revealed that aromatherapy significantly increased subjective sleep quality (a lower score indicates better sleep quality) [standardized mean difference (SMD) = −1.52, 95% CI (−2.38, −0.67), p < 0.01] and reduced fatigue [SMD = −1.14, 95% CI (−1.95, −0.33), p = 0.01], anxiety [SMD = −1.38, 95% CI (−2.09, −0.67), p < 0.01], symptoms of restless legs syndrome [RLS; SMD = −1.71, 95% CI (−2.09, −1.33), p < 0.01], and arteriovenous fistula puncture pain [SMD= −1.56, 95% CI (−2.60, −0.52), p < 0.01]. Conclusions Aromatherapy may be used as a novel complementary and alternative therapy to improve sleep quality and reduce fatigue, anxiety, symptoms of RLS, and arteriovenous fistula puncture pain in patients on MHD.

Impact of personalized nutritional intervention on nutritional status and quality of life of maintenance hemodialysis patients with protein energy wasting

BACKGROUND: Protein energy wasting (PEW) is a common multifactorial problem affecting maintenance hemodialysis (MHD) patients. OBJECTIVES: We aimed to explore the impact of personalized nutritional intervention on nutritional status and quality of life (QOL) in MHD patients. METHODS: Interventional study included 18 MHD patients suffering from PEW. They were subjected to personalized nutritional intervention for 6 months according to Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guidelines (2000). QOL was evaluated by using the Kidney Disease Quality of Life (36 KDQOL-36). Nutritional status and QOL of those patients were re-assessed after 6 months and compared to those at the baseline. RESULTS: Fourteen patients completed six months of the study. Following such intervention, half of these patients became no longer suffering from PEW (responder group). Most of the nutritional and QOL data improved in the responder in contrary to the non-responder group of patients. The baseline level of parathyroid hormone (PTH) was significantly higher but physical health was significantly lower in non-responder than responder groups. CONCLUSIONS: Implementation of an internationally acknowledged nutritional program could improve the nutritional status and QOL of MHD patients with PEW. Moreover, PTH level, and physical health of the studied patients could contribute to the positive response to nutritional intervention.

Correlation of Body Composition and Quality of Life in Maintenance Hemodialysis Patients

Background: Due to the occurrence of hemodialysis, the life expectancy of end-stage renal disease (ESRD) patients is lengthening. However, their quality of life (QoL) is decreasing. The QoL of ESRD patients is composed of physical component score (PCS), mental component score (MCS), and kidney-related component score (KDCS) components. Nutritional status is one of the influencing factors of QoL. It is unclear whether free fat mass (FFM) or fat mass contributes to the increase of QoL in ESRD patients. Objectives: This study aimed to identify the correlation between FFM percentage and the QoL of ESRD patients. Methods: This cross-sectional study was conducted in Hemodialysis Unit, Division of Kidney and Hypertension, Dr. Cipto Mangunkusumo General Hospital, Jakarta from June to July 2018. In this study, 102 subjects were included. Blood samples were collected for laboratory examination. FFM percentage was measured using bioimpedance analysis (BIA). Meanwhile, QoL was evaluated using KDQOL SF-36 version 1.3. Statistical analysis was done using Pearson correlation test. Analysis of QoL was done based on fat percentage using ANOVA test. Results: In this study, the overall KDQOL score was 47.86 ± 6.56 with PCS 40.97 ± 9.66, MCS 46.6 (22.05 - 59.95), and KDCS 55.98 ± 9.02. FFM percentage was 74.21 ± 1% with mean mass of 43.06 ± 8.16 kg. Statistical analysis showed no correlation between FFM percentage and overall KDQOL score (r 0.032, P 0.750). However, there was a significant correlation between PCS and FFM (r 0.223, P 0.024). Conclusions: There is a weak positive correlation between FFM in kg and the physical quality of end-stage kidney disease (ESKD) patients.

Effect of Self-Determination Theory on Knowledge, Treatment Adherence, and Self-Management of Patients with Maintenance Hemodialysis.

Our aim of this study was to investigate the effect of self-determination theory on awareness of relevant knowledge, treatment compliance, and self-management level in maintenance hemodialysis (MHD) patients. A total of 90 patients who received MHD treatment in our hospital from April 2018 to June 2020 were selected and randomly divided into the intervention group and the routine group with 45 cases in each group. Both groups were given basic hemodialysis patient management measures, and the intervention group was given self-determination theory to manage patients on this basis. The awareness rate of hemodialysis patient-related knowledge, patient treatment compliance, patient self-management scores, and quality of life scores were compared between the two groups before intervention and 6 months after intervention. After intervention, the awareness rate of dialysis principle, reasonable diet, internal fistula protection, and complication prevention knowledge in the intervention group was higher t (P < 0.05); before intervention, there was no significant difference in the scores of all dimensions of compliance between the two groups (P > 0.05); after intervention, the dietary compliance, fluid intake compliance, dialysis regimen compliance, and total score of compliance in the intervention group were higher than those in the conventional group (P < 0.05). After intervention, the total scores of problem solving, partnership, emotional processing, self-care activities, and self-management in the intervention group were higher than those in the conventional group, (P < 0.05). After intervention, the physical domain, psychological domain, social relationship domain, and total scores of quality of life in the intervention group were higher than those in the conventional group (P < 0.05). Self-determination theory management is effective in improving the awareness of hemodialysis-related knowledge, treatment compliance, self-management level, and quality of life in MHD patients.

Explore the Effect of Clinical Pathway Combined with Nutritional Care on the Nursing Effect and Quality of Life of Maintenance Hemodialysis Patients

Explore the Effect of Clinical Pathway Combined with Nutritional Care on the Nursing Effect and Quality of Life of Maintenance Hemodialysis Patients

Effects of Expanded Hemodialysis with Medium Cut-Off Membranes on Maintenance Hemodialysis Patients: A Review.

Kidney failure is associated with high morbidity and mortality. Hemodialysis, the most prevalent modality of renal replacement therapy, uses the principle of semipermeable membranes to remove solutes and water in the plasma of patients with kidney failure. With the evolution of hemodialysis technology over the last half century, the clearance of small water-soluble molecules in such patients is adequate. However, middle molecules uremic toxins are still retained in the plasma and cause cardiovascular events, anemia, and malnutrition, which significantly contribute to poor quality of life and high mortality in maintenance hemodialysis patients. A new class of membrane, defined as a medium cut-off (MCO) membrane, has emerged in recent years. Expanded hemodialysis with MCO membranes is now recognized as the artificial kidney model closest to natural kidney physiology. This review summarizes the unique morphological characteristics and internal filtration–backfiltration mechanism of MCO membranes, and describes their effects on removing uremic toxins, alleviating inflammation and cardiovascular risk, and improving quality of life in maintenance hemodialysis patients.

Validation of the functional assessment of anorexia/cachexia therapy instrument to assess quality of life in maintenance hemodialysis patients with cachexia.

Many patients on maintenance hemodialysis (MHD) eventually suffer from cachexia. The Functional Assessment of Anorexia/Cachexia Therapy (FAACT) is a tool used to evaluate the quality of life of patients with cachexia related to various diseases, but its suitability for use in MHD patients has yet to be verified. This study aimed to explore the validation of the FAACT in MHD patients by conducting reliability and validity tests. Qualified MHD patients were selected to complete the FAACT and Kidney Disease Quality of Life Short Form 36 (KDQOL-36) questionnaires, and their demographic data and biochemical test results were collected from electronic medical records. Next, the Cronbach's alpha coefficient, paired sample t test and ICC were used to analyze the scale consistency. Additionally, the association between the KDQOL-36 and FAACT was analyzed using Bland-Altman plots and Pearson correlation analysis. Finally, the patients were divided into groups to evaluate discriminant validity. A total of 299 patients were included in this study. The Cronbach's alpha coefficients of the FAACT and its anorexia-cachexia subscale (ACS) were 0.904 and 0.842, respectively, and their ICC exceeded 0.90. The correlation coefficients between the FAACT and its items ranged from 0.146 to 0.631, and the correlation coefficients between the FAACT and KDQOL-36 dimensions ranged from 0.446 to 0.617. The Bland-Altman plots between the FAACT and KDQOL-36 showed that only 3.3% of the points were outside the 95% limits of agreement. The effects of cachexia status (present or absent) on FAACT and ACS scores had effect sizes of 0.54 (P< 0.001) and 0.60 (P< 0.001), respectively. The FAACT and ACS also significantly discriminated between patients with and without inflammation (P< 0.001). The FAACT and ACS have acceptable reliability and validity in MHD patients and are suitable for measuring the quality of life of MHD patients with cachexia.

Chronic Pain and Quality of Life in Maintenance Hemodialysis Patients in China: A Multicenter, Cross-Sectional Study.

PurposePatients undergoing maintenance hemodialysis (MHD) frequently experience chronic pain, which can severely affect their quality of life (QOL). The objective of this study was to evaluate the prevalence of chronic pain in MHD patients and examine the factors associated with QOL.Patients and MethodsA cross-sectional questionnaire-based survey was conducted between October 2020 and April 2021, 1204 MHD patients from nine hemodialysis units were screened for chronic pain in Chengdu, China, and 296 MHD patients with chronic pain were enrolled in this study. We analyzed data on clinicodemographic characteristics, pain interference and severity (Brief Pain Inventory), QOL (Medical Outcomes Study 36-item Short Form Health Survey - mental component summary [MCS] and physical component summary [PCS]), pain self-efficacy (Pain Self-Efficacy Questionnaire), and social support (Social Support Rating Scale).ResultsThe prevalence of chronic pain in MHD patients was 26.74% in this study. The most common areas of pain were lower back (63.5%), lower limbs (55.0%), and head (33.5%), 36.5% did not implement any measures to relieve it. Of the patients who did receive pain treatment or medication, 56.9% reported that the measures they took had less than half of the pain relief. MHD patients with chronic pain had poor QOL based on scores on the MCS (53 ± 16.76) and PCS (40.56 ± 13.81). Stepwise multiple regression identified age, financial strain, pain interference, social support, and pain self-efficacy as independent predictors of QOL. Pain self-efficacy was significantly associated with social support (r = 0.5, p < 0.01), MCS (r = 0.69, p < 0.01), and PCS (r = 0.8, p < 0.01). The mediating effects of pain self-efficacy were 70.31% on the relationship between social support and MCS, and 75.62% on the relationship between social support and PCS.ConclusionChronic pain is prevalent and undermanaged in Chinese MHD patients, resulting in worse QOL. Healthcare providers should focus on pain management and the impact of psychosocial factors on patient QOL. Further research should deepen our understanding of how pain self-efficacy mediates the relationship between social support and QOL.

Analysis of quality of life and risk factors in 122 patients with persistent hemodialysis.

Objectives:To summarize existing evidence on the quality of life and influencing factors in maintenance hemodialysis (MHD) patients.Methods:Total 122 MHD patients treated in the department of hemodialysis, Liyang branch of Jiangsu Provincial People’s Hospital from January 2018 to June 2020 were selected as the patient group. and 98 healthy persons in the same period were selected as the control group. The quality of life of the two groups was investigated by SF-36 score scale. At the same time, the clinical data of the patient group were investigated. Influencing factors of patients’ quality of life were analyzed by univariate test, and independent risk factors were analyzed by logistic multiple regression.Results:Univariate analysis showed that age, education, marital status, dialysis time, urea clearance index (Kt/V), income level, diabetic nephropathy, nutritional status, medical insurance type, depression and anxiety were single factors influencing the quality of life of MHD patients (P<0.05). Logistic multiple regression analysis showed that age ≥ 60 years, dialysis time ≥ one year, income less than 3000 yuan/month, primary disease is diabetic nephropathy., low medical insurance reimbursement, depression and anxiety were independent risk factors affecting the quality of life of MHD patients (P < 0.05).Conclusions:There was a relatively high proportion of patients with age ≥ 60 years, dialysis time ≥ one year, income less than 3000 yuan/month, primary disease is diabetic nephropathy, low medical insurance reimbursement, depression and anxiety. Timely nursing interventions such as reasonable nutritional support, comprehensive monitoring and psychological counseling for patients with the above situation may be helpful in improving quality of life of MHD patients.

The Influence of SDM-Based Individualized Management Model on the Health Outcome and Quality of Life of Maintenance Hemodialysis Patients

Background Chronic kidney disease is a common clinical problem that endangers human physical and mental health and life safety. It eventually evolves into end-stage renal disease, and the incidence has increased year by year. It has been reported that the incidence of chronic kidney disease in China is about 10 %, and most patients need to carry out dialysis to maintain life. Objective To observe the influence of an individualized management model based on shared decision-making (SDM) between doctors, nurses and patients on the health outcomes and quality of life of maintenance hemodialysis patients. Methods A total of 100 end-stage renal disease patients treated with maintenance hemodialysis intervention in the Department of Nephrology, Changyisha City Fourth Hospital from May 2020 to May2021 were selected. According to the order of admission, they were randomly divided into control groups (n=50)) And the observation group (n=50). The control group received conventional management mode intervention, and the observation group received SDM-based individualized management mode intervention. The blood pressure and fluid control of the two groups were recorded, and the self-management behavior scale for hemodialysis patients (SMSH), the satisfaction survey questionnaire for patient participation in medical decision-making, and the kidney disease-related quality of life scale (KDTA) were used to evaluate the self-management ability of the two groups. Satisfaction and quality of life. Results After the intervention, fluid intake, weight gain between dialysis intervals, and the number of dialysis-related complications in the observation group decreased significantly (P&lt;0.05), while the number of dialysis-related complications in the control group decreased (P&lt;0.05), but fluid The intake and weight gain between dialysis intervals were similar to those before the intervention (P&gt;0.05), and the fluid control in the observation group improved more significantly than the control group after the intervention (P&lt;0.05). After the intervention, the systolic and diastolic blood pressure of the observation group decreased significantly (P&lt;0.05), and the systolic and diastolic blood pressure of the control group were similar to those before the intervention (P&gt;0.05). The blood pressure of the observation group improved more significantly than the control group after the intervention (P&lt;0.05). After the intervention, the two groups of SMSH scale scores (problem solving, self-care, partnership, emotional processing, etc.), satisfaction scores (information, communication and negotiation, decision-making, total satisfaction and confidence, etc.), quality of life scores (symptoms, kidney disease, etc.) The impact of kidney disease, the burden of kidney disease, work status, cognitive function, social quality, sleep, social support, etc.) have been greatly improved (P&lt;0.05), and the SMSH scale score, satisfaction score, quality of life of the observation group after intervention The score improved more significantly than the control group (P&lt;0.05). Conclusion Intervention of maintenance hemodialysis patients based on an individualized management model of SDM can improve the self-management ability and satisfaction of patients, improve the quality of life, and reduce the occurrence of adverse events and complications.

According to Revised EWGSOP Sarcopenia Consensus Cut-Off Points, Low Physical Function Is Associated With Nutritional Status and Quality of Life in Maintenance Hemodialysis Patients

The aim of this study is to assess the association of nutritional status and quality of life with low physical function, according to the revised European Working Group on Sarcopenia in Older People (EWGSOP) - sarcopenia consensus cut-offs in maintenance hemodialysis patients. This is a cross-sectional study including patients on maintenance hemodialysis. Participants were submitted to a single evaluation of physical function, nutritional status, and quality of life. Handgrip strength, Short Physical Performance Battery (SPPB), sit-to-stand test, and gait speed were performed to evaluate physical function. Cut-offs proposed by the revised EWGSOP consensus were considered. Malnutrition Inflammation Score was used to assess nutritional status. Quality of life was assessed by the 36-Item Short Form Health Survey. Seventy-seven patients were enrolled, 64.9% male, mean age 55±14years. According to the cut-offs proposed by the most recent EWGSOP consensus, 55.8% of patients presented SPPB <8, 48.1% gait speed test ≤0.8m/seconds, sit-to-stand test >15seconds, and 39.0% handgrip strength <27 kg and <16kg for men and women, respectively. Malnutrition Inflammation Score was significantly associated with all physical function parameters, except gait speed, in receiver operating characteristic curve and logistic regression. The 36-Item Short Form Health Survey domains or component summary were associated with SSPB, gait speed, and handgrip strength in logistic regression. Poor nutritional status and quality of life are associated with low physical function (according to the cut-offs proposed by EWGSOP) in hemodialysis patients.

The relationship between self-management level and quality of life in maintenance hemodialysis patients

The relationship between self-management level and quality of life in maintenance hemodialysis patients

Impact of patient counseling on treatment adherence behavior and quality of life in maintenance hemodialysis patients.

Life in end-stage renal disease (ESRD) is miserable; food and fluid restrictions are mandatory due to impaired renal function. Patient involvement forms a key role in the management of ESRD. Hence, a direct impact of patient counseling on treatment adherence and quality of life (QOL) could be established, which forms the basis of this study. We conducted a prospective interventional study of 10 months, where the ESRD-Adherence Questionnaire and Kidney Disease QOL (KDQOL) data were used to study the effect of patient counseling. A total of 121 patients enrolled in the study with mean age of 62.14 ± 11.41 years. The adherence factors indicated that 97% were adherent to dialysis sessions, followed by 67.77% toward diet and 60.33% toward fluid. On assessing the influence of counseling on QOL and adherence to various factors affecting ESRD, a positive correlation could be observed, which indicates the impact of pharmacist intervention in improving the QOL and patient compliance, thus the need for periodic counseling was established as an effective way to improve health-related QOL and awareness in ESRD.

Combined aerobic resistance exercise improves dialysis adequacy and quality of life in patients on maintenance hemodialysis
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This study aims to compare the effect of pure aerobic exercise and combined aerobic resistance exercise on dialysis adequacy and quality of life in patients on maintenance hemodialysis. A total of 45 patients on maintenance hemodialysis were divided into three groups: pure aerobic exercise group, combined aerobic resistance exercise group, and control group. Patients in the control group were only given the usual treatment, which included dietary guidance, drug therapy, and hemodialysis. The other training groups underwent 12-week exercise intervention therapy on the basis of the usual treatment. Blood samples were collected before and after the hemodialysis, at the beginning and end of the intervention for these three groups. Then, the blood urea nitrogen (BUN) concentration was determined, the urea clearance index (Kt/v) and urea degradation rate (URR) were calculated, the dialysis adequacy was evaluated, and the short form-36 (SF-36) scale was used to evaluate the life quality. Before intervention, there was no significant difference in general health condition (GH), Kt/v, URR, SF-36 total score, and the score of each dimension in the three groups. After the intervention therapy, the Kt/v, URR, GH, vitality (VT), and SF-36 total score markedly improved in the pure aerobic exercise group, while the Kt/v, URR, GH, VT, physical functioning (PF), and SF-36 total score significantly increased in the combined aerobic resistance exercise group. Furthermore, compared with the pure aerobic exercise group, the improvement effect of body function (PF score) was better in the combined aerobic resistance exercise group. Both pure aerobic exercise and combined aerobic resistance exercise can significantly improve the dialysis adequacy and quality of life of maintenance hemodialysis patients. Compared with the pure aerobic exercise group, the effect of combined aerobic resistance exercise on PF was better.
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The effect of fine nursing intervention in improving the negative emotion and quality of life of maintenance hemodialysis patients

Objective To explore the effect of fine nursing intervention on improving negative emotion and quality of life in patients with maintenance hemodialysis. Methods A total of 106 cases of maintenance hemodialysis patients who were enrolled in this hospital from February 2017 to February 2018 were randomly divided into control group and observation group according to the random number table method, 53 cases in each group.During hemodialysis, the patients in the control group were given routine clinical nursing interventions for hemodialysis, and the patients in the observation group were given Refined nursing intervention based on routine nursing interventions.The quality of life, adherence to treatment, social support, social avoidance, and distress scores were compared between the two groups before and after intervention. Results Before the nursing intervention, there was no significant difference in KDQOL-SFTM(Kidney Disease and Quality of Life Short Form) scores between the two groups (P>0.05). The KDQOL-SFTM score in the observation group was (65.18±10.57) points, which was higher than that in the control group (59.27±10.24) points, and the difference was statistically significant(P 0.05). The SAS (Self-Rating Anxiety Scale) and SDS (Self-Rating Depression Scale) scores of the two groups after nursing were lower than those before nursing. Compared with the control group, the reduction in the study group was more significant, and the difference was statistically significant (P<0.05). After intervention, SSRS (Social Support Rating Scale) scores of both groups were higher than before intervention, and the study group was higher than the control group, with statistically significant differences (P<0.05). Social Avoidance and Distress Scale scores of both groups were lower than before intervention, and the research group was lower than the control group, with statistically significant differences (P<0.05). Conclusions Refined nursing intervention for patients undergoing maintenance hemodialysis can effectively improve their quality of life, improve treatment compliance, and help patients return to society, which is worthy of clinical promotion. Key words: Maintenance hemodialysis; Refined nursing intervention; Quality of life; Negative emdotion; Social avoidance

Lower urinary tract symptoms impair the quality of life in maintenance hemodialysis patients

BackgroundWith aging, and as the duration of their dependence on dialysis becomes longer, maintenance hemodialysis patients experience decreased urine volume and lose the need to urinate. It is not known whether lower urinary tract symptoms (LUTS) affect the quality of life (QOL) in maintenance hemodialysis patients. We report an observational study that used validated questionnaires to evaluate LUTS and the influence of LUTS on QOL in a group of maintenance hemodialysis patients.MethodsStable patients who were on maintenance hemodialysis were surveyed with the Overactive Bladder Symptom Score and International Prostate Symptom Score, as the disease-specific validated questionnaires for overactive bladder and benign prostatic hypertrophy, to assess the LUTS and with King’s Health Questionnaire to assess the influence of LUTS on QOL.ResultsThis study included 131 patients with a mean age and hemodialysis duration of 69.1 years and 98.1 months. The disease-specific validated questionnaires found that 20 patients of them experienced LUTS. The mean QOL score of King’s Health Questionnaire was significantly impaired (p < 0.01), and hemodialysis duration was significantly shorter (p < 0.01) in the LUTS patients than in the non-LUTS patients. Single and multiple regression analysis showed that LUTS was independently associated with the QOL score of King’s Health Questionnaire (correlation coefficient 0.292; 95% confidence interval 20.36–89.47; p < 0.01).ConclusionsLUTS exists in maintenance hemodialysis patients and impairs the QOL of them assessed with the validated questionnaires. Urological interventions may contribute to improving the QOL of maintenance hemodialysis patients who experiences LUTS.