Quality In Hemodialysis Patients Research Articles

Sleep quality assessment using polysomnography in children on regular hemodialysis

Studies examining sleep patterns in children on hemodialysis (HD) are lacking. This cross-sectional, control-matched group study was performed to assess the sleep quality in children on HD. The assessment was made using a subjective sleep assessment and sleep questionnaire and objective analysis was made using full night polysomnography. A total of 25 children with end-stage renal disease (ESRD) on HD were compared with 15 age- and sex-matched controls. The average age of the cases was 14 ± 4 years, 52% were males and the mean body mass index was 20 ± 3.8 kg/m². The average duration on dialysis was 2.6 ± 2 years. Analysis of subjective data revealed markedly affected sleep quality in HD patients, as evidenced by excessive day time sleepiness (P <0.005), night awakening (P <0.005), difficult morning arousal (P <0.005) and limb pains (P <0.005). Objective analysis showed differences in sleep architecture, less slow wave sleep in HD children, similar rapid eye movement and non-rapid eye movement, more sleep disordered breathing (P <0.0001) and more periodic limb movement disorders (P <0.0001). Our study suggests that children on regular HD have markedly affected objective as well as subjective quality of sleep.

The effect of acupressure on sleep quality in hemodialysis patients

Our purpose was to investigate the effects of acupressure on sleep quality in hemodialysis patients. Randomized clinical trial. The setting of the study was dialysis wards located in two university hospitals (Imam and Golestan) in Ahvaz, Iran. 48 end-stage renal disease patients on hemodialysis who scored 5 points or higher on the Pittsburgh Sleep Quality Index (PSQI) were enrolled to the study. Acupressure group received acupressure intervention on the Shenmen (He7) and He Gu (Li4) points in the hands and Sanyingjao (sp6) point in the feet for 4 weeks beside routine care and control group received only routine care. subjective sleep quality, latency and duration, habitual sleep efficiency; sleep disturbances, daytime functional status, and use of sleeping medications. The result indicated significant differences between the acupressure group and the control group after intervention in PSQI global scores (p<0.001) and all sleep quality indices between two groups after intervention: subjective sleep quality (p<0.001), sleep latency (p<0.001), sleep duration (p<0.001), sleep efficiency (p=0.006), sleep disturbance (p<0.001), the use of sleeping medication (p=0.028), and daytime dysfunction (p<0.001). This study supports the effectiveness of acupressure in improving sleep quality of end-stage renal disease patients as a noninvasive therapy.

Association of nutritional status and diet quality in hemodialysis patients

Variety and adequacy of food intake as well as dietary pattern affect nutritional status of hemodialysis (HD) patient's. The aim of this study was to investigate the quality of diet and nutritional status in HD patients and to find out the relationships among the variables. We assessed nutritional status and diet quality of 63 HD patients (age: 55.3 ± 11.9 yrs; men/women ratio: 49.2%/50.8%) using Subjective Global Assessment (SGA) and 3‐day diet recall methods, respectively. Patient's daily energy intake (DEI) and protein intake (DPI) were 21.9 ± 6.7 kcal/BW/day and 0.9 ± 0.3 g/BW/day, respectively. About 70% of HD patients appeared to have lower daily energy and protein intake compared to recommended amount. More than 50% of HD patients had lower intake of vitamin C, B1, B2, niacin, folate, calcium, and zinc below75% of Dietary recommended intakes. Nutrient intakes per 1,000kcal indicated that HD patients had diets that were lower in nutrient density for Vitamin C, B1, B2, folate, and calcium. There was significant positive correlation between DEI and SGA scores (r=0.3, p&lt;0.05). DQI‐I was significantly correlated with DEI, DPI and lean body mass (kg) (r=0.5, p&lt;0.01; r=0.4, p&lt;0.01; r=0.3, p&lt;0.05, respectively). As increased in disease severity measured by End‐Stage Renal Disease Severity Index (ESRD‐SI), FVS score decreased (r=−0.3, p&lt;0.05). The results of this study indicate that HD patients in Korea consumed less calories, protein, vitamin C, B1, B2, folate, and calcium than recommended amount for each nutrient for HD patients. This study also confirmed that nutritional status and disease severity were significantly correlated with dietary quality.Grant Funding Source: ASN

Predictors of Sleep Quality in Hemodialysis Patients

Poor sleep quality (SQ) is common in hemodialysis (HD) patients. Factors associated with poor SQ are not well understood. The objectives of the present study were to determine the prevalence of poor SQ in HD patients in our region and to examine the association between SQ and health-related quality of life (HRQoL), depression, and certain clinical and laboratory parameters. A total of 233 HD patients at 5 centers in the city center of Konya, Turkey were included in this study. Their demographic data and biochemical parameters were analyzed. All patients were instructed to complete Turkish versions of three questionnaires, namely, a modified post-sleep inventory (PSI), Beck Depression Inventory (BDI) and a Short Form of Medical Outcomes Study (SF-36). The mean age of the patients was 52.8 +/- 15.3 years and the male to female ratio was 1.33:1. The prevalence of poor sleepers, defined as those having a total sleep score (PSI-4 score) > or = 4, was 60.9%. Compared with good sleepers, poor sleepers had higher BDI scores and as well as lower PCS and MCS domains of HRQoL. In addition, poor sleepers were older and more likely to be unemployed. There was a significant inverse correlation of PSI-4 score with PCS and MCS, and significant positive correlation of PSI-4 score with BDI and age (p < 0.001). The significant independent predictors of PSI-4 score were BDI score, MCS score and employment status. Depression, MCS score and employment status were the most important predictors of sleep quality in HD patients.

Ich Denk’ es War Ein Gutes Jahr (Reinhard Mey, 1968) – The year 2010 Balance

As Editors of the IJAO, we committed to consolidating its legacy and expanding its function of providing clinicians with updated information on available treatments based on artificial, bioartificial, and tissue engineered organs. A short analysis of this year’s contributions to the IJAO - without pretending to be exhaustive - provides interesting information on the evolution of the field. Many contributions focused on hemodialysis (HD) and filtration treatments of acute or chronic kidney failure patients, the actual legacy of the past. The analysis of these papers shows that current research mainly focuses on identifying factors that would improve the quality of life of HD patients. Guney et al (2) showed that socio-psychological factors, such as depression, the mental component score, age and unemployment, are the best predictors of poor sleep quality in HD patients. Materials used for the HD treatment and the administered drugs seem also to play a role. Matsumura et al (3) reported that HD with high flux polysulfone membranes at whose surface vitaminE was bonded could reduce intradialytic hypotension, presumably by reducing the intradialytic oxidative stress caused by dialyzer bioincompatibility. Davenport (4) reported that in HD treatments using a negative sodium gradient patients could be ultrafiltered without setting up intracompartmental fluid gradients. The poor reliability of current techniques to monitor sodium levels in dialysate and the patient limits this approach. Tao et al (5) reported that the use for one year of dialysate meeting the bacteriological purity requirements of some national agencies would almost double the serum level of lipoprotein (a) (Lp(a)), a risk factor for cardiovascular complications, whereas in patients treated with ultrapure dialysate Lp(a) levels did not increase significantly. Anemia in HD is generally treated with in

Influence of Hepatitis C Virus Infection on Health Related Quality of Life of Hemodialysis Patients

Background: Improvement of hemodialysis patients' quality of life is a problem of great concern of the last decade. Hepatitis C virus (HCV) is a frequent complication of treatment of chronic renal failure (CRF). The influence of chronic HCV-infection on hemodialysis patients' quality of life has been slightly studied. The aim of this research was to evaluate quality of life of patients with CRF on hemodialysis depending on HCV infection. Methods and Methods: Quality of life was been studied with the use of SF-36 questionnaire. Forty-eight patient' s (male/female: 24/24, age: 55.3±1.7 years, HD duration: 68.2±8.1 months) were included. Two groups of patients were compared. The first group was represented by 20 patients with markers of HCV-infection (anti-HCV and RNA HCV in blood). The second group (control group) included 28 non-infected patients. Activity of alanine aminotransferase was higher in group 1 in comparison with the control group (32.1±7.08 vs. 16.6±1.59 U/l, p=0.02) as well as activity of aspartate aminotransferase (30±3.79 vs. 18.5±1.16 U/l, p=0.001). Other parameters were not different between HCV-positive and HCV-negative patients. The concentration of bilirubin in groups 1 and 2 amounted to 11.3±0.9 and 10.2±0.75 mmole/l, albumin – 40.8±0.87 and 40.7±0.83 g/l, hemoglobin – 117.9±4.59 and 109.7±2.68 g/l, Kt/V – 1.5±0.1 and 1.7±0.1, respectively. Results: Average values of quality of life basic characteristics of hemodialysis patients with HCV-infection and non-infected patients were compared. Scoring evaluation specifying parameters being significant for quality of life were slightly lower in hemodialysis patients infected by HCV in comparison with control group. Value of scales “symptom/problem”, “work status”, “cognitive function”, “sleep”, “pain” amounted to 66.9±0.51 vs. 69.4±0.43; 12.7±0.51 vs. 17.2±0.43; 75.5±0.51 vs. 76.9±0.45; 46.5±0.51 vs. 54.4±0.44 and 50.4±0.51 vs. 54.4±0.44, respectively. However, such differences failed to reach the level of statistical confidence. Conclusions: Thus, it was not possible to show convincingly distinction in life quality of hemodialysis patients depending on HCVinfection.