Quality Of Life In Hemodialysis Patients Research Articles

The Impact of Pre-Dialytic Endurance Training on Nutritional Status and Quality of Life in Stable Hemodialysis Patients (Sawada Study)

Background. Protein-energy malnutrition and decreased quality of life (QOL) are common in hemodialysis (HD) patients. Although several studies have proved that regular exercise has beneficial effects, few control studies have shown the effects of exercise training on the nutritional status and QOL in HD patients. Methods. Fifty-five HD patients were recruited, and 22 of them were trained to exercise on an ergometer prior to dialysis three times a week for one year. Serum albumin levels, creatinine generation rate (CGR), and the Short Form 36 were assessed as outcome measures. Results. The serum albumin levels and CGR increased in the training group compared with baseline. The QOL scores also increased in half of the physical health and mental health dimensions in the training group. Conclusion. These observations suggest that low-dose, long-term pre-dialytic endurance training might reverse the poor clinical outcome by improving the nutritional status and QOL in HD patients.

Treatment with antidepressive drugs improved quality of life in chronic hemodialysis patients

Despite some improvements in dialysis therapies, depression still remains an important problem in chronic hemodialysis (HD) patients. In this study, we aimed to investigate the association of depression and its treatment with quality of life (QOL) in HD patients. 97 HD patients (52 male, 45 female, mean age 55 +/- 16 years) were enrolled. All patients had been dialyzed for more than 6 months. In order to evaluate QOL of the patients, a short form of Medical Outcomes Study (SF-36) was used. Depression was assessed by using Beck Depression Inventory (BDI). Patients who had BDI score > or = 15 were diagnosed as to have depression. Patients with depression received antidepressive treatment (sertralin HCl, 50 mg/day) for an 8-week period. After 8-week antidepressive treatment, all biochemical analysis, SF-36 and BDI were performed again. 40 patients (20 male, 20 female, mean age 56 +/- 14 years) had depression. All parameters related to QOL were significantly decreased in patients with depression as compared to patients without depression. Severity of depression was correlated with QOL parameters. After 8 weeks of treatment, as parallel to changes in BDI, QOL parameters improved in patients with depression. Decrease in QOL, associated with depression and antidepressive treatment, improves QOL in HD patients. Hemodialysis patients should be followed-up closely for presence of depression. Treatment of depression with antidepressive drug regimen would lead to relieve the symptoms related to depression and improvement of QOL in these patients. Antidepressive treatment should be required more often than we prescribe in routine clinical practice now.

Quality of Life in Black Hemodialysis Patients

The objectives of this study were to describe quality of life in a sample of black in-center hemodialysis patients, to identify relationships between quality of life (QOL) and selected demographic and illness variables, and to identify changes in quality of life over time. Data were collected at two points in time, 3 months apart. The data were obtained from 79 patients in two inner-city dialysis units and included persons new to dialysis. Structured interviews were conducted using the Quality of Life Index. On the average, these patients were satisfied with their QOL, although there was a large range of scores. Psychological/spiritual QOL (M = 4.27) was higher than health and functioning quality of life (M = 3.77) at both time periods. Younger age (M = 4.07) and more education (M = 4.00) were associated with poorer psychological/spiritual QOL at Time 1, whereas lower hematocrits (M = 3.55) and being new to dialysis (M = 3.41) were associated with poorer health and functioning QOL. The QOL of these black hemodialysis patients was fairly high and similar to the QOL previously reported for whites, suggesting that interventions to improve QOL in hemodialysis patients do not need to be tailored by race. In addition, findings suggest that nursing support may be the most needed during the early stages of dialysis.