Cross-sectional study of quality of life and symptoms in chronic renal disease patients: The modification of diet in renal disease study (original) (raw)
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Patients with Chronic Kidney Disease (CKD) endure compromised health-related quality of life (HRQOL). Although the link between HRQOL and increased mortality in ESRD patients is well documented, less is known about the relationship between CKD and HRQOL. Various co-morbid conditions related to CKD play a substantial role in the impaired HRQOL in CKD. Hypertension, both a cause and complication of CKD, negatively affects HRQOL due to associated co-morbidities, side effects from anti-hypertensive medications and awareness of the diagnosis. This review focuses on health related quality of life in end stage renal disease and chronic kidney disease. From the review of literature, it can be concluded that HRQOL declines with advanced stages of chronic kidney disease. The finding of different HRQOL scores among CKD patients support the need to individualize the concept of HRQOL, so that the crucial aspects of life can be assessed in our patients and integrate these domains into a comprehen...
Journal of Renal and Hepatic Disorders
The aim of this study was to assess the quality of life (QoL) in end-stage renal disease (ESRD) patients undergoing hemodialysis and to examine the clinical and demographic attributes associated with it.This is a multicenter, cross-sectional study, conducted in 2018, in which 367 patients with ESRD undergoing hemodialysis were recruited. Data were collected through a two-part anon-ymous, self-completed questionnaire. The first part contained questions regarding demographic, social, and clinical information, and the Greek version of Missoula–Vitas Quality of Life Index-15 (MVQoL-15) scale was used to assess QoL. Descriptive and inferential statistical methods were applied. All reported p-values were two-tailed, and the statistical significance level was set at 0.05. Of the study participants, 62.1% were male, with a mean age of 61.80 ±15.11. Of the participants, 67.3% were living in urban areas and 59.1% were married. The majority of the Hemodialysis (HD) patients evaluated possessiv...
Health-Related Quality of Life in End-Stage Renal Disease Patients and Healthy Individuals
Galen Medical Journal, 2020
Background: Health-related quality of life (HRQOL) is an important outcome measure in patients with end-stage renal disease (ESRD). HRQOL is assumed to improve with kidney transplantation and compared to hemodialysis. However, there is no evidence regarding HRQOL to support the optimal treatment choice for patients on hemodialysis who hesitate opting for transplantation. Therefore, this study aims to compare HRQOL between patients with ESRD and healthy individuals. Materials and Methods: This case-control study was performed of 50 patients with ESRD under hemodialysis and 100 healthy participants as controls. HRQOL was assess using the SF-36 questionnaire. Data was analysis by using linear regression to compared HRQOL between groups, and adjusted for age, gender, dialysis duration. Results: Most of the patients were males (62%) and aged 21 to 60 years old (82%). The patients and healthy subjects were significantly different in terms of the presence of chronic diseases (P<0.05). E...
A cross-sectional study regarding the impact of end-stage renal disease on quality of life
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
The number and severity of physical and psychological symptoms reported by chronic hemodialysis (HD) patients are significant and increasing; with a clear need to clarify which symptom intervention is the most needed. Measurements of quality of life (QoL) have shown, for many decades, an impairment of both physical and psychological aspects in both chronic kidney disease (CKD) pre-dialysis and in end stage renal disease (ESRD) patients. This cross-sectional study was conducted assess the quality of life of a Romanian hemodialysis population and the impact of several clinical and biochemical factors. A total of 102 patients (41 males, 61 females) with a mean age of 52.5 +/- 12.0 years, who were treated with HD three times per week in our dialysis center were included in the study. All subjects completed the Short Form Health Survey Questionnaire (SF-36). Clinical and biochemical parameters were extracted from the EUCLID electronic database. Our measurement showed a deteriorated QoL i...
The quality of life in end stage renal disease care
Transplant International, 1998
Survival in end-stage renal disease seems to depend more on age and associated diseases than on the form of treatment. Previously published comments on the quality of life experienced by patients treated by hemodialysis, peritoneal dialysis and transplantation were based on subjective estimates or on the use of unvalidated instruments. We have used a modified form of a "time trade-off" technique to estimate the patient's perception of the utility or worth of their ESRD health state. It was used successfully in 42 of 50 stable chronic hemodialysis patients. The correlation between paired observations six weeks apart (a test of temporal stability) was 0.80. Evidence for the validity of this instrument was obtained by comparing it with the physicians' assessment of the patient's health state.
Medicina
Background: Health-related quality of life is rapidly becoming recognized as an important indicator of how a disease affects patient lives and for evaluating the quality of care, especially for chronic conditions such as chronic kidney disease (CKD). Objectives: This study is an attempt to assess the quality of life in patients with chronic kidney disease at MMIMSR and also identify characteristics that may be associated with their worsening quality of life. Materials and Methods: This cross-sectional investigation was conducted at the in-patient department (IPD) of the MMIMSR hospital. This study included 105 CKD patients and used a systematic random sampling method for quantitative analysis. This study utilized a 36-item short-form SF-36 (v1.3) questionnaire to assess HRQoL in CKD patients. Descriptive statistics were employed at the baseline. Chi square and ANOVA were used to draw comparisons between two groups or more than two groups, respectively. Logistic regression analysis w...
American Journal of Kidney Diseases, 2001
• The Choices for Healthy Outcomes in Caring for End-Stage Renal Disease ([ESRD] CHOICE) Study was designed to evaluate the effectiveness of alternative dialysis prescriptions. As part of CHOICE, we developed an instrument for measuring health-related quality of life (HRQOL) for patients with ESRD that would complement the Medical Outcomes Study 36-Item Short-Form Survey (SF-36) and be sensitive to differences in dialysis modality (hemodialysis [HD] and peritoneal dialysis [PD]) and dialysis dose. The selection of HRQOL domains to be included was based on: (1) a structured literature review of 47 articles describing 53 different instruments; (2) content analysis of five focus groups with HD and PD patients, nephrologists, and other providers; (3) a survey of 110 dialysis providers about features of different modalities that affect patient HRQOL; and (4) a semistructured survey of 25 patients with ESRD on the effects of dialysis on functioning and HRQOL. To help prioritize domains and items identified by these methods, a representative sample of 136 dialysis patients rated each item for frequency and bother. A panel of nephrologists provided advice about the salience of items to modality or dose. Items and scales were selected with a preference for existing measures tested in patients with ESRD and were tested for reliability and validity. The first four steps yielded 22 HRQOL domains that included 96 items: 8 generic domains in the SF-36 (health perceptions, physical, social, physical and emotional role function, pain, mental health, and energy); 8 additional generic domains (cognitive functioning, sexual functioning, sleep, work, recreation, travel, finances, and general quality of life); and 6 ESRD-specific domains (diet, freedom, time, body image, dialysis access [catheters and/or vascular], and symptoms). New items were developed or adapted to assess ESRD-specific domains. Scales for these items showed adequate internal consistency (Cronbach's ~ > 0.70, except for time [~ = 0.57] and quality of life [~ = 0.68]), as well as convergent and discriminant construct validity in a sample of 928 patients. The final questionnaire included 21 domains (time was deleted) and 83 items. We have designed a patient-centered instrument, the CHOICE Health Experience Questionnaire, that addresses domains that may be sensitive to differences in dialysis modality and dose and shows evidence for reliability and validity as a measure of HRQOL in ESRD.
Health-related quality of life assessment in chronic kidney disease
Expert Review of Pharmacoeconomics & Outcomes Research, 2003
Chronic kidney disease affects over ten million Americans. Most severely affected patients undergo dialysis or transplantation at high economic and human cost. Each year, 70,000 Americans die from causes related to kidney failure. Health-related quality of life has been an important area of investigation. Recent advances include the development of new instruments that better distinguish among treatment modalities and differing patient populations. This article provides a brief state-of-the-art review of health-related quality of life instruments in chronic kidney disease, describes issues affecting patients, factors associated with decreased health-related quality of life and summarizes studies of health-related quality of life in this population. It concludes with our recommendations for further work and a look at what the future might hold.
Predictors of quality of life in patients with end-stage renal disease on hemodialysis
International Journal of Nephrology and Renovascular Disease, 2015
Background: Assessment of quality of life (QOL) of end-stage renal disease (ESRD) patients (physical, mental, and social well-being) has become an essential tool to develop better plans of care. Objective of this study is to determine which demographic and biochemical parameters correlate with the QOL scores in patients with ESRD on hemodialysis (HD) using Kidney Disease QOL-36 surveys (KDQOL). Methods: A retrospective chart review of all ESRD patients who underwent HD at an outpatient center. The five components of the KDQOL were the primary end points of this study (burden of kidney disease, symptoms and problems, effects of kidney disease on daily life, mental component survey, and physical component survey). Scores were grouped into three categories (below average, average, and above average). In addition to demographics (age, sex, and race), the independent variables such as weight gain, number of years on dialysis, urea reduction ratio, calcium, phosphorus, parathyroid hormone, albumin, and hemoglobin in the serum were collected. Chi-square analysis for dependent variables and the nominal independent variables was used, and analysis of variance analysis was used for continuous independent variables. Ordinal regression using PLUM (polytomous universal model) method was used to weigh out possible effects of confounders. Results: The cohort size was 111 patients. Mean age was 61.8 (±15.5) years; there were more males than females (64.9% vs 35.1%), the mean time-on-dialysis at the time of the study was 4.3 (4.8) years. Approximately two-thirds of the responses on all five domains of the questionnaire ranked average when compared to the national numbers. The remainders were split between above average (20.6%) and below average (13.4%). In our cohort, no relationships were statistically significant between the five dependent variables of interest and the independent variables by chi-square-and t-test analyses. This was further confirmed by regression analysis. Of note, sex carried the strongest statistical significance (with a P-value of 0.16) as a predictor of "the burden of kidney disease on daily life" in ordinal regression. Conclusion: Prior studies have shown variables such as serum phosphate level, intradialytic weight gain, and dialysis adequacy are associated with lower KDQOL scores; however, this was not evident in our analysis likely due to smaller sample size. Larger size studies are required to better understand the predictors of QOL in ESRD patients on HD.