A Study on Adequacy of Hemodialysis and Quality Of Life in Esrd Patients (original) (raw)
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Clinical Journal of the American Society of Nephrology, 2009
Background and objectives: Persons with ESRD identify non-disease-specific conditions as negatively affecting their quality of life. It is unknown how these non-ESRD-specific conditions correlate with each other and with ESRD-specific conditions such as anemia, renal osteodystrophy, dialysis access, and dialysis adequacy. The objectives of this study were to determine the prevalence and inter-relatedness of selected conditions among persons receiving hemodialysis and to analyze the relationship between non-ESRD-specific and ESRD-specific conditions. Design, setting, participants, & measurements: This was an observational cohort study of persons with ESRD that included standardized assessments for pain, fatigue, depression, cognitive impairment, and impaired physical performance. The study was conducted at three dialysis clinics in one urban geographic area. Of the 134 persons who met exclusion criteria, 25 declined participation, yielding a sample size of 109. Results: Pain was present in >81% of participants, fatigue and impaired physical performance in >60% participants, and cognitive impairment and depression in >25% of participants. Pain, fatigue, and depression were highly correlated, but had no correlation with use of a catheter for access, hemoglobin (Hgb), intact parathyroid hormone (iPTH), phosphorous, or Kt/V values outside of the range of guidelines. There was a modest correlation between cognitive function and both Hgb and iPTH. Conclusions: Non-ESRD-specific conditions such as fatigue, pain, and depression are as prevalent as ESRD-specific conditions, and the magnitude of the correlations between the non-ESRD-specific conditions is greater than the correlations between non-ESRD-specific and ESRD-specific conditions. Current guidelines may be failing to address a substantial component of the disease burden for persons with ESRD.
Assessment of Haemodialysis Adequacy among ESRD Patients in Port Harcourt
2020
Background: Chronic renal failure is the progressive loss of function of kidney and patient requires a long treatment in the form of renal replacement therapy. Haemodialysis is one of the modalities of renal replacement management, during which the body’s waste products, including creatinine, urea and excess water, are removed. The purpose of the study is to elucidate the adequacy of haemodialysis among patients with ESRD in Port Harcourt. Materials and Methods: This is a prospective study involving Seventy-four ESRD patients who are undergoing haemodialysis. 5mls of blood was collected from each patient pre-dialysis and post-dialysis to determine the level of urea and creatinine.Ureareduction ratio (URR) was calculated and used as a determinant of haemodialysis adequacy. Results: Most of ESRD patients were within the age bracket of 5160 years (40%). The mean URR was 42%. URR of the first session (35%) was compared with URR after the second (41%) and third (39%) sessions and the p-v...
Characteristics of ESRD Patients who have been on Long-term Hemodialysis Therapy in Egypt
Asian Journal of Medicine and Health, 2021
Background: It is well-known that hemodialysis extends the life of end-stage renal disease (ESRD) patients, who would have otherwise died. The characteristics of long-term patients on hemodialysis (HD) were not evaluated before in Egypt. We aimed at identifying the specific characteristics of the patients who have survived on hemodialysis for more than 20 years in Egypt. Subjects and Methods: During the years 2018 and 2019, the twenty-seven governorate health affairs Directories of the Egyptian Ministry of Health were contacted to participate in data collection. The dialysis physicians in each hemodialysis unit were sent a questionnaire form requesting to submit information, on the characteristics of patients who have been on HD therapy for twenty years or more. Results: Seventy-three patients were encountered from a total number of 26000 HD patients to have been on HD therapy; with a range between 20 and 30 years. Males constituted the majority of these patients. Sixty-eight pati...
American Journal of Kidney Diseases, 2013
Intensive (longer and more frequent) hemodialysis has emerged as an alternative to conventional hemodialysis for the treatment of patients with end-stage renal disease. However, given the differences in dialysis delivery and models of care associated with intensive dialysis, alternative approaches to patient management may be required. The purpose of this work was to develop a clinical practice guideline for the Canadian Society of Nephrology. We applied the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach for guideline development and performed targeted systematic reviews and metaanalysis (when appropriate) to address prioritized clinical management questions. We included studies addressing the treatment of patients with end-stage renal disease with short daily (Ն5 days per week, Ͻ3 hours per session), long (3-4 days per week, Ն5.5 hours per session), or long-frequent (Ն5 days per week, Ն5.5 hours per session) hemodialysis. We included clinical trials and observational studies with or without a control arm (1990 and later). Based on a prioritization exercise, 6 interventions of interest included optimal vascular access type, buttonhole cannulation, antimicrobial prophylaxis for buttonhole cannulation, closed connector devices, and dialysate calcium and dialysate phosphate additives for patients receiving intensive hemodialysis. We developed 6 recommendations addressing the interventions of interest. Overall quality of the evidence was very low and all recommendations were conditional. We provide detailed commentaries to guide in shared decision making. The main limitation was the very low overall quality of evidence that precluded strong recommendations. Most included studies were small single-arm observational studies. Three randomized controlled trials were applicable, but provided only indirect evidence. Published information for patient values and preference was lacking. In conclusion, we provide 6 recommendations for the practice of intensive hemodialysis. However, due to very low-quality evidence, all recommendations were conditional. We therefore also highlight priorities for future research.
Introduction: End-stage renal disease (ESRD) disease is a public health problem worldwide that is highly associated with medical, social and psychological disorders particularly in those treated with Hemodialysis. It leads to loss in mobility, exercise capacity, and self-assessed physical function, and is further associated with reduced ability to work and function in daily life. Objectives: This study was aimed to assess the quality of life (QOL) among Hemodialysis patients admitted at the National Ribat University Hospital and Ibn Sina Specialized Hospital during June-October 2017. Methodology: A cross-sectional prospective study conducted at Hemodialysis units of National Ribat University Hospital and Ibn Sina Specialized Hospital in 120 patients undergoing regular Hemodialysis for more than six months. The WHO quality of life questionnaire was used. Verbal and written consent was taken from any patient after explaining the purpose of the study. Statistical analysis was performed using SPSS version 25.0. Results: One hundred-twenty patients were enrolled which included forty males (66.7%) and twenty (33.3%) females. The assessment of quality of life shows only 10% have good QOL, 46.6% have moderate QOL, 40% have poor QOL and 3.3% have very poor QOL. Conclusion: Generally person with ESRD are more likely to have reduced quality of life and poor overall health in compared with subjects with normal renal function. This findings suggest that ESRD maintained on prolonged Hemodialysis is associated with reduced relatively decreased QOL and long term bad outcomes affecting subject’s overall aspects of health.
A Comprehensive Review on Revivification for ESRD Patients -Haemodialysis
https://www.ijhsr.org/IJHSR\_Vol.12\_Issue.11\_Nov2022/IJHSR-Abstract16.html, 2022
Renal system plays a vital role in removing metabolic waste product toxins like urea, uric acid, creatinine from blood and excrete it through urine. Abnormalities in Renal anatomical or in physiological condition can lead to the development of Acute kidney injury, it is reversible but in certain case due to progression of disease condition leads to CKD. Chronic kidney disease (CKD) which is characterized by structural and functional changes of the kidney with glomerular filtration rate of less than 60ml/min/1.73 m. sq. Here, Haemodialysis, extracorporeal procedure to eliminate waste from the body. During this procedure patient may experience various complications such vascular access stenosis, thrombosis of haemodialysis access, thrombus in the dialysis catheter, dialysis access infections, cardiovascular abnormalities, bone disorders, anemia, nutrition deficiency, fluid imbalance, hypotension, The changes in the lifestyle modifications and diet restriction should be maintained by haemodialysis patient to prevent further progression of the disease, complication and to improve the quality of life.
Factors Affecting Quality of Life among Hemodialysis Patients
2017
Dialysis is most commonly prescribed for patients with temporary or permanent kidney failure. People with endstage renal disease (ESRD) have kidneys that are no longer capable of adequately removing fluids and wastes from their body or of maintaining the proper level of certain kidney regulated chemicals in the bloodstream. Study was aimed to assess the factors affecting of quality of life of patients on Hemodialysis & to assess the association between the factors affecting quality of life and demographic variables of patient on Hemodialysis. Methodology: Non experimental design was used with descriptive research approach, study sample was 50 Hemodialysis patient selected by convenient sampling technique. Results: Majority 48% Hemodialysis patient had more than 50 years, 26% patients had 40 to 50 years, 18% patients had up to 30 years and 8% patients had in group of 30 to 40 years majority of them 50% had just complete primary education , 34% had complete secondary education, while ...
2016
Fatigue is one of the most common symptoms of haemodialysis patients and is associated with poor quality of life. Purpose: To investigate the levels of fatigue and its correlation with quality of life of haemodialysis patients. Results: Of the 134 haemodialysis patients, the majority of patients (52,9%) seemed to have low rates of fatigue (10 <FAS <= 20). However, 15% of these patients seemed to appear high to very high levels of fatigue (30 <FAS <= 50). Studying the quality of life of these patients we can observe a correlation between fatigue and quality of life. In particular , patients who experience higher rates of fatigue seem to have worse quality of life (MVQOLI total score 2.90) than those experiencing lower rates of fatigue (MVOQLI total score 3.67) (p <0,005). Conclusions: The analysis of the results enable us to understand the correlation between fatigue and quality of life among haemodialysis patients with ESRD and the importance of prevention, diagnosis and treatment of fatigue in order to optimize the quality of life in dialysis patients with ESRD.
Introduction: Among patients with end stage renal disease (ESRD) who are treated with haemodialysis, solute clearance and nutritional adequacy are determinants of mortality. The aim of this study was to assess the adequacy of haemodialysis among patients with ESRD in Sokoto. Material and Methods: This was a prospective study that included fifty three (53) ESRD patients that are on maintenance haemodialysis. Each patient was dialyzed thrice using same dialyzer after reprocessing with 4% formaldehyde. Demographic and socio-economic data were obtained using questionnaires administered to each patient. Blood samples were collected at the baseline, before and after each haemodialysis session and the urea, albumin and total protein were estimated for. Urea reduction ratio (URR) was calculated and used as a measure of haemodialysis adequacy. Results: The mean age of the patients was 40.49 ±2.00years. The mean urea reduction ratio was 57.83±0.83%, URR after first dialyzer use (i.e. 57.93 ±1...
American Journal of Kidney Diseases, 2005
Background: We performed a systematic review of randomized controlled trials (RCTs) comparing hemodialysis (HD), hemofiltration (HF), hemodiafiltration (HDF), and acetate-free biofiltration (AFB) in the treatment of patients with end-stage renal disease to assess their clinical effectiveness. Methods: The Cochrane CENTRAL Registry, MEDLINE, EMBASE, CINAHL, the American College of Physicians Database, Database of Abstracts of Reviews of Effectiveness, and reference lists were searched for randomized trials of HF, HDF, and AFB compared with HD; HDF compared with AFB; and HF compared with HDF. Two reviewers extracted data for all-cause mortality; hypotension, headache, nausea, vomiting, and any other adverse symptoms; quality of life (QoL); hospitalization; dialysis adequacy; and end-of-treatment  2 -microglobulin levels. Analysis was by means of a random-effects model, and results are expressed as relative risk (RR) and weighted mean difference (WMD) with 95% confidence intervals (CIs). Results: Eighteen eligible trials (588 patients) were identified. HDF was associated with significantly greater mortality risk than HD (4 trials, 326 patients; RR, 3.52; 95% CI, 1.37 to 9.47). Risk for mortality was not different among the other comparisons. Risks for hypotension episodes and dialysis-related symptoms were not significantly different with HD, HF, HDF, and AFB (18 trials, 583 patients). QoL, assessed by using an unvalidated scoring tool, appeared to be significantly improved in patients on HDF therapy than those on HD therapy (1 trial, 67 patients; WMD, 0.6; 95% CI, 0.3 to 0.9), but this was not evident when validated QoL assessment tools were used. Use of AFB compared with HDF was not associated with a significant difference in risk for hospitalization (1 trial, 11 patients; WMD, -0.45; 95% CI, -1.42 to 0.52). HDF in comparison to HD did not reduce the risk for carpal tunnel syndrome (1 trial, 67 patients; RR, 2.04; 95% CI, 0.59 to 7.00). Kt/V was significantly different with HDF compared with HD (3 trials, 124 patients; WMD, 0.14; 95% CI, 0.05 to 0.22). No other substantial data for these interventions and their impact on major patient-centered outcomes were available. Conclusion: The trials assessed were not powered adequately and had suboptimal method quality. It is not possible on the basis of effectiveness to prefer one extracorporeal renal replacement therapy modality to the other for end-stage kidney disease because significant differences in clinically important outcomes have not been shown by available published RCTs. Am J Kidney Dis 45:437-447.