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Published in: BMC Nephrology 1/2021

Open Access 01-12-2021 | Chronic Kidney Disease | Research

Is health-related quality of life associated with adequacy of hemodialysis in chronic kidney disease patients?

Authors: Lamia M. Hasan, Dina A. H. Shaheen, Ghada A. H. El Kannishy, Nagy A. H. Sayed-Ahmed, Ahmed M. Abd El Wahab

Published in: BMC Nephrology | Issue 1/2021

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Abstract

Introduction

Monitoring Health Related Quality of Life (HRQoL) in different stages of chronic kidney disease is advised by all nephrology societies. We aimed to study the relation between quality of life and dialysis adequacy.

Methods

One hundred patients (51% males), on regular hemodialysis 3/week for > 6 months in two hospitals were included. Single pool Kt/V was used to assess dialysis adequacy. Patients were grouped into 3 divisions according to Kt/v: Group A > 1.5 (n = 24), group B 1.2–1.5 (n = 54) and group C < 1.2 (n = 22). KDQOL-SF™ questionnaire was used to study quality of life in our groups. Group C was reassessed after 3 months of improving Kt/v.

Results

Mean values were: Kt/V (1.48 ± 0.41), Cognitive Function (84.27 ± 9.96), Work status (30.00 ± 33.33), Energy (45.70 ± 13.89), Physical Function and Role limitations due to physical function (45.30 ± 12.39 and 31.25 ± 19.26, respectively). Group A had significantly higher scores of KDQOL-SF except Role limitations due to Physical Function. All subscales improved in group C after Kt/v improvement except 3 subscales, namely, work status, patient satisfaction and role limitation due to physical and emotional functions.

Conclusion

Inadequate HD badly affects quality of life and improving adequacy refines many components of quality of life.
Literature
1.
2.
go back to reference Makusidi M, Liman H, Yakubu A, Isah M, Abdullahi S, Chijioke A. Hemodialysis performance and outcomes among end stage renal disease patients from Sokoto, North-Western Nigeria. Indian J Nephrol. 2014;24(2):82.PubMedPubMedCentralCrossRef Makusidi M, Liman H, Yakubu A, Isah M, Abdullahi S, Chijioke A. Hemodialysis performance and outcomes among end stage renal disease patients from Sokoto, North-Western Nigeria. Indian J Nephrol. 2014;24(2):82.PubMedPubMedCentralCrossRef
3.
go back to reference Sultania P, Sharma SK, Sharma S. Adequacy of hemodialysis in Nepalese patients undergoing maintenance hemodialysis. J Nepal Med Assoc. 2009;48(173). Sultania P, Sharma SK, Sharma S. Adequacy of hemodialysis in Nepalese patients undergoing maintenance hemodialysis. J Nepal Med Assoc. 2009;48(173).
4.
go back to reference Ayoub A, Hijjazi K. Quality of life in dialysis patients from the United Arab Emirates. J Fam Community Med. 2013;20(2):106.CrossRef Ayoub A, Hijjazi K. Quality of life in dialysis patients from the United Arab Emirates. J Fam Community Med. 2013;20(2):106.CrossRef
5.
go back to reference Held PJ, Port FK, Wolfe RA, et al. The dose of hemodialysis and patient mortality. Kidney Int. 1996;50(2):550–6.PubMedCrossRef Held PJ, Port FK, Wolfe RA, et al. The dose of hemodialysis and patient mortality. Kidney Int. 1996;50(2):550–6.PubMedCrossRef
6.
go back to reference Barril G, Besada E, Caro P, et al. News and traditional indications from short daily dialysis: different schemes to optimized ESF response. Hemodial Int. 2004;8(1):85.CrossRef Barril G, Besada E, Caro P, et al. News and traditional indications from short daily dialysis: different schemes to optimized ESF response. Hemodial Int. 2004;8(1):85.CrossRef
7.
go back to reference Johansen KL, Chertow GM, Ng AV, et al. Physical activity levels in patients on hemodialysis and healthy sedentary controls. Kidney Int. 2000;57(6):2564–70.PubMedCrossRef Johansen KL, Chertow GM, Ng AV, et al. Physical activity levels in patients on hemodialysis and healthy sedentary controls. Kidney Int. 2000;57(6):2564–70.PubMedCrossRef
8.
go back to reference Kimmel PL, Patel SS. Quality of life in patients with chronic kidney disease: focus on end-stage renal disease treated with hemodialysis. Semin Nephrol. 2006:68–79 Elsevier. Kimmel PL, Patel SS. Quality of life in patients with chronic kidney disease: focus on end-stage renal disease treated with hemodialysis. Semin Nephrol. 2006:68–79 Elsevier.
9.
go back to reference Bethesda MD. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2017. Bethesda MD. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2017.
10.
go back to reference Davison SN, Jhangri GS. The impact of chronic pain on depression, sleep, and the desire to withdraw from dialysis in hemodialysis patients. J Pain Symptom Manag. 2005;30(5):465–73.CrossRef Davison SN, Jhangri GS. The impact of chronic pain on depression, sleep, and the desire to withdraw from dialysis in hemodialysis patients. J Pain Symptom Manag. 2005;30(5):465–73.CrossRef
11.
go back to reference Mujais SK, Story K, Brouillette J, et al. Health-related quality of life in CKD patients: correlates and evolution over time. Clin J Am Soc Nephrol. 2009;4(8):1293–301.PubMedPubMedCentralCrossRef Mujais SK, Story K, Brouillette J, et al. Health-related quality of life in CKD patients: correlates and evolution over time. Clin J Am Soc Nephrol. 2009;4(8):1293–301.PubMedPubMedCentralCrossRef
12.
go back to reference Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB. Development of the kidney disease quality of life (KDQOLTM) instrument. Qual Life Res. 1994;3(5):329–38.PubMedCrossRef Hays RD, Kallich JD, Mapes DL, Coons SJ, Carter WB. Development of the kidney disease quality of life (KDQOLTM) instrument. Qual Life Res. 1994;3(5):329–38.PubMedCrossRef
13.
go back to reference Hays RD, Kallich JD, Mapes DL, et al. Kidney disease quality of life short form (KDQOL-SF), version 1.3: a manual for use and scoring, vol. 39. Santa Monica: Rand; 1997. Hays RD, Kallich JD, Mapes DL, et al. Kidney disease quality of life short form (KDQOL-SF), version 1.3: a manual for use and scoring, vol. 39. Santa Monica: Rand; 1997.
14.
go back to reference Daugirdas JT, Depner TA, Gotch FA, et al. Comparison of methods to predict equilibrated Kt/V in the HEMO pilot study. Kidney Int. 1997;52(5):1395–405.PubMedCrossRef Daugirdas JT, Depner TA, Gotch FA, et al. Comparison of methods to predict equilibrated Kt/V in the HEMO pilot study. Kidney Int. 1997;52(5):1395–405.PubMedCrossRef
15.
go back to reference Korevaar JC, Merkus MP, Jansen MAM, Dekker FW, Boeschoten EW, Krediet RT. Qual Life Res. 2002;11(5):437–47.PubMedCrossRef Korevaar JC, Merkus MP, Jansen MAM, Dekker FW, Boeschoten EW, Krediet RT. Qual Life Res. 2002;11(5):437–47.PubMedCrossRef
16.
go back to reference Ware JE, Keller SD, Kosinski M. SF-36 physical and mental health summary scales: Health Assessment Lab Boston; 1994. Ware JE, Keller SD, Kosinski M. SF-36 physical and mental health summary scales: Health Assessment Lab Boston; 1994.
17.
go back to reference Czyżewski L, Sańko-Resmer J, Wyzgał J, Kurowski A. Assessment of health-related quality of life of patients after kidney transplantation in comparison with hemodialysis and peritoneal dialysis. Ann Transplant. 2014;19:576–85.PubMedCrossRef Czyżewski L, Sańko-Resmer J, Wyzgał J, Kurowski A. Assessment of health-related quality of life of patients after kidney transplantation in comparison with hemodialysis and peritoneal dialysis. Ann Transplant. 2014;19:576–85.PubMedCrossRef
18.
go back to reference ElHafeez SA, Sallam SA, Gad ZM, Zoccali C, Torino C, Tripepi G, et al. Cultural adaptation and validation of the “kidney disease and quality of life-short form (KDQOL-SF™) version 1.3” questionnaire in Egypt. BMC Nephrol. 2012;13(1):170.CrossRef ElHafeez SA, Sallam SA, Gad ZM, Zoccali C, Torino C, Tripepi G, et al. Cultural adaptation and validation of the “kidney disease and quality of life-short form (KDQOL-SF™) version 1.3” questionnaire in Egypt. BMC Nephrol. 2012;13(1):170.CrossRef
19.
go back to reference Danquah FVN, Zimmerman L, Diamond PM, Meininger J, Bergstrom N. Frequency, severity, and distress of dialysis-related symptoms reported by patients on hemodialysis. Nephrol Nurs J. 2010;37(6):627–39.PubMed Danquah FVN, Zimmerman L, Diamond PM, Meininger J, Bergstrom N. Frequency, severity, and distress of dialysis-related symptoms reported by patients on hemodialysis. Nephrol Nurs J. 2010;37(6):627–39.PubMed
20.
go back to reference KDOQI. Clinical practice guidelines and clinical practice recommendations for 2006 updates: hemodialysis adequacy, peritoneal dialysis adequacy and vascular access. Am J Kidney Dis. 2006;48(1):1–322. KDOQI. Clinical practice guidelines and clinical practice recommendations for 2006 updates: hemodialysis adequacy, peritoneal dialysis adequacy and vascular access. Am J Kidney Dis. 2006;48(1):1–322.
21.
go back to reference Port FK, Ashby VB, Dhingra RK, Roys EC, Wolfe RA. Dialysis dose and body mass index are strongly associated with survival in hemodialysis patients. J Am Soc Nephrol. 2002;13(4):1061–6.PubMedCrossRef Port FK, Ashby VB, Dhingra RK, Roys EC, Wolfe RA. Dialysis dose and body mass index are strongly associated with survival in hemodialysis patients. J Am Soc Nephrol. 2002;13(4):1061–6.PubMedCrossRef
22.
go back to reference Brenner B, Taal M, Chertow G, Marsden P, Skorecki K, Yu A. Brenner and Rector's the kidney E-book; 2011. p. 2314–8. Brenner B, Taal M, Chertow G, Marsden P, Skorecki K, Yu A. Brenner and Rector's the kidney E-book; 2011. p. 2314–8.
23.
go back to reference Eknoyan G, Beck GJ, Cheung AK, Daugirdas JT, Greene T, Kusek JW, et al. Effect of dialysis dose and membrane flux in maintenance hemodialysis. N Engl J Med. 2002;347(25):2010–9.PubMedCrossRef Eknoyan G, Beck GJ, Cheung AK, Daugirdas JT, Greene T, Kusek JW, et al. Effect of dialysis dose and membrane flux in maintenance hemodialysis. N Engl J Med. 2002;347(25):2010–9.PubMedCrossRef
24.
go back to reference KDIGO. Clinical practice guideline for anemia in chronic kidney disease. Kidney Int. 2012;2:279. KDIGO. Clinical practice guideline for anemia in chronic kidney disease. Kidney Int. 2012;2:279.
25.
go back to reference KDIGO. Clinical practice guideline for the diagnosis, evaluation, prevention and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int. 2009;76(113):1–130. KDIGO. Clinical practice guideline for the diagnosis, evaluation, prevention and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int. 2009;76(113):1–130.
26.
go back to reference Danielski M, Ikizler TA, McMonagle E, Kane JC, Pupim L, Morrow J, et al. Linkage of hypoalbuminemia, inflammation, and oxidative stress in patients receiving maintenance hemodialysis therapy. Am J Kidney Dis. 2003;42(2):286–94.PubMedCrossRef Danielski M, Ikizler TA, McMonagle E, Kane JC, Pupim L, Morrow J, et al. Linkage of hypoalbuminemia, inflammation, and oxidative stress in patients receiving maintenance hemodialysis therapy. Am J Kidney Dis. 2003;42(2):286–94.PubMedCrossRef
27.
go back to reference Sridhar NR, Josyula S. Hypoalbuminemia in hemodialyzed end stage renal disease patients: risk factors and relationships-a 2 year single center study. BMC Nephrol. 2013;14(1):242.PubMedPubMedCentralCrossRef Sridhar NR, Josyula S. Hypoalbuminemia in hemodialyzed end stage renal disease patients: risk factors and relationships-a 2 year single center study. BMC Nephrol. 2013;14(1):242.PubMedPubMedCentralCrossRef
28.
go back to reference Daugirdas JT, Depner TA, Inrig J, Mehrotra R, Rocco MV, Suri RS, et al. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis. 2015;66(5):884–930.CrossRef Daugirdas JT, Depner TA, Inrig J, Mehrotra R, Rocco MV, Suri RS, et al. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis. 2015;66(5):884–930.CrossRef
29.
go back to reference DeOreo PB. Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance. Am J Kidney Dis. 1997;30(2):204–12.PubMedCrossRef DeOreo PB. Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance. Am J Kidney Dis. 1997;30(2):204–12.PubMedCrossRef
30.
go back to reference Mapes DL, Bragg-Gresham JL, Bommer J, Fukuhara S, McKevitt P, Wikström B, et al. Health-related quality of life in the dialysis outcomes and practice patterns study (DOPPS). Am J Kidney Dis. 2004;44:54–60.PubMedCrossRef Mapes DL, Bragg-Gresham JL, Bommer J, Fukuhara S, McKevitt P, Wikström B, et al. Health-related quality of life in the dialysis outcomes and practice patterns study (DOPPS). Am J Kidney Dis. 2004;44:54–60.PubMedCrossRef
31.
go back to reference Pisoni RL, Gillespie BW, Dickinson DM, Chen K, Kutner MH, Wolfe RA. The Dialysis outcomes and practice patterns study (DOPPS): design, data elements, and methodology. Am J Kidney Dis. 2004;44:7–15.PubMedCrossRef Pisoni RL, Gillespie BW, Dickinson DM, Chen K, Kutner MH, Wolfe RA. The Dialysis outcomes and practice patterns study (DOPPS): design, data elements, and methodology. Am J Kidney Dis. 2004;44:7–15.PubMedCrossRef
32.
go back to reference Johansen KL. Exercise in the end-stage renal disease population. J Am Soc Nephrol. 2007;18(6):1845–54.PubMedCrossRef Johansen KL. Exercise in the end-stage renal disease population. J Am Soc Nephrol. 2007;18(6):1845–54.PubMedCrossRef
33.
go back to reference Kosmadakis GC, Bevington A, Smith A, Clapp E, Viana J, Bishop N, et al. Physical exercise in patients with severe kidney disease. Nephron Clin Pract. 2010;115(1):c7–c16.PubMedCrossRef Kosmadakis GC, Bevington A, Smith A, Clapp E, Viana J, Bishop N, et al. Physical exercise in patients with severe kidney disease. Nephron Clin Pract. 2010;115(1):c7–c16.PubMedCrossRef
34.
go back to reference Liu Y-M, Yeh M-L, Chung Y-C. Improving physiological and psychological status in a hemodialysis patient: a nursing experience using an exercise training program. Hu Li Za Zhi. 2013;60(5):104.PubMed Liu Y-M, Yeh M-L, Chung Y-C. Improving physiological and psychological status in a hemodialysis patient: a nursing experience using an exercise training program. Hu Li Za Zhi. 2013;60(5):104.PubMed
35.
go back to reference Cheema BSB, Fiatarone Singh MA. Exercise training in patients receiving maintenance hemodialysis: a systematic review of clinical trials. Am J Nephrol. 2005;25(4):352–64.PubMedCrossRef Cheema BSB, Fiatarone Singh MA. Exercise training in patients receiving maintenance hemodialysis: a systematic review of clinical trials. Am J Nephrol. 2005;25(4):352–64.PubMedCrossRef
36.
go back to reference Miller BW, Cress CL, Johnson ME, Nichols DH, Schnitzler MA. Exercise during hemodialysis decreases the use of antihypertensive medications. Am J Kidney Dis. 2002;39(4):828–33.PubMedCrossRef Miller BW, Cress CL, Johnson ME, Nichols DH, Schnitzler MA. Exercise during hemodialysis decreases the use of antihypertensive medications. Am J Kidney Dis. 2002;39(4):828–33.PubMedCrossRef
37.
go back to reference Painter P. Physical functioning in end-stage renal disease patients: update 2005. Hemodial Int. 2005;9(3):218–35.PubMedCrossRef Painter P. Physical functioning in end-stage renal disease patients: update 2005. Hemodial Int. 2005;9(3):218–35.PubMedCrossRef
40.
go back to reference Hedayati SS, Yalamanchili V, Finkelstein FO. A practical approach to the treatment of depression in patients with chronic kidney disease and end-stage renal disease. Kidney Int. 2012;81(3):247–55.PubMedCrossRef Hedayati SS, Yalamanchili V, Finkelstein FO. A practical approach to the treatment of depression in patients with chronic kidney disease and end-stage renal disease. Kidney Int. 2012;81(3):247–55.PubMedCrossRef
41.
go back to reference Merkus MP, Jager KJ, Dekker FW, et al. Quality of life in patients on chronic dialysis: self-assessment 3 months after the start of treatment. Am J Kidney Dis. 1997;29(4):584–92.PubMedCrossRef Merkus MP, Jager KJ, Dekker FW, et al. Quality of life in patients on chronic dialysis: self-assessment 3 months after the start of treatment. Am J Kidney Dis. 1997;29(4):584–92.PubMedCrossRef
42.
go back to reference Kuhlmann MK, Kotanko P, Levin NW. Haemodialysis: Dialysis prescription and adequacy. In: Feehally J et al's comprehensive clinical nephrology sixth edition, vol. 1082. Edinburgh London new York; 2019. p. 1089. Kuhlmann MK, Kotanko P, Levin NW. Haemodialysis: Dialysis prescription and adequacy. In: Feehally J et al's comprehensive clinical nephrology sixth edition, vol. 1082. Edinburgh London new York; 2019. p. 1089.
43.
go back to reference Babu A, Singh J, Ganesh N. A study on adequacy of hemodialysis and quality of life in Esrd patients OSR. J Pharm Biol Sci (IOSR-JPBS). 2018;18:24–30. Babu A, Singh J, Ganesh N. A study on adequacy of hemodialysis and quality of life in Esrd patients OSR. J Pharm Biol Sci (IOSR-JPBS). 2018;18:24–30.
44.
go back to reference Chen JB, Lam KK, Su YJ, et al. Relationship between Kt/V urea-based dialysis 9/1adequacy and nutritional status and their effect on the components of the quality of life in incident peritoneal dialysis patients. BMC Nephrol. 2012;13(1):39.PubMedPubMedCentralCrossRef Chen JB, Lam KK, Su YJ, et al. Relationship between Kt/V urea-based dialysis 9/1adequacy and nutritional status and their effect on the components of the quality of life in incident peritoneal dialysis patients. BMC Nephrol. 2012;13(1):39.PubMedPubMedCentralCrossRef
45.
go back to reference El-Sheikh M, El-Ghazaly G. Assessment of hemodialysis adequacy in patients with chronic kidney disease in the hemodialysis unit at Tanta University Hospital in Egypt. Indian J Nephrol. 2016;26(6):398.PubMedPubMedCentralCrossRef El-Sheikh M, El-Ghazaly G. Assessment of hemodialysis adequacy in patients with chronic kidney disease in the hemodialysis unit at Tanta University Hospital in Egypt. Indian J Nephrol. 2016;26(6):398.PubMedPubMedCentralCrossRef
46.
go back to reference Stolic R, Trajkovic G, Jovanovic A, et al. Carotid ultrasonographic parameters as markers of atherogenesis and mortality rate in patients on hemodialysis. Vojnosanit Pregl. 2010;67(11):916–22.PubMedCrossRef Stolic R, Trajkovic G, Jovanovic A, et al. Carotid ultrasonographic parameters as markers of atherogenesis and mortality rate in patients on hemodialysis. Vojnosanit Pregl. 2010;67(11):916–22.PubMedCrossRef
47.
go back to reference Locatelli F, Buoncristiani U, Canaud B, Kohler H, Petitclerc T, Zucchelli P. Haemodialysis with on-line monitoring equipment: tools or toys? Nephrol Dial Transplant. 2005;20(1):22–33.PubMedCrossRef Locatelli F, Buoncristiani U, Canaud B, Kohler H, Petitclerc T, Zucchelli P. Haemodialysis with on-line monitoring equipment: tools or toys? Nephrol Dial Transplant. 2005;20(1):22–33.PubMedCrossRef
48.
go back to reference Cigarran S, Coronel F, Torrente J, Sevilla M, Baylón J. Risk of inadequate Dialysis dose in hemodialysis patients with high Watson volume. A warning. Hemodial Int. 2004a;8(1):84.CrossRef Cigarran S, Coronel F, Torrente J, Sevilla M, Baylón J. Risk of inadequate Dialysis dose in hemodialysis patients with high Watson volume. A warning. Hemodial Int. 2004a;8(1):84.CrossRef
49.
go back to reference Manns BJ, Johnson JA, Taub K, Mortis G, Ghali WA, Donaldson C. Dialysis adequacy and health related quality of life in hemodialysis patients. ASAIO J. 2002;48(5):565–9.PubMedCrossRef Manns BJ, Johnson JA, Taub K, Mortis G, Ghali WA, Donaldson C. Dialysis adequacy and health related quality of life in hemodialysis patients. ASAIO J. 2002;48(5):565–9.PubMedCrossRef
50.
go back to reference Kalender N, Tosun N. Determination of the relationship between adequacy of dialysis and quality of life and self-care agency. J Clin Nurs. 2014;23(5–6):820–8.PubMedCrossRef Kalender N, Tosun N. Determination of the relationship between adequacy of dialysis and quality of life and self-care agency. J Clin Nurs. 2014;23(5–6):820–8.PubMedCrossRef
51.
go back to reference Morton AR, Meers C, Singer MA, et al. Quantity of dialysis: quality of life--what is the relationship? ASAIO J (American Society for Artificial Internal Organs: 1992). 1996;42(5):M713–7.CrossRef Morton AR, Meers C, Singer MA, et al. Quantity of dialysis: quality of life--what is the relationship? ASAIO J (American Society for Artificial Internal Organs: 1992). 1996;42(5):M713–7.CrossRef
Metadata
Title
Is health-related quality of life associated with adequacy of hemodialysis in chronic kidney disease patients?
Authors
Lamia M. Hasan
Dina A. H. Shaheen
Ghada A. H. El Kannishy
Nagy A. H. Sayed-Ahmed
Ahmed M. Abd El Wahab
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2021
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-021-02539-z

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