The effect of a novel, digital physical activity and emotional well-being intervention on health-related quality of life in people with chronic kidney disease: trial design and baseline data from a multicentre prospective, wait-list randomised controlled trial (kidney BEAM).

BACKGROUND: Physical activity and emotional self-management has the potential to enhance health-related quality of life (HRQoL), but few people with chronic kidney disease (CKD) have access to resources and support. The Kidney BEAM trial aims to evaluate whether an evidence-based physical activity and emotional wellbeing self-management programme (Kidney BEAM) leads to improvements in HRQoL in people with CKD. METHODS: This was a prospective, multicentre, randomised waitlist-controlled trial, with health economic analysis and nested qualitative studies. In total, three hundred and four adults with established CKD were recruited from 11 UK kidney units. Participants were randomly assigned to the intervention (Kidney BEAM) or a wait list control group (1:1). The primary outcome was the between-group difference in Kidney Disease Quality of Life (KDQoL) mental component summary score (MCS) at 12 weeks. Secondary outcomes included the KDQoL physical component summary score, kidney-specific scores, fatigue, life participation, depression and anxiety, physical function, clinical chemistry, healthcare utilisation and harms. All outcomes were measured at baseline and 12 weeks, with long-term HRQoL and adherence also collected at six months follow-up. A nested qualitative study explored experience and impact of using Kidney BEAM. RESULTS: 340 participants were randomised to Kidney BEAM (n = 173) and waiting list (n = 167) groups. There were 96 (55%) and 89 (53%) males in the intervention and waiting list groups respectively, and the mean (SD) age was 53 (14) years in both groups. Ethnicity, body mass, CKD stage, and history of diabetes and hypertension were comparable across groups. The mean (SD) of the MCS was similar in both groups, 44.7 (10.8) and 45.9 (10.6) in the intervention and waiting list groups respectively. CONCLUSION: Results from this trial will establish whether the Kidney BEAM self management programme is a cost-effective method of enhancing mental and physical wellbeing of people with CKD. TRIAL REGISTRATION: NCT04872933. Registered 5th May 2021.

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

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.

Transcultural adaptation and validation of the Mexican version of the kidney disease questionnaire KDQOL-SF36 version 1.3.

PURPOSE: To translate the Kidney Disease Quality of Life Short Form 36 (KDQOL-SF36) v1.3 questionnaire into the Spanish language, adapt it culturally, and validate it in the Mexican population. METHODS: The translation and transcultural adaptation were performed according to the recommendations of RAND Health (translation/pilot test/back-translation). We used coefficient alpha to determine the internal consistency, intra- and interobserver intraclass correlation coefficients (ICCs) to determine the test-retest reliability, and Pearson correlation coefficients to confirm the construct validity. RESULTS: The questionnaires were applied to 194 Mexican on haemodialysis. In total, 37.6 % lived in the northern region of Mexico, 28.9 % lived in the southern region, and 33.5 % lived in the central region. The average age was 54 ± 16 years, and 54.6 % were male. The intra- and interobserver ICCs were ≥0.7 for most dimensions evaluated (range 0.5-0.9). The internal consistency was acceptable, with coefficient alpha values ≥0.7 for 12 of the 18 dimensions (range 0.4-0.9). The construct validity was acceptable, especially in the generic component SF36, with correlation coefficients >0.5 for most dimensions. CONCLUSIONS: Psychometric testing indicated that the Mexican version of the KDQOL-SF36 provided valid and reliable scores that were similar to the results obtained with the original English version.

Differences in quality of life between Jewish and Arab patients on hemodialysis.

PURPOSE: Higher health-related quality of life (HRQOL) in dialysis patients has been associated with fewer hospitalizations and lower mortality. Since Arab patients on dialysis have better survival rates than Jewish patients, we hypothesized that they would have higher HRQOL. We also studied the impact of several risk factors on HRQOL in each population. METHODS: Based on a national dialysis registry, patients from 64 hemodialysis units were recruited to participate. Patients who consented were interviewed face-to-face, using the Kidney Disease Quality of Life Short Form (KDQOL-SF36) questionnaire. RESULTS: Five hundred and fifty-eight (50.6%) Jewish and 544 (49.4%) Arab patients participated in the study. For Arab patients mean crude scores for the "mental component summary" and KDQOL scores were significantly lower than for Jewish patients [31.6 (95% Cl 30.0-33.3) vs. 38.0 (95% Cl 36.1-39.9), p < 0.0001 and 55.6 (95% Cl 54.5-56.7) vs. 59.8 (95% Cl 58.6-60.9), p < 0.0001, respectively]. Much lower scores were observed for Arabs in the "emotional role" and "work status" subscales. The two populations had similar general health assessments and albumin level. For both, HRQOL was positively associated with higher educational level, higher albumin level, and dialysis connection by fistula or graft; and negatively associated with low income and diabetes. HRQOL was negatively associated with previous cerebrovascular accident among Arabs and with female gender among Jews. CONCLUSIONS: Differences between Jews and Arabs in subscales related to psychosocial factors suggest that cultural differences in the perceptions of sickness and health may be relevant here. Future studies should explore such possibility and focus on the large gap in the "work status" subscale.

Lower residual renal function is a risk factor for depression and impaired health-related quality of life in Korean peritoneal dialysis patients.

We retrospectively evaluated demographic and biochemical parameters associated with depression and health-related quality of life (HRQOL) in maintenance peritoneal dialysis (PD) patients. This study included 105 patients maintaining PD at Seoul National University Hospital. Data were collected from electronic medical record. Korean Beck's Depression Inventory and Korean version of Kidney Disease Quality of Life short form, version 1.3 were used to evaluate depression and HRQOL, respectively. Moderate to severe depression was found in 24.8% of patients. Patients with lower normalized protein equivalent of nitrogen appearance (nPNA) (< 1.2 g/kg/day), lower weekly renal Kt/V(urea) (< 0.2), and lower serum albumin level (≤ 4.0 g/dL) were associated with depression (P < 0.05). Among them, lower weekly renal Kt/V(urea) was the only independent risk factor associated with depression (OR = 3.1, P = 0.007). Depressed patients showed significantly lower scores in every dimension of HRQOL (P < 0.001). Lower weekly renal Kt/V(urea) (ß = 0.24, P = 0.005) and lower nPNA (ß = 0.15, P = 0.03) were the independent risk factors associated with lower kidney dialysis component summary, whereas lower plasma hemoglobin level was the consistent risk factor for lower physical component summary (ß = 0.22, P = 0.03) and mental component summary (ß = 0.22, P = 0.01). Depression is a prevalent psychological problem in PD population. Residual renal function is the most important factor associated with depression and impaired HRQOL in PD patients.

The Influence of an Unexpected Switch of Hemodialysis Facilities on the Quality of Life (QOL) in Hemodialysis Patients.

Background: We experienced a sudden breakdown of hemodialysis system during a clinical study of dermal itch and serum BNP concentrations. Patients and Methods: Forty-eight hemodialysis patients were enrolled in the itch-related study. It was intended to improve itch by lowering BNP with supportive communication between the patients and the dialysis staff. We planned to collect data, including visual analogue scale (VAS), dermatology life quality index (DLQI), blood samples and QOL score (KDQOL-SF), four times over a four week interval. The first data was obtained just prior to switching facilities due to a breakdown. The patients underwent hemodialysis in other facilities for two weeks and underwent determination of their clinical data, including QOL scores, three times. Results: While mean blood pressure showed no significant differences, serum albumin, iron and phosphate levels were worsened significantly between pre- and post-relocation. Serum BNP and DLQI showed no significant changes. VAS was significantly worsened. The mean values of the cognitive function in the KDQOL-SF and sleep and the role-physical, role-emotional, social function, dialysis staff's encouragement in SF-36 analysis were identified as statistically significant items by MANOVA. Both SF-12 physical and mental composites were also statistically significant. Although SF-12 physical composites were significant among the patients under 66 yrs of age (median), eight factors were significant among those over 66 yrs. Independent analyses revealed every item that was detected worsened significantly after the switch of facilities. Conclusion: Unexpected switching of hemodialysis facilities severely impacts the QOL for a long duration as well as the patients' symptom and laboratory data.

Estado nutricional e qualidade de vida de renais crônicos / Nutritional condition and quality of life of chronic kidney patients

Objetivo: identificar e correlacionar o estado nutricional, a qualidade de vida e o consumo alimentar em pacientes com DRC em hemodiálise. Método: trata-se de um estudo quantitativo, descritivo, observacional, do tipo transversal, com delineamento amostral não probabilístico. Compôs-se a amostra do estudo por 63 indivíduos, dos 21 aos 86 anos. Avaliou-se o EN por meio de parâmetros antropométricos e bioquímicos, IMC e Avaliação Subjetiva Global (ASG). Utilizaram-se um recordatório de 24 horas para o consumo alimentar e, para a QV, o questionário Kidney Disease Quality Of Life Short Form (KDQOL-SF). Resultados: verificou-se que, entre as comorbidades relacionadas à IRC, prevaleceu o diabetes (76%). Observou-se que, segundo o protocolo de PEW, 73% dos pacientes estavam eutróficos e, pelo IMC, 57% estavam eutróficos. Conclusão: concluiu-se que os coeficientes tiveram uma correlação não substancial ou baixa para EN e QV e consumo alimentar. Observou-se a inadequação no consumo alimentar e nos parâmetros bioquímicos.(AU)

Objective: to identify and correlate nutritional status, quality of life and food intake in patients with CKD on hemodialysis. Method: this is a quantitative, descriptive, observational, cross-sectional study with a nonprobabilistic sample design. The study sample consisted of 63 individuals, from 21 to 86 years old. EN was assessed by anthropometric and biochemical parameters, BMI and Global Subjective Assessment (GSA). A 24- hour dietary recall was used for food consumption and, for QOL, the Kidney Disease Quality Of Life Short Form questionnaire (KDQOL-SF). Results: it was found that among the comorbidities related to CKF, diabetes prevailed (76%). According to the PEW protocol, 73% of the patients were eutrophic and, by BMI, 57% were eutrophic. Conclusion: it was concluded that the coefficients had a non-substantial or low correlation for EN and QL and food intake. Inadequate food intake and biochemical parameters were observed.(AU)

Objetivo: identificar y correlacionar el estado nutricional, la calidad de vida y la ingesta de alimentos en pacientes con ERC en hemodiálisis. Método: este es un estudio cuantitativo, descriptivo, observacional, transversal con un diseño de muestra no probabilístico. La muestra del estudio consistió en 63 individuos, de 21 a 86 años. Se evaluó el EN mediante parámetros antropométricos y bioquímicos, IMC y Evaluación Subjetiva Global (ESG). Se utilizó un recordatorio de 24 horas para el consumo de alimentos y, para la calidad de vida, el cuestionario Kidney Disease Quality Of Life Short Form (KDQOL-SF). Resultados: se encontró que entre las comorbilidades relacionadas con la IRC prevaleció la diabetes (76%). Según el protocolo PEW, el 73% de los pacientes eran eutróficos y, según el IMC, el 57% eran eutróficos. Conclusión: se concluyó que los coeficientes tenían una correlación no sustancial o baja para EN y CV y la ingesta de alimentos. Se observó una ingesta inadecuada de alimentos y en los parámetros bioquímicos.(AU)

Adaptación tranccultural del cuestionario kdqolsf 36 para evaluar calidad de vvida en pacientes con enfermedad renal crónica en Colombia / Adaptaton transccultura kdqol questionnaire sf 36 to assess quality off life in patients with chronic kidney disease in Colombia / Adaptaço transcuultural do questionário kdqol sf 36 para avaliar qualidade de vida em pacientes com doença renal crônica na Colômbia

El objetivo de este trabajo es adaptar transculturalmente, para el uso en Colombia, el cuestionario para calidad de vida en pacientes con enfermedad renal crónica terminal, KDQOL-SF-36 Kidney Disease Quality of Life (instrumento mixto). Al realizar esta adaptación, se busca que el significado y semántica de las preguntas sean consistentes para ser aplicados en población Colombiana. Método: para la realización de todo el proceso de adaptación se tomaron en cuenta las recomendaciones dadas por la Organización Europea para la Investigación y el Tratamiento del Cáncer (EORTC), la aplicación del cuestionario en los grupos pilotos se llevo a cabo mediante entrevista, autoadministración y entrevista en grupos focales. Resultados: durante el proceso de adaptación se realizaron diversos cambios en el cuestionario, la mayoría de ellos en la fase de traducción desde los lineamientos seguidos en la metodología. Conclusiones: en este momento en Colombia se cuenta con la versión adaptada de la escala KDQOL-SF-36, para pacientes con enfermedad renal crónica terminal.

The aim of this work is to obtain a Colombian transcultural adaptation version of the instrument 'kidney disease quality of life' KDQOL - SF - 36 (mixed instrument) in subjects with end stage renal disease. By doing this work it is intended that the meaning and context of the questions be consistent to be applied in Colombian population. Method: For the accomplishment of the whole process of adjustment, the recommendations given by the European Organization for Research and Treatment of Cancer (EORTC) were taken in account; the application of the questionnaire in the pilot groups was carried out by interview, self administration and focal group interviews. Results: during the process of adjustment, several changes were made to the questionnaire, most of them in the translation phase from the standards followed in the methodology. Conclusions: Currently in Colombia the adapted version of the KDQOL-SF-36 scale is being used for subjects with end stage renal disease.

O objetivo destetrabalho é adaptar transculturalmente para o uso na Colômbia o questionário para qualidade de vida em pacientes com doença renal crônica terminal KDQOL-SF-36 KidneyDisease- QualityofLife (instrumento misto). Ao realizar esta adaptação procura-se que o significado e semântica das perguntas sejam consistentes para ser aplicados em população Colombiana. Método: para a realização de todo o processo de adaptação se tiveram em conta as recomendações dadas pela Organização Europeia para a Pesquisae o Tratamento do Câncer (EORTC), a aplicação do questionário nos grupos pilotos, se levou a cabo mediante entrevista, autoadministração e entrevista em grupos focais. Resultados: durante o processo de adaptação se realizaram diversos câmbios ao questionário a maioria de eles na fase de tradução desde os lineamentos seguidos na metodologia. Conclusões: em este momento na Colômbia se conta com a versão adaptada da escala KDQOL-SF-36 para pacientes com doença renal crônica terminal.

Avaliação da qualidade de vida dos pacientes submetidos à hemodiálise / Assessment of quality of life in patients undergoing hemodialysis

JUSTIFICATIVA E OBJETIVOS: A insuficiência renal crônica (IRC) é uma doença que acomete grande parcela da população, provoca graves consequências na vida do paciente, inclusive quando este precisa ser submetido ao tratamento, que, por sua vez, também compromete as dimensões física, psíquica e social, as quais podem influenciar diretamente na qualidade de vida (QV). Portanto, o objetivo deste estudo foi avaliar a QV dos pacientes submetidos à hemodiálise. MÉTODO: Estudo descritivo transversal, realizado com uma amostra de conveniência. Foi utilizado o Kidney Disease and Quality of Life Short Form (KDQOL SF-36). Os voluntários eram portadores de IRC, submetidos ao tratamento de hemodiálise em uma clínica de terapia renal substitutiva, no período de junho a julho de 2006. Para análise dos dados, foi aplicada estatística descritiva. RESULTADOS: Dos 62 pacientes que atendiam aos critérios de inclusão e exclusão, apenas 37 responderam ao questionário. Destes, 16 eram homens (43,24%) e 21 mulheres (56,76%). Das dimensões analisadas, a de papel profissional e função física foram as que apresentaram menor média de escore, enquanto que a maior média foi observada no estímulo por parte da equipe de diálise. CONCLUSÃO: A pontuação média encontrada nas diferentes dimensões indicou boa QV nesta população, uma vez quea maioria das dimensões avaliadas apresentaram escores nas 4ª e 5ª faixas. A identificação desses indicadores qualitativos poderá auxiliar na terapêutica, bem como influenciar na perspectiva de vida desses pacientes.

BACKGROUND AND OBJECTIVES: Chronic renal failure (CRF) is a disease which affects a large part of the population, causes serious consequences in the patient's life, inclusively when he/she needs to undergo a treatment that, in turn, also compromises the physical, mental and social dimensions, which can directly influence these patient's quality of life (QOL). Therefore, the aim of this study was to evaluated the quality of life of patients undergo hemodialysis. METHOD: This is a descriptive cross-sectional study, conducted with a convenience sample, which used the questionnaire of Kidney Disease and Quality of Life - Short Form (KDQOL SF-36). The volunteers were patients diagnosed with CRF and undergoing a hemodialysis treatment at a clinic for renal replacement therapy in the period from June to July 2006. For data analysis, was applied descriptive statistics. RESULTS: From the 62 patients who met the inclusion and exclusion criteria, only 37 answered the questionaire. From these, 16 men (43.24%) and 21 women (56.76%). Among the analyzed dimensions, those of professional role and physical function were the ones with the lower score average, whereas the highest average was observed in the incentive on the part of the dialysis team. CONCLUSION: The average score found in the different dimensions indicates a good quality of life in this population, since most of the assessed dimensions presented score in the 4th and 5th ranges. The identification of these qualitative indicators may help in the treatment, as well how influencing in life expectancy of these patients.

Qualidade de vida: pacientes com insuficiência renal crônica no município de Caruaru, PE / Life quality: patients with chronic renal failure in the city of Caruaru, PE

Introdução: Qualidade de vida é uma dimensão que tem sido amplamente investigada na saúde da população, independente da faixa etária. Uma condição crônica é um fator que interfere na realização das atividades da vida diária e na percepção de bem-estar individual, como é o caso dos pacientes em tratamento por hemodiálise. Objetivo: Descrever as características e analisar as possíveis associações entre a Insuficiência Renal Crônica (IRC) e a qualidade de vida em uma amostra representativa de pacientes como agravo no município de Caruaru, PE. Método: A pesquisa foi realizada nos centros de tratamentos dialíticos na cidade de Caruaru, onde toda a população com IRC é atendida (n = 192), sendo 82 pacientes do Centro Regional de Hemodiálise do Agreste (CRHA) e 110 da clínica SOS Rim – Clínica Nefrológica de Caruaru. Para a composição da amostra foi realizado um censo e todos os pacientes cadastrados foram pré-selecionados inicialmente para o estudo. Resultados: Verificou-se que a maioria dos participantes relatou algum grau de incômodo: dores musculares (69,4), cãibras (89,8), coceiras (67,3), fraqueza muscular (73,5), diminuição de líquido (91,8), diminuição alimentar (85,7) e capacidade de trabalhar(75,5). Já quando questionados se o esforço físico interfere na sua qualidade de vida, este estudo revelou que 70,3 afirmam que sim. Em relação à saúde, 80,6 das pessoas dizem que a doença renal crônica interfere de forma negativa na qualidade de vida. Conclusão: Os dados indicam que pacientes com IRC apresentam diminuição na qualidade de vida graças a repercussões musculoesqueléticas, tais como cãibras, fraqueza muscular e esforço físico.

Life quality has been a subject of growing research in studies of population health, in all times of ages. A chronic condition is a factor that interferes with the conduct of activities of daily living and the perception of individual well-being, as is the case of patients being treated by hemodialysis. Objective: To describe the characteristics and to analyze the possible associations between the CRF and life quality related to health in a representative sample of patients which was worsted in the city of Caruaru, PE. Method: The survey was conducted in dialysis treatment centers in Caruaru city, where all population with CRF is attended (n = 192), being 82 patients of the Regional Hemodialysis Center (Centro Regional de Hemodiálise do Agreste - CRHA) and 110 patients of the SOS Rim Clinic - Caruaru's Nephrological Clinical. For the composition of the sample was accomplished a census and all patients enrolled were initially preselected first for study. Results: It was verified that the majority of study participants reported some degree of discomfort: muscle pain (69.4 percent), cramps (89.8 percent), itching (67.3 percent), weakness (73.5 percent), reduced net (91.8 percent), decreased food (85.7 percent) and ability to work (75.5 percent). When asked if the physical effort interferes with their quality of life, this study revealed that 70.3 percent say so. In relation to health, 80.6 percent of people say that kidney disease interferes in a negative way on the quality of life. Conclusion: The data in this study indicate that patients with CRF have decreased in life quality due to musculoskeletal repercussions such as cramps, muscle weakness and physical effort.