Background/Aims: It is relevant to investigate health-related quality of life (HRQOL) in dialysis and chronic kidney disease (CKD) patients in order to optimise treatment. The aim of this study was to investigate HRQOL in dialysis and CKD patients, to compare results from patients treated with hemodialysis (HD) and peritoneal dialysis (PD) and to investigate the prediction of dialysis quality control parameters (blood hemoglobin, plasma albumin, and Kt/V) and tobacco smoking in disease-specific HRQOL. Methods: Seventy-one HD, 59 PD, and 63 CKD patients participated in the study. Dialysis quality control parameters were measured and the patients completed the questionnaire Kidney Disease Quality Of Life. Results: PD patients rated Dialysis Staff Encouragement and Patient Satisfaction better than HD patients (p≤ 0.05). Dialysis patients scored significant lower than the general population in all generic HRQOL scales (p ≤ 0.01), whereas CKD patients scored lower than the general population in 5 of 8 scales (p ≤ 0.05). The dialysis quality parameters did not predict dialysis patients’ disease specific HRQOL, but tobacco consumption was independently associated with low scores on a number of HRQOL scales. Conclusion: Based on the results, it is suggested to include elements of HRQOL as a supplement to standard quality control parameters. It is also suggested routinely to include information of the beneficial effects of physical activity already in the predialysis program, and to focus on smoking as a very important risk factor.
With the exception of the scale "quality of social interaction" the Danish translation of the KDQOL-SF achieved values in the internal consistency reliability test of the same level as the original U.S. version. When data were stratified according to dialysis treatment, the reliability of PD patients scores was lower. Generic data from the questionnaire SF36 should be scored according to the Danish SF36 manual.
Sexual dysfunction was found to be more than two times as frequent in Danish female predialysis patients with CKD stage 4-5 compared to age- and gender-matched healthy controls, and this result emphasizes the need for attention towards sexual function in the treatment for CKD.
Background: Muscle function is impaired in uraemic patients and several causes have been proposed. Deficiency of 25-hydroxyvitamin D (25-OHD), which affects muscle function in non-uraemic patients, may very well also be associated with the myopathy found in these patients. The aim of this study was to investigate the association between 25-OHD and muscle function as well as physical function in chronic kidney disease (CKD) and peritoneal dialysis (PD) patients. Methods: In this cross-sectional study, 21 adult patients with CKD stage 3–5 and 21 patients treated with PD were included. Standard biochemistry parameters were measured including 25-OHD, 1,25-dihydroxycholecalciferol (1,25-OHD) and parathyroid hormone analysis. Muscle function was determined by 30-second surface electromyography (sEMG) recordings of a right thigh muscle (vastus lateralis) and a second left finger muscle (second dorsal interosseous) under voluntary contractions. Physical function was determined using a 30-second Chair Stand Test and the Short Form 36 quality of life questionnaire. Clinical characteristics were collected from the patient records. Results: Moderate vitamin 25-OHD deficiency (<40 nmol/l) was measured in 52% of patients with CKD and in 71% of the patients on PD. Severe deficiency (<15 nmol/l) was measured in 14% of patients on PD. There were no significant differences between the CKD and PD patients in terms of sEMG results. 25-OHD was not correlated to any results from the tests of sEMG or physical function. However, a higher sEMG frequency and signal root mean square (RMS) were positively associated with a higher Chair Stand Test score. Time to maximum sEMG frequency was negatively correlated to the Chair Stand Test score (p < 0.05), and positively correlated to the level of comorbidity (p < 0.05). sEMG signal peak-peak amplitude, frequency and RMS were positively correlated to the quality of life scales Physical Function, Role Physical, General Health, Vitality, Social Function, Mental Health, and Physical Component Scale (p < 0.001). Conclusions: 25-OHD deficiency was prevalent in uraemic patients in the present study. Muscle function as determined using sEMG and the Chair Stand Test was not associated with 25-OHD. The results may be biased by the limited variation in 25-OHD and masked by effects of several other variables in this very sick population.
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