The relationship between breakfast, lunch and dinner eating pattern and hemodialysis sessions, quality of life, depression and appetite in hemodialysis patients

Objective

To evaluate the relationship between eating pattern (regular breakfast, lunch and dinner) and dialysis sessions, laboratory and sociodemographic characteristics in hemodialysis (HD) patients.

Materials and Methods

In this cross-sectional study eating patterns, sociodemographic, laboratory and clinical parameters, depressive symptoms, quality of life, cognitive function and appetite status were assessed.

Results

Eighty-two HD patients on morning session and 60 patients on midday HD session schedules were included. Ten patients had only breakfast, 17 patients had only lunch, 26 patients had only dinner, 5 patients had breakfast and lunch but not dinner, 28 patients had breakfast and dinner but not lunch, 29 patients had lunch and dinner but not breakfast, and 19 patients had neither breakfast, nor lunch, nor dinner. In the whole group, only 8 patients reported that they had regularly eaten breakfast, lunch or dinner in all days of the week. Midday HD session, better appetite, and higher income were independently associated with having breakfast. Morning HD session, better appetite score, and higher income were independently associated with having lunch. Morning session versus midday session, nPNA, presence of hypertension, and the Mental Component Summary Score of SF-36 were independently associated with having dinner.

Conclusion

The majority of HD patients eat one or two meals per day. Having breakfast (or lunch) is associated with midday dialysis session (or morning dialysis session, respectively), better appetite, and satisfactory income. Eating dinner was associated with morning dialysis session, hypertension, higher protein intake and higher SF-36 mental component summary score.     

Nutritional status and depression, sleep disorder, and quality of life in hemodialysis patients.

OBJECTIVE: The malnutrition-inflammation score (MIS) is a scoring system that measures malnutrition and inflammation. We sought to explore its associations with depression, sleep disturbance, and quality of life. DESIGN: This was a cross-sectional study. SETTING: This study took place at the Baskent University Outpatient Hemodialysis Unit (Ankara, Turkey). PATIENTS: We enrolled 67 hemodialysis patients (male/female, 34/33; age, 47.7 +/- 11.4 years [mean +/- SD]; hemodialysis duration, 103.7 +/- 59.1 months [mean +/- SD]). INTERVENTION: We retrospectively recorded patients' monthly clinical and laboratory findings from the previous 6 months. The same physician calculated MIS scores. We interviewed all patients, and each completed a Beck Depression Inventory (BDI) assessment. We used the Pittsburgh Sleep Quality Index (PSQI) to assess quality of sleep, and the Medical Outcomes Study 36-item short form (SF-36) questionnaire to evaluate health-related quality of life. MAIN OUTCOME MEASURES: The main outcome measures involved the univariate and multivariate relationships of the MIS with BDI, PSQI, and SF-36. RESULTS: Patients with PSQI scores of < or = 5 ("good sleepers") had lower MIS scores than did poor sleepers (6.8 +/- 2.5 vs. 8.8 +/- 3.2, P < .05). Patients with moderate-to-severe depression (BDI score > or = 19) had higher MIS scores (9.0 +/- 3.2 vs. 6.5 +/- 2.5, P = .005) and higher PSQI scores (7.6 +/- 2.1 vs. 4.7 +/- 1.8, P = .001), compared with patients with BDI scores < 19. Increased MIS scores were correlated with increased comorbidity (P = .01) and poor SF-36 scores (P = .009). CONCLUSION: Increased MIS is significantly associated with the presence of depression, sleep disorders, and poor quality of life. This close relationship may help establish the MIS as an important determinant of the increased morbidity and mortality of hemodialysis patients.     

Effects of regular exercise on anxiety,depression, and quality of life in maintenance hemodialysis patients

BACKGROUND: Psychological problems such as depression and anxiety are common in hemodialysis patients. In several studies, exercise programs were effective in relieving depression or anxiety in these patients, although not all agree. PURPOSE: In this study, we evaluated the effects of an exercise program on exercise capacity, anxiety, depression and quality of life in maintenance hemodialysis patients. METHODS: Twenty hemodialysis patients were enrolled in the study. Six patients were later excluded; two due to anemia, one due to nausea with vomiting during exercise, one due to a neurologic problem, and the other two due to noncompliance. Thus, fourteen patients, 3 men and 11 women, aged 42 +/- 10 years, completed the study. The exercise program composed of bicycle ergometer, treadmill or upper limb ergometer, 60 min per session, 3 times per week, for 12 weeks. At the beginning and the end of the exercise program, the exercise capacity was determined by measuring the maximal oxygen consumption and exercise duration. In addition, psychological tests for the assessment of depression, anxiety and quality of life were performed. RESULTS: Maximal oxygen consumption was increased from 26.3 +/- 4.6 mL/kg/min to 29.8 +/- 4.9 mL/kg/min (p = 0.013). Exercise duration was 483 +/- 138 s at the start. At the end of the exercise program it was increased to 607 +/-119s (p = 0.002). The score of anxiety was significantly improved from 47.9 +/- 5.9 to 42.8 +/- 6.3 after exercise (p = 0.004). Though it did not reach statistical significance there was a trend of improvement in depression (from 44.8 +/- 8.4 to 39.7 +/- 6.4, p = 0.073). The score of quality of life also showed a significant improvement (from 124.5 +/- 16.5 to 133.6 +/- 19.3, p = 0.031). CONCLUSION: The results of this study indicate that an appropriate application of exercise program would improve the psychological status in long-term maintenance hemodialysis patients.     

Correlation between quality of life and mineral metabolism in maintenance hemodialysis patients

Objective With multi-center investigation, to assess the life quality of patients with maintained hemodialysis (MHD) in Liaoning Province and to explore the relationship among the mineral metabolism, the life quality of the patients with MHD, and the repeated hospitalization within the latest three years. Methods 1192 patients with hemodialysis (at least 3 months) from January to March in 2015 at ten blood purification centers in Liaoning Province were selected for the cross - sectional survey. The Kidney Health-related Quality of Life (HRQOL) version 1.3 was used to evaluate the MHD patients' life quality. The total length of hospitalization was divided into four groups: 0 days, 3 to 15 days, 16 to 30 days and above 30 days. Results When serum calcium value ranged from 2.1 to 2.5 mmol/L, kidney - disease component summary (KDCS), mental component summary (MCS), physical component summary (PCS) and SF-36+KDCS corresponded to a higher value (P＜0.05). When serum phosphorus value ranged from 1.13 to 1.78 mmol/L, KDCS and SF-36+KDCS corresponded to a higher value (P＜0.05). When the calcium phosphorus product value ranged from 40.68 to 49.94, MCS corresponded to a higher value (P＜0.05). KDCS showed a linear correlation with age (P＜0.001), dialysis age, serum calcium (less than or equal to 2.5 mmol/L) (P＜0.05); PCS showed a linear correlation with age (P＜0.001) and dialysis age (P＜0.05); SF-36+KDCS showed a linear correlation with age (P＜0.001), and serum calcium (less than or equal to 2.5 mmol/L) (P＜0.05), while age and dialysis age were negatively correlated. The hospitalization days showed a linear correlation with age, dialysis age (P＜0.001) and serum phosphorus, calcium phosphorus product value (P＜0.05), while dialysis age and calcium phosphorus product value were negatively correlated. Among different groups of total hospitalization days in three years, age, hemodialysis age, serum calcium, serum phosphorus, calcium-phosphorus product value and quality of life values were all statistically significant (P＜0.05). Conclusions The life quality of patients with MHD were correlated with serum calcium, phosphorus, calcium and phosphorus product value, iPTH, dialysis age and age, while age and dialysis age were of negative correlation. The total number of hospitalization days in 3 years was closely linearly correlated with age and dialysis age, significantly correlated with serum phosphorus, calcium and phosphorus product value, while dialysis age, calcium and phosphorus product value were in a negative correlation. The total number of hospitalization in 3 years was correlated with the patients' age, dialysis age, serum calcium, serum phosphorus, calcium and phosphorus product value and quality of life.     

Restless legs syndrome in hemodialysis patients: health-related quality of life and laboratory data analysis

AIMS: To compare clinical data, sleep quality and health-related quality of life (HRQOL) with and without RLS in HD patients. MATERIALS AND METHODS: The international RLS study group diagnosis questionnaire was completed by 228 HD patients. The Pittsburg Sleep Quality Index (PSQI) for the evaluation of sleep quality and the Kidney Disease Quality of Life (KDQOL-SF) for the analysis of HRQOL were also used. RESULTS: 53 (23%) patients were diagnosed as RLS. Age and age at the initiation of HD were significantly younger in the RLS group. Serum calcium concentration (Ca) was significantly higher in the RLS group. Sleep quality evaluated by PSQI was significantly lower in the RLS group. In SF-36 domains of KDQOL-SF, bodily pain, general health perceptions, vitality, role functioning emotional, mental health and mental component score were significantly lower in the RLS group. In kidney targeted scales of KDQOL-SF, symptoms/problems, burden of kidney disease, cognitive function, quality of social interaction, sleep and patient satisfaction were significantly lower in the RLS group. CONCLUSION: High Ca was possibly connected to the pathophysiology of RLS which impaired sleep quality as well as HRQOL including mental health and many kidney disease related scales.     

Association between serum bicarbonate and pH with depression,cognition and sleep quality in hemodialysis patients

Abstract

Metabolic acidosis is a common feature in chronic renal failure patients, worsening progressively as renal function declines. There are conflicting data in hemodialysis (HD) patients with regard to acidosis, alkalosis and mortality. In HD patients, cognitive impairment, depression, sleep disorders and impaired quality of life are very common. Besides, these conditions are related with increased morbidity and mortality. However, no previous study investigated the relationship between pH, venous bicarbonate and anion gap with depression, sleep problems and cognitive function in HD patients. In this study we investigated these relationships. In total, 65 HD patients were included. The demographic parameters and laboratory parameters including bicarbonate, pH and anion gap was measured for all patients. Depressive symptoms, sleep quality and cognitive function, were measured by Beck depression inventory, The Pittsburgh Sleep Quality Index and by Mini Mental State Examination, respectively. We found that, sleep quality but not cognitive function or depression was independently related with venous pH and bicarbonate. Anion gap has no independent relationship with sleep quality, cognitive function and depression. In conclusion, metabolic acidosis and bicarbonate levels were independently related with sleep quality in HD patients. However, there was no association between metabolic acidosis and bicarbonate levels with cognitive function and depression.     

Differences in health-related quality of life between elderly and younger patients on hemodialysis

BACKGROUND: It has been demonstrated that elderly patients have a great capacity of adaptation to renal replacement therapy (RRT). The aim of this study was to assess the health-related quality of life (HRQoL) of a cohort of patients at 3 and 12 months after the start of hemodialysis, searching for differences between elderly (aged>or=65 years) and younger (aged <65 years) patients. METHODS: This was a longitudinal prospective study of 93 patients starting RRT. HRQoL was assessed using the SF-36 health survey and the physical symptom dimension of the Kidney Disease Questionnaire (KDQ) at 3 and 12 months from the start of RRT. Physical component summary (PCS), mental component summary (MCS) and standardized scores, in which a lower score indicated lower HRQoL, by age and sex were obtained. RESULTS: Mean (SD) age was 66 years (12.26 years). At 3 months, differences between younger patients and elderly ones were statistically significant in the general health dimension, and at 12 months in physical functioning, role physical, general health dimensions and PCS, indicating less loss of HRQoL in elderly patients. At 3 months it was found that the functional state measured on the Karnofsky scale was independently associated with PCS (p=0.003), and hematocrit to MCS (p=0.036). At 1 year, PCS was independently associated with age (p=0.043) and Karnofsky score (p=0.039). CONCLUSIONS: Using scores standardized by age and sex, elderly patients had less loss of HRQoL in the physical aspects, than younger patients at 1 year from the start of hemodialysis.     

Correlation between laboratory parameters on admission and outcome of COVID-19 in maintenance hemodialysis patients

International Urology and Nephrology - This present study aims to investigate the relationship between laboratory parameters on admission and prognosis of coronavirus disease 2019 (COVID-19) in...     

Relationship between enthesitis,clinical parameters and quality of life in spondyloarthritis

ObjectiveTo investigate the involvement of enthesis and its correlation with clinical and quality of life parameters in patients with spondyloarthritis (SpA).MethodsOne hundred and eighteen patients who comply with the SpA classification criteria of the European Spondylarthropathy Study Group (ESSG) were included into the study. Clinical parameters such as morning stiffness, rest pain, activity pain, tender joints and swollen joints were evaluated. Enthesitis were assessed by Mander Enthesis Index (MEI). The quality of life was assessed by Short Form-36 (SF-36).ResultsThe incidence of enthesitis in patient with SpA was found at a rate of 84.9%. There was a significant correlation between MEI and morning stiffness, disease duration, tender joints and six subgroups of SF-36. The highest correlation was found between MEI and number of tender joint (p < 0.001).ConclusionEnthesitis is commonly seen among patients with SpA. Enthesitis also affects the life quality of patients negatively.     

宫颈癌患者焦虑抑郁状况与生活质量相关性的研究

目的:本研究旨在了解宫颈癌患者的心理状况及生活质量,探讨宫颈癌患者焦虑抑郁状况与生活质量关系。方法:本研究通过一般人口特征量表、Zung抑郁自评量表(SDS)、Zung焦虑自评量表(SAS)及宫颈癌患者生活质量测评量表FACT-C问卷调查以了解宫颈癌患者与正常健康人心理状况和生活质量及相关的影响因素。结果:观察组的SDS与SAS评分都高于对照组(P<0.05)。观察组生活质量各维度得分都明显高于对照组(P<0.05)。观察组的生活质量情况得分与焦虑抑郁评分呈负相关(P相似文献   

Relation between pulmonary function and inflammatory biomarkers in hemodialysis patients

The purpose of our study was to investigate the relationship between pulmonary function and serum levels of C-reactive protein (CRP), ferritin, albumin, and erythrocyte sedimentation rate, as inflammatory biomarkers, in hemodialysis patients. Ninety-eight patients, who were dialyzed at least for 3 months, were included in this study. Patients' blood samples were collected and pulmonary function tests, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow (PEF) were measured and expressed as the %predicted using appropriate normal values for the patients' sex, age, and height (%FVC, %FEV1, and %PEF), at the same time. The patients with CRP ≥ 10 μg/mL were significantly older and had lower values of %FEV1, %FVC and %PEF (p = 0.006, p = 0.001, and p = 0.016, respectively); whereas just %FEV1 (p = 0.025) and %FVC (p = 0.009) had significant differences between the patients with ferritin ≥ 100 μg/L and other patients. However, no other significant differences were found between inflammatory biomarkers and the pulmonary function tests. We concluded that inflammation has a close relation with pulmonary dysfunction in hemodialysis patients.     

Racial differences in health-related quality of life among hemodialysis patients

BACKGROUND; Despite technical progress in therapy, hemodialysis patients continue to report health-related quality of life (HRQOL) substantially lower than that of the general population. While African Americans with end-stage renal disease (ESRD) survive longer than members of other races, few studies have compared the HRQOL of African Americans with that of non-African Americans. METHODS: We examined differences in sociodemographic, clinical, and HRQOL variables by race. A multiple regression model assessed the extent to which race was associated with differences in HRQOL scores after adjustment for sociodemographic and clinical variables. Racial differences in the relationship between comorbid disease severity and HRQOL were explored. RESULTS; In adjusted models, African Americans had higher scores in the Index of Well-Being and burden of kidney disease, but lower scores in cognitive function (all P < 0.05). For scales reflecting symptoms and effects of kidney disease, sleep quality, and the Physical Component Summary, the fall in HRQOL with increasing comorbidity was significantly greater in non-African Americans (all P < 0.05). After adjustment, there were no racial differences in scores on the Mental Component Summary, social support, dialysis staff encouragement, or patient satisfaction. CONCLUSION: To our knowledge, ESRD is the only chronic illness for which African Americans report significantly better psychologic well being and a lower burden of disease than non-African Americans. Further research is needed to understand whether these experiences affect health care utilization, medical decision making, and patient survival. Clarification of the reasons for race differences may suggest measures to improve HRQOL for all patients with ESRD.     

Relation between interdialytic weight gain,body weight and nutrition in hemodialysis patients

BACKGROUND: Though interdialytic weight gain (IDWG) is used as an index of fluid and dietary compliance among hemodialysis patients, neither its clinical correlates nor an actual 'normal range' is established. Consequently, clinicians impose uniform dietary and fluid restrictions to limit IDWG, hoping to avoid symptomatic intravascular volume overload. METHODS: We studied 309 stable hemodialysis patients over a 3-month period to determine the spectrum of their IDWG and the relation between IDWG, dry weight, nutritional and demographic parameters. RESULTS: Mean IDWG was 2.8 +/- 1.2 kg (range -0.8 to 8.2 kg). Dry weight had a direct correlation with actual IDWG (r = 0.31; p = 0.001) but an inverse correlation with percent IDWG (r = -0.25; p = 0.001). IDWG was less in older patients (r = -0.34; p = 0.001) even after adjustment for dry weight. Actual IDWG was greater in men than women (3.1 +/- 1.2 vs. 2.5 +/- 1.2 kg, p = 0.001), but was equivalent after adjustment for dry weight (men 4.2 +/- 1.8%; women 3.9 +/- 1.9%, p = 0.1). Hematocrit (r = 0.14; p = 0.02) and serum creatinine concentration (r = 0.18; p = 0.02) had direct correlations with IDWG. CONCLUSIONS: We conclude that IDWG in hemodialysis patients is proportional to body weight. Differences in body weight explain excess IDWG in men but not in younger hemodialysis patients. Fluid and dietary restrictions in hemodialysis patients should be individually prescribed as opposed to a fixed amount irrespective of body weight.     

健康教育对长期血液透析患者生活质量的影响

目的:探讨长期血液透析患者生活质量的提高.方法:对2008年1月-2009年6月进行血液透析的65例患者进行健康教育.结果:本组65例患者均由住院转为门诊透析,回家后除生活自理外,还能做力所能及的工作.结论:健康教育使长期血液透析患者的生活质量提高,增强战胜疾病的信心,延长其生命,同时密切了护患关系.     

血友病患者焦虑抑郁状况与生活质量调查分析

目的 了解血友病患者焦虑、抑郁状况及影响因素,并探究其与生活质量的关系。方法 采用一般情况调查表、焦虑自评量表、抑郁自评量表和健康状况调查表对89例血友病患者进行调查。结果 血友病患者焦虑总分为51.25（44.37,59.95）分、抑郁总分53.75（42.50,61.87）分。焦虑、抑郁与生活质量呈负相关（均P＜0.05）。多元线性回归显示,家庭来源、是否独生子女、经济条件和出血频率是血友病患者焦虑、抑郁的影响因素（均P＜0.05）。结论 血友病患者容易出现焦虑、抑郁负面情绪,生活质量下降,医护人员应重点关注来自农村、独生子女、家庭经济条件差以及经常出血的患者,采取针对性的干预措施,降低其焦虑、抑郁水平,提高生活质量。     

长程血液透析对维持性血液透析患者生活质量的影响

目的 研究长程血液透析(LSHD)对维持性血液透析(MHD)患者生活质量的影响.方法 选取首都医科大学附属北京友谊医院血液净化中心40例MHD患者,通过问卷调查和收集临床资料相结合的方法,进行前瞻性配对临床研究.根据临床资料、检验指标、睡眠质量将患者配对分组为普通透析(HD)组和LSHD组,各20例,进行6个月的临床试验,观察两组患者临床表现、生化指标及生活质量的情况.结果 LSHD组的Kt/V(1.73±0.36比1.41±0.23,P＜0.05)、血红蛋白[(124.67±9.08)比(110.55±9.01) g/L,P＜0.01]、血清白蛋白[(45.01±2.66)比(39.28±2.63) g/L,P＜0.01]显著高于HD组 ;血压控制比例(14/20比5/20,P=0.010)和睡眠质量(16/20比5/20,P=0.001)显著优于HD组 ;生活质量SF-36评分显著高于HD组(P＜0.05),差异均有统计学意义.结论 长程透析可以改善MHD患者睡眠质量、营养状况,从而改善生活质量.     

维持性血液透析患者生活质量与蛋白质能量消耗和微炎症状态的相关性研究

目的 探讨维持性血液透析(MHD)患者生活质量(QOL)与蛋白质能量消耗(PEW)和微炎症状态(MIS)的关系.方法 采用病例对照研究,观察2016年5月至2018年6月在桂平市人民医院行血液透析治疗的慢性肾脏病5期患者,按照是否合并PEW分为PEW组和非PEW组,按照是否存在MIS分为MIS组与非MIS组;分析患者的...