Palabras clave
Chronic kidney disease
hemodialysis
quality of life.
hemodialysis
quality of life.
Cómo citar
1.
Varela DC, Gaurían Parra M, Hincapié NA, Hincapié SP, Rodriguez K. Factores no tradicionales influyentes en la calidad de vida de los pacientes de hemodiálisis. Rev. Colomb. Nefrol. [Internet]. 2 de enero de 2014 [citado 3 de julio de 2024];1(1):17-24. Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/169
Resumen
Introducción: La prevalencia de pacientes con enfermedad renal crónica (ERC) en fases avanzadas, con requerimiento de diálisis, continúa creciendo. Una meta para el equipo tratante, el paciente y sus cuidadores es lograr un tratamiento que brinde un impacto en el pronóstico y en la calidad de vida (CV).
Metodología: En 100 pacientes con ERC en hemodiálisis, asignados en forma aleatoria, se evaluó la calidad de vida por medio del SF-36, se evaluó: capacidad funcional por medio del Karnofsky, capacidad de realizar las labores ásicas de la vida diaria por medio del índice de Barthel, presencia de depresión por medio del test de Beck, funcionalidad familiar por medio del APGAR familiar, estado cognoscitivo por medio del Minimental y presencia de comorbilidades por medio del índice de Charlson correlacionado con la sumatoria de componentes físicos (PCS) y mentales (MCS) del SF-36, en pacientes pertenecientes a 2 unidades renales en Medellín y Bogotá, Colombia.
Resultados: Se encontró una disminución de la CV en los componentes físicos (PCS) y mental (MCS) respecto a la población general. Se encontró una correlación significativa entre PCS bajo y diabetes mellitus (p=0,008 IC95% 2,49- 6). MCS bajo presentó relación con PTH (p=0,046 IC95%: 0,000-0,014), el índice de Karnofsky (p=0,034 IC95% 0,244- ,984) y el test de depresión de Beck (p=0,000 IC95% -13,606- -6,253).
Conclusiones: La CV de los pacientes en hemodiálisis se encuentra afectada con mayor impacto en PCS, existe relación significativa entre el MCS con estado funcional y depresión. Para mejorar la CV del paciente en hemodiálisis, se debe medir y hacer el seguimiento a variables no tradicionalmente medidas y optimizar el enfoque terapéutico dirigido a rehabilitación física, estado nutricional, funcional y psicológico.
Citas
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2. Gómez RA. Renal disease in Colombia. Ren Fail. 2006;28(8):643-7.
3. Weiner DE, Tighiouart H, Amin MG et al. Chronic kidney disease as a risk factor for cardiovascular disease and all- ause mortality: a pooled analysis of community-based studies. J Am SocNephrol 2004;15:1307-1315.
4. Kalantar-Zadeh K, Kopple JD, Block G et al. Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. J Am SocNephrol 2001;12:2797-2806.
5. Lopes AA, Bragg-Gresham JL, Satayathum S et al. Health-related quality of life and associated outcomes among hemodialysis patients of different ethnicities in the United States: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 2003;41:605-615.
6. Lowrie EG, Curtin RB, LePain N et al. Medical outcomes study short form-36: a consistent and powerful predictor of morbidity and mortality in dialysis patients. Am J Kidney Dis 2003;41:1286-1292.
7. Unruh M, Benz R, Greene T et al. Effects of hemodialysis dose and membrane flux on health-related quality of life in the HEMO Study. Kidney Int 2004;66:355-366.
8. Kimmel PL, Emont SL, Newmann JM et al. ESRD patient quality of life: symptoms, spiritual beliefs, psychosocial factors, and ethnicity. Am J Kidney Dis 2003;42:713-721.
9. Kusek JW, Greene P, Wang SR et al. Cross-sectional study of healthrelated quality of life in African Americans with chronic renal insufficiency: the African American Study of Kidney Disease and Hypertension Trial. Am J Kidney Dis 2002;39:513-524.
10. Perlman RL, Finkelstein FO, Liu L et al. Quality of life in chronic kidney disease (CKD): a cross-sectional analysis in the Renal Research Institute-CKD study. Am J Kidney Dis 2005;45:658-666.
11. Tsai YC, Hung CC, Hwang SJ, et al. Quality of life predicts risks of end-stage renal disease and mortality in patients with chronic kidney disease. Nephrol Dial Transplant. 2010;25(5):1621-6.
12. Davison SN, Jhangri GS. The Relationship Between Spirituality, Psychosocial Adjustment to Illness, and Health- elated Quality of Life in Patients With Advanced Chronic idney Disease. J Pain Symptom Manage. 2012 Aug 20.
13. Davison SN, Jhangri GS. Existential and religious dimensions of spirituality and their relationship with health-related quality of life in chronic kidney disease. Clin JAm SocNephrol. 2010 Nov;5(11):1969-76.
14. Farag YM, Keithi-Reddy SR, Mittal BV, et al. Anemia, inflammation and health-related quality of life in chronic kidney disease patients. ClinNephrol. 2011 Jun;75(6):524-33.
15. Clement FM, Klarenbach S, Tonelli M, et al. The impact of selecting a high hemoglobin target level on health- elated quality of life for patients with chronic kidney disease: a systematic review and meta-analysis. Arch Intern Med. 2009 Jun 22;169(12):1104-12.
16. Finkelstein FO, Story K, Firanek C, et al. Health-related quality of life and hemoglobin levels in chronic kidney disease patients. Clin J Am SocNephrol. 2009 Jan;4(1):33-8.
17. Covic A, Seica A, Gusbeth-Tatomir P, et al. Hemoglobin normalization trials in chronic kidney disease: what should we learn about quality of life as an end point? J Nephrol. 2008 Jul-Aug;21(4):478-84.
18. Johansen KL, Chertow GM. Chronic kidney disease mineral bone disorder and health-related quality of life among incident end-stage renal-disease patients. J Ren Nutr. 2007 Sep;17(5):305-13.
19. Mucsi I, Kovacs AZ, Molnar MZ, et al. Co-morbidity and quality of life in chronic kidney disease patients. J Nephrol. 2008 Mar-Apr;21Suppl 13:S84-91.
20. Soni RK, Porter AC, Lash JP, et al. Health-related quality of life in hypertension, chronic kidney disease, and coexistent chronic health conditions. Adv Chronic Kidney Dis. 2010 Jul;17(4):17-26.
21. Porter A, Fischer MJ, Brooks D, et al. Quality of life and psychosocial factors in African Americans with hypertensive chronic kidney disease. Transl Res. 2012 Jan;159(1):4-11.
22. McHorney CA, Ware JE Jr, Raczek AE. The MOS 36- tem Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health construct. Med Care. 1993 Mar;31(3):247-63.
23. McHorney CA, Ware JE Jr, Lu JF, et al. The MOS 36- tem Short Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994 Jan;32(1):40-66.
24. Vilagut G, Valderas JM, Ferrer M, et al. [Interpretation of SF-36 and SF-12 questionnaires in Spain: physical and mental components]. Med Clin (Barc). 2008 May 4;130(19):726-35.
25. Alonso J, Prieto L, Anto JM. [The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): an instrument for measuring clinical results]. MedClin (Barc). 1995 May 27;104(20):771-6.
26. Alonso J, Regidor E, Barrio G, et al. [Population reference values of the Spanish version of the Health Questionnaire SF-36]. MedClin(Barc). 1998 Oct 10;111(11):410-6.
27. Ayuso-Mateos JL, Lasa L, Vázquez-Barquero JL. [Internal and external validity of the Spanish version of SF- 6]. Med Clin (Barc). 1999 Jun 12;113(1):37.
28. Karnorfsky DA, Abelman WH, Craver LF, Burchenal JH. The use of nitrogen mustards in the palliative treatment of cancer. Cancer 1948;1:634-6456.
29. Mahoney F. Barthel D. “Functional evaluation: the Barthel Index”. Md Med J 1965;14:61-65.
30. Craven, J.L., Rodin, G.M., Littlefield, C. “The Beck Depression Inventory as a screening device for major depression in renal dialysis patients”. Int J Psychiatry Med 1988;18(4):365-374.
31. Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis, 1987;40(5):373-383.
32. Folstein, M., Folstein, S.E., McHugh, P.R. “Mini-Mental State” a Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of PsychiatricResearch, 1975;12(3);189-198.
33. Smilkstein G. The family APGAR: a proposal for a family function test and its use by physicians. J FamPract 1978;6:1231-9.
34. Bellon JA, Delgado A, Luna del Castillo JD, Lardelli P. Validez y fiabilidad del cuestionario de función familiar Apgar- familiar. Aten Primaria 1996;18(6):289-96.
35. Mandoorah QM, Shaheen FA, Mandoorah SM, et al. Impact of demographic and comorbid conditions on quality of life of hemodialysis patients: a cross-sectional study. Saudi J Kidney Dis Transpl. 2014 Mar;25(2):432-7.
36. Van Diepen M, Schroijen MA, Dekkers OM, et al. Predicting mortality in patients with diabetes starting dialysis. PLoS One. 2014 Mar;4;9(3):e89744.
37. Arogundade FA1, Zayed B, Daba M, Barsoum RS. Correlation between Karnofsky Performance Status Scale and Short-Form Health Survey in patients on maintenance hemodialysis. J Natl Med Assoc. 2004 Dec;96(12):1661-7.
38. Grincenkov FR1, Fernandes N, Chaoubah A. Factors associated with the quality of life of incident patients on PD in Brazil (BRAZPD).J Bras Nefrol. 2011 Mar;33(1):38-44.
39. Andrade CP, Cruz MC, Urrutia M, et al. Evaluation of depressive symptoms in patients with chronic renal failure. J Nephrol. 2010 Mar-Apr; 23(2):168-74.
40. Tinetti ME, Fried T. The end of the disease era. Am J Med. 2004 Feb 1;116(3):179-85.
2. Gómez RA. Renal disease in Colombia. Ren Fail. 2006;28(8):643-7.
3. Weiner DE, Tighiouart H, Amin MG et al. Chronic kidney disease as a risk factor for cardiovascular disease and all- ause mortality: a pooled analysis of community-based studies. J Am SocNephrol 2004;15:1307-1315.
4. Kalantar-Zadeh K, Kopple JD, Block G et al. Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. J Am SocNephrol 2001;12:2797-2806.
5. Lopes AA, Bragg-Gresham JL, Satayathum S et al. Health-related quality of life and associated outcomes among hemodialysis patients of different ethnicities in the United States: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 2003;41:605-615.
6. Lowrie EG, Curtin RB, LePain N et al. Medical outcomes study short form-36: a consistent and powerful predictor of morbidity and mortality in dialysis patients. Am J Kidney Dis 2003;41:1286-1292.
7. Unruh M, Benz R, Greene T et al. Effects of hemodialysis dose and membrane flux on health-related quality of life in the HEMO Study. Kidney Int 2004;66:355-366.
8. Kimmel PL, Emont SL, Newmann JM et al. ESRD patient quality of life: symptoms, spiritual beliefs, psychosocial factors, and ethnicity. Am J Kidney Dis 2003;42:713-721.
9. Kusek JW, Greene P, Wang SR et al. Cross-sectional study of healthrelated quality of life in African Americans with chronic renal insufficiency: the African American Study of Kidney Disease and Hypertension Trial. Am J Kidney Dis 2002;39:513-524.
10. Perlman RL, Finkelstein FO, Liu L et al. Quality of life in chronic kidney disease (CKD): a cross-sectional analysis in the Renal Research Institute-CKD study. Am J Kidney Dis 2005;45:658-666.
11. Tsai YC, Hung CC, Hwang SJ, et al. Quality of life predicts risks of end-stage renal disease and mortality in patients with chronic kidney disease. Nephrol Dial Transplant. 2010;25(5):1621-6.
12. Davison SN, Jhangri GS. The Relationship Between Spirituality, Psychosocial Adjustment to Illness, and Health- elated Quality of Life in Patients With Advanced Chronic idney Disease. J Pain Symptom Manage. 2012 Aug 20.
13. Davison SN, Jhangri GS. Existential and religious dimensions of spirituality and their relationship with health-related quality of life in chronic kidney disease. Clin JAm SocNephrol. 2010 Nov;5(11):1969-76.
14. Farag YM, Keithi-Reddy SR, Mittal BV, et al. Anemia, inflammation and health-related quality of life in chronic kidney disease patients. ClinNephrol. 2011 Jun;75(6):524-33.
15. Clement FM, Klarenbach S, Tonelli M, et al. The impact of selecting a high hemoglobin target level on health- elated quality of life for patients with chronic kidney disease: a systematic review and meta-analysis. Arch Intern Med. 2009 Jun 22;169(12):1104-12.
16. Finkelstein FO, Story K, Firanek C, et al. Health-related quality of life and hemoglobin levels in chronic kidney disease patients. Clin J Am SocNephrol. 2009 Jan;4(1):33-8.
17. Covic A, Seica A, Gusbeth-Tatomir P, et al. Hemoglobin normalization trials in chronic kidney disease: what should we learn about quality of life as an end point? J Nephrol. 2008 Jul-Aug;21(4):478-84.
18. Johansen KL, Chertow GM. Chronic kidney disease mineral bone disorder and health-related quality of life among incident end-stage renal-disease patients. J Ren Nutr. 2007 Sep;17(5):305-13.
19. Mucsi I, Kovacs AZ, Molnar MZ, et al. Co-morbidity and quality of life in chronic kidney disease patients. J Nephrol. 2008 Mar-Apr;21Suppl 13:S84-91.
20. Soni RK, Porter AC, Lash JP, et al. Health-related quality of life in hypertension, chronic kidney disease, and coexistent chronic health conditions. Adv Chronic Kidney Dis. 2010 Jul;17(4):17-26.
21. Porter A, Fischer MJ, Brooks D, et al. Quality of life and psychosocial factors in African Americans with hypertensive chronic kidney disease. Transl Res. 2012 Jan;159(1):4-11.
22. McHorney CA, Ware JE Jr, Raczek AE. The MOS 36- tem Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health construct. Med Care. 1993 Mar;31(3):247-63.
23. McHorney CA, Ware JE Jr, Lu JF, et al. The MOS 36- tem Short Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994 Jan;32(1):40-66.
24. Vilagut G, Valderas JM, Ferrer M, et al. [Interpretation of SF-36 and SF-12 questionnaires in Spain: physical and mental components]. Med Clin (Barc). 2008 May 4;130(19):726-35.
25. Alonso J, Prieto L, Anto JM. [The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): an instrument for measuring clinical results]. MedClin (Barc). 1995 May 27;104(20):771-6.
26. Alonso J, Regidor E, Barrio G, et al. [Population reference values of the Spanish version of the Health Questionnaire SF-36]. MedClin(Barc). 1998 Oct 10;111(11):410-6.
27. Ayuso-Mateos JL, Lasa L, Vázquez-Barquero JL. [Internal and external validity of the Spanish version of SF- 6]. Med Clin (Barc). 1999 Jun 12;113(1):37.
28. Karnorfsky DA, Abelman WH, Craver LF, Burchenal JH. The use of nitrogen mustards in the palliative treatment of cancer. Cancer 1948;1:634-6456.
29. Mahoney F. Barthel D. “Functional evaluation: the Barthel Index”. Md Med J 1965;14:61-65.
30. Craven, J.L., Rodin, G.M., Littlefield, C. “The Beck Depression Inventory as a screening device for major depression in renal dialysis patients”. Int J Psychiatry Med 1988;18(4):365-374.
31. Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis, 1987;40(5):373-383.
32. Folstein, M., Folstein, S.E., McHugh, P.R. “Mini-Mental State” a Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of PsychiatricResearch, 1975;12(3);189-198.
33. Smilkstein G. The family APGAR: a proposal for a family function test and its use by physicians. J FamPract 1978;6:1231-9.
34. Bellon JA, Delgado A, Luna del Castillo JD, Lardelli P. Validez y fiabilidad del cuestionario de función familiar Apgar- familiar. Aten Primaria 1996;18(6):289-96.
35. Mandoorah QM, Shaheen FA, Mandoorah SM, et al. Impact of demographic and comorbid conditions on quality of life of hemodialysis patients: a cross-sectional study. Saudi J Kidney Dis Transpl. 2014 Mar;25(2):432-7.
36. Van Diepen M, Schroijen MA, Dekkers OM, et al. Predicting mortality in patients with diabetes starting dialysis. PLoS One. 2014 Mar;4;9(3):e89744.
37. Arogundade FA1, Zayed B, Daba M, Barsoum RS. Correlation between Karnofsky Performance Status Scale and Short-Form Health Survey in patients on maintenance hemodialysis. J Natl Med Assoc. 2004 Dec;96(12):1661-7.
38. Grincenkov FR1, Fernandes N, Chaoubah A. Factors associated with the quality of life of incident patients on PD in Brazil (BRAZPD).J Bras Nefrol. 2011 Mar;33(1):38-44.
39. Andrade CP, Cruz MC, Urrutia M, et al. Evaluation of depressive symptoms in patients with chronic renal failure. J Nephrol. 2010 Mar-Apr; 23(2):168-74.
40. Tinetti ME, Fried T. The end of the disease era. Am J Med. 2004 Feb 1;116(3):179-85.
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