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      Análisis de la calidad de vida del paciente en prediálisis y su relación con la dependencia para las actividades instrumentales de la vida diaria Translated title: Analysis of the quality of life of the predialysis patient and the relationship with the dependency for the instrumental activities of daily living

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          Abstract

          Resumen Objetivos: Analizar la calidad de vida relacionada con la salud de los pacientes con enfermedad renal crónica avanzada y determinar su relación con la dependencia para las actividades instrumentales de la vida diaria. Material y Método: Se realizó un estudio descriptivo transversal en el Servicio de Nefrología del Hospital Universitario Reina Sofía de Córdoba, en el que se incluyeron pacientes con enfermedad renal crónica avanzada en estadios 4-5. Se utilizaron los siguientes cuestionarios: KDQOL-SF, para analizar la calidad de vida relacionada con la salud; Lawton y Brody, para dependencia para las actividades instrumentales de la vida diaria. Resultados: Se estudiaron 105 pacientes con una edad de 67,8±15,7 años; 35 mujeres (33,3%). En el KDQOL-SF, las dimensiones más afectadas fueron los Cambios en el estado de salud, Situación laboral, Carga de la enfermedad renal, Salud general, Vitalidad y Rol físico. El 57,1% de la muestra tenían algún grado de dependencia para las actividades instrumentales de la vida diaria. Los pacientes con mayor grado de dependencia presentaron peores puntuaciones en las dimensiones Efectos de la enfermedad renal, Situación laboral, Función cognitiva, Sueño, Función física, Rol físico, Dolor, Función social y Vitalidad. Conclusiones: Los pacientes en prediálisis tienen disminuida la calidad de vida relacionada con la salud en las dimensiones Cambios en el estado de salud, Situación laboral, Carga de la enfermedad renal, Salud general, Vitalidad y Rol físico. Más de la mitad de la muestra presentan algún tipo grado de dependencia para la realización de las actividades instrumentales de la vida diaria.

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          Abstract Objectives: To analyze the health-related quality of life (HRQoL) in patients with advanced chronic kidney disease in pre-dialysis and the relationship with the dependency for the instrumental activities of daily living (IADL). Material and Method: A descriptive and cross-sectional study was carried out in the Nephrology Service of the Reina Sofía University Hospital in Córdoba. It was a non-probability accidental sampling. The following questionnaires were used: KDQOL-SF to analyze HRQoL and Lawton y Brody for IADL dependency. Results: 105 patients on pre-dialysis were studied with an age of 67,8±15,7 years and 35 women (33,3%). With regards to the KDQOL, the most affected dimensions were Changes in health status, Work situation, Burden of kidney disease, General health, Vitality and Physical role. 57.1% of the participants had some degree of dependence for the instrumental activities of daily life. Patients with a higher degree of dependency had worse scores in the dimensions Effects of kidney disease, Work situation, Cognitive function, Sleep, Physical function, Physical role, Pain, Social function and Vitality. Conclusions: Pre-dialysis patients have a decreased health-related quality of life in the dimensions Changes in health status, Work situation, Burden of kidney disease, General health, Vitality and Physical role. More than half of the participants show some type of dependency to carry out the instrumental activities of daily life.

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          Quality of life in chronic kidney disease (CKD): a cross-sectional analysis in the Renal Research Institute-CKD study.

          Sanjay Rajagopalan, Friedrich Port, Fredric Finkelstein … (2005)
          Health-related quality of life (QOL) is an important measure of how disease affects patients' lives. Dialysis patients have decreased QOL relative to healthy controls. Little is known about QOL in patients with chronic kidney disease (CKD) before renal replacement therapy. The Medical Outcomes Study Short Form-36 (SF-36), a standard QOL instrument, was used to evaluate 634 patients (mean glomerular filtration rate [GFR], 23.6 +/- 9.6 mL/min/1.73 m2 [0.39 +/- 0.16 mL/s/1.73 m2]) enrolled in a 4-center, prospective, observational study of CKD. SF-36 scores in these patients were compared with those in a prevalent cohort of hemodialysis (HD) patients and healthy controls (both from historical data). QOL data also were analyzed for correlations with GFR and albumin and hemoglobin levels in multivariable analyses. Patients with CKD had higher SF-36 scores than a large cohort of HD patients (P < 0.0001 for 8 scales and 2 summary scales), but lower scores than those reported for the US adult population (P < 0.0001 for 7 of 8 scales and 1 of 2 summary scales). Patients with CKD stage 4 had lower QOL scores than patients with CKD stage 5, although differences were not significant. Hemoglobin level was associated positively with higher mental and physical QOL scores (P < 0.05) in all individual and component scales except Pain. SF-36 scores were higher in this CKD cohort compared with HD patients, but lower than in healthy controls. GFR was not significantly associated with QOL. Hemoglobin level predicted both physical and mental domains of the SF-36. Longitudinal studies are needed to define at-risk periods for decreases in QOL during progression of CKD.
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            Prevalence of chronic renal disease in Spain: Results of the EPIRCE study

            Alfonso Otero González, A. de Francisco, P Gayoso … (2010)
            Introduction: Chronic kidney disease (CKD) is an independent cardiovascular risk factor. The knowledge of prevalence in general population may help to early detection of CKD and prevent or delay its progression. Methods: Sociodemographic, baseline characteristics, and CKD prevalence (measured by centralized serum creatinine and MDRD equation) were evaluated in a randomly selected sample of general population aged 20 years or older, collected in all Spanish regions and stratified by habitat, age and sex according to 2001 census (n = 2,746). Univariate and multivariate logistic regression analyses were used to evaluate associations with CKD risk factors. Results: Mean age was 49.5 years. The overall prevalence of Kidney Disease Outcomes Quality Initiative grades 3-5 CKD was 6.8%, with a 95% confidence interval (CI) of 5.4 to 8.2 (3.3% for age 40-64 years and 21.4% for age >64 years). The prevalence estimates of CKD stages were: 0.99% for stage 1 (glomerular filtration rate [GFR] >90 ml/min per 1.73 m² with proteinuria); 1.3% for stage 2 (GFR 60-89); 5.4% for stage 3a (GFR 45-59); 1.1% for stage 3b (GFR 30-44); 0.27% for stage 4 (GFR 15-29); and 0.03% for stage 5 (GFR <15). An important prevalence of classical cardiovascular risk factors was observed: dyslipemia (29.3%), obesity (26.1%), hypertension (24.1%), diabetes (9.2%) and current smoking (25.5%). The independent predictor factors for CKD were age, obesity and previously diagnosed hypertension. Conclusions: The prevalence of CKD at any stage in general population from Spain is relatively high, especially in the elderly, and similar to countries of the same geographical area. Independently of age, two modifiable risks factors, hypertension and obesity, are associated with an increased prevalence of CKD.
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              Health-related quality of life in different stages of chronic kidney disease and at initiation of dialysis treatment

              Agneta Pagels, Birgitta Söderkvist, Charlotte Medin … (2012)
              Objectives To evaluate health-related quality of life (HRQoL) in patients in different stages of chronic kidney disease (CKD) up to initiation of dialysis treatment and to explore possible correlating and influencing factors. Methods Cross-sectional design with 535 patients in CKD stages 2–5 and 55 controls assessed for HRQoL through SF-36 together with biomarkers. Results All HRQoL dimensions deteriorated significantly with CKD stages with the lowest scores in CKD 5. The largest differences between the patient groups were seen in ‘physical functioning’, ‘role physical’, ‘general health’ and in physical summary scores (PCS). The smallest disparities were seen in mental health and pain. Patients in CKD stages 2–3 showed significantly decreased HRQoL compared to matched controls, with differences of large magnitude - effect size (ES) ≥ .80 - in ‘general health’ and PCS. Patients in CDK 4 demonstrated deteriorated scores with a large magnitude in ‘physical function’, ‘general health’ and PCS compared to the patients in CKD 2–3. Patients in CKD 5 demonstrated deteriorated scores with a medium sized magnitude (ES 0.5 – 0.79) in ‘role emotional’ and mental summary scores compared to the patients in CKD 4. Glomerular filtration rate <45 ml/min/1.73 m², age ≥ 61 years, cardiovascular disease (CVD), diabetes, C-reactive protein (CRP) ≥5 mg/L, haemoglobin ≤110 g/L, p-albumin ≤ 35 g/L and overweight were associated with impaired HRQoL. CRP and CVD were the most important predictors of impaired HRQoL, followed by reduced GFR and diabetes. Conclusions Having CKD implies impaired HRQoL, also in earlier stages of the disease. At the time for dialysis initiation HRQoL is substantially deteriorated. Co-existing conditions, such as inflammation and cardiovascular disease seem to be powerful predictors of impaired HRQoL in patients with CKD. Within routine renal care, strategies to improve function and well-being considering the management of co-existing conditions like inflammation and CVD need to be developed.
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                Author and article information

                Journal
                Journal ID (publisher-id): enefro
                Title: Enfermería Nefrológica
                Abbreviated Title: Enferm Nefrol
                Publisher: Sociedad Española de Enfermería Nefrológica (Madrid, Madrid, Spain )
                ISSN (Print): 2254-2884
                ISSN (Electronic): 2255-3517
                Publication date (Print and electronic): December 2020
                Volume: 23
                Issue: 4
                Pages: 361-370
                Affiliations
                [1] Córdoba Andalucía orgnameUniversidad de Córdoba orgdiv1Departamento de Enfermería orgdiv2Facultad de Medicina y Enfermería Spain
                [2] Córdoba orgnameHospital Universitario Reina Sofía orgdiv1Servicio de Nefrología Spain
                [3] Córdoba orgnameInstituto Maimónides de Investigación Biomédica de Córdoba Spain
                Article
                Publisher ID: S2254-28842020000400005 Publisher ID: S2254-2884(20)02300400005
                DOI: 10.37551/s2254-28842020037
                SO-VID: 8633af0c-2844-4e98-865b-61cac90ba300
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                Date received : 05 October 2020
                Date accepted : 07 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 10
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                SciELO Spain

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                Subject: Originales

                Keywords: pre-dialysis,prediálisis,basic activities of daily living.,actividades instrumentales de la vida diaria,health-related quality of life,ACKD,actividades básicas de la vida diaria,calidad de vida relacionada con la salud,instrumental activities of daily living,ERCA
                Data availability:
                Keywords: pre-dialysis, prediálisis, basic activities of daily living., actividades instrumentales de la vida diaria, health-related quality of life, ACKD, actividades básicas de la vida diaria, calidad de vida relacionada con la salud, instrumental activities of daily living, ERCA

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