Abstract
Number of patients treated with methods of renal replacement therapy (RRT) in Ukraine is growing faster than world population (growth rate – 7%), while the growth rate of the same indicator in Europe is 2%. Long-term RRT is accompanied by the progression of cardiovascular disease (CVD) in this population of patients. CVD significantly worsens the prognosis of survival and quality of life (QOL) of patients and increases the cost of treatment.
The objective of our research was to investigate the quality of life of patients with chronic kidney disease with concomitant chronic heart failure and without it who were under hemodialysis (HD) outpatient treatment.
Materials and methods. The study included 88 patients who were treated with outpatient HD in the department of extracorporeal detoxification methods in the Ivano-Frankivsk Regional Hospital. The average age of the patients was 50.8 ± 5.85, the median of HD treatment duration constituted 5.58±1.32 years. The examined patients included 47 (53.4%) men and 41 (46.65%) women. Patients were divided into two groups. The I group consisted of patients on dialysis with no signs of chronic heart failure (CHF). The II group included patients who needed RRT with defined FC III CHF IIA. A specific questionnaire Kidney Disease Quality of Life Short Form (KDQL - SFТМ) was used to assess QOL of patients with lost renal function.
Results of the research. Direct correlation between total QOL index and albumin levels (r=+0.32), total protein (r=+0.54) was observed. C-reactive protein negatively correlated with QOL (r=−0.51). The presence of CHF in patients on HD was found to limit the full life much stronger than in patients with isolated terminal CKD. Higher level of perception of QOL was marked in patients with HD compared with patients on HD with concomitant CHF.
Conclusions. The results make possible not only to ascertain differences in QOL, but also provide an opportunity to improve QOL adjusting CHF therapy and achieve control over the chronic inflammation syndrome.
References
Vasilieva IA. The Russian version of the questionnaire Kidny disease and quality of life short form (KDQOL-SF™) as a valuable diagnostic tool for assessing the quality of life of dialysis patients. Nefrologiya. 2007; 1: 64-70.
Shifris IM, Krot VF, Honchar YuI. The incidence of hospitalized patients with stage V D chronic kidney disease. Ukraiinskyi zhurnal nefrolohii ta dializu. 2014; 4: 31-40.
Krylova MI, Shutov EV, Ermolenko VM. Survival and quality of life of patients with renal replacement therapy. Vestnik YGU. 2010; 2: 63-70.
Kozliuk NI [et. al] National registry of patients with chronic kidney disease: 2013. Academy of Medical Sciences of Ukraine, Ministry of Health of Ukraine, Institute of Nephrology of AMS of Ukraine. Chief Editor MO Kolesnyk. Kyiv. 2014; 89.
Rivara MB, Robinson-Cohen C, Kestenbaum B. [et al.] Changes in symptom burden and physical performance with initiation of dialysis in patients with chronic kidney disease. Hemodialysis International. 2015; 19: 147-150.
Hays RD, Kallich JD, Mapes DL [et al.] Development of the kidney disease quality of life (KDQOL) instrument. Qual. Life Res. 1994; 3: 329-38.
O’Shaughnessy DV, Elder GJ, O’Shaughnessy DV. Patient-level outcomes: the missing link. Nephrology. 2009; 14: 443-451.
Lang RM, Badano LP, Mor-Avi V [et al.] Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging (2015). Journal of the American Society of Echocardiography. 2015; 28 (1): 1-39.
Amro A, Waldum B, Dammen T [et al.] Symptom clusters in patients on dialysis and their association with quality-of-life outcomes. Journal of Renal Care. 2014; 40(1): 23-33.
White C, McDonnell H. Psychosocial distress in patients with end-stage kidney disease. Journal of Renal Care. 2014; 40: 74-81.

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