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Association between quality of life and various aspects of intradialytic hypotension including patient-reported intradialytic symptom score.
BMC Nephrol. 2019 05 14; 20(1):164.BN

Abstract

BACKGROUND

There is increasing awareness that, besides patient survival, Quality of Life (QOL) is a relevant outcome factor for patients who have a chronic disease. In haemodialysis (HD) patients, intradialytic hypotension (IDH) is considered one of the most frequent complications, and this is often accompanied by symptoms. Several studies have investigated QOL in dialysis patients, however, research on the association between intradialytic symptoms and QOL is minimal. The goal of this study was to determine whether the occurrence of IDH has an influence on the perception of QOL.

METHODS

During 3 months, haemodynamic data, clinical events, and interventions of 2623 HD-sessions from 82 patients were prospectively collected. The patients filled out a patient-reported intradialytic symptom score (PRISS) after each HD session. IDH was defined according to the EBPG as a decrease in SBP ≥20 mmHg or in MAP ≥10 mmHg associated with a clinical event and need for nursing interventions. Patient's self-assessment of QOL was evaluated by the 36-Item Short-Form Health Survey.

RESULTS

There were no significant associations between the mental summary score or the physical summary score and the proportion of dialysis sessions that fulfilled the full EBPG definition. A lower PRISS was significantly associated with the proportion of dialysis sessions that fulfilled the full EBPG definition (R = - 0.35, P = 0.0011), the proportion of dialysis sessions with a clinical event (R = - 0.64, P = 0.001), and the proportion of dialysis sessions with nursing interventions (R = - 0.41, P = 0.0001). The physical component summary and mental component summary were significantly negatively associated with the variable diabetes and positively with PRISS (P = 0.003 and P = 0.005, respectively). UF volume was significantly negatively associated with mental health (P = 0.02) and general health (P = 0.01).

CONCLUSIONS

Our findings suggest that the EBPG definition of IDH does not capture aspects of intradialytic symptomatology that are relevant for the patient's QOL. In contrast, we found a significant association between QOL and a simple patient-reported intra-dialytic symptom score, implying that how patients experience HD treatment influences their QOL.

Authors+Show Affiliations

Dialysis Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands. h.kuipers@dcg.nl.Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.Hanze University Groningen, University of Applied Sciences, Groningen, The Netherlands.Hanze University Groningen, University of Applied Sciences, Groningen, The Netherlands.Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. University of Utrecht Medical Center, University of Utrecht, Utrecht, The Netherlands.Dialysis Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands.Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31088398

Citation

Kuipers, Johanna, et al. "Association Between Quality of Life and Various Aspects of Intradialytic Hypotension Including Patient-reported Intradialytic Symptom Score." BMC Nephrology, vol. 20, no. 1, 2019, p. 164.
Kuipers J, Oosterhuis JK, Paans W, et al. Association between quality of life and various aspects of intradialytic hypotension including patient-reported intradialytic symptom score. BMC Nephrol. 2019;20(1):164.
Kuipers, J., Oosterhuis, J. K., Paans, W., Krijnen, W. P., Gaillard, C. A. J. M., Westerhuis, R., & Franssen, C. F. M. (2019). Association between quality of life and various aspects of intradialytic hypotension including patient-reported intradialytic symptom score. BMC Nephrology, 20(1), 164. https://doi.org/10.1186/s12882-019-1366-2
Kuipers J, et al. Association Between Quality of Life and Various Aspects of Intradialytic Hypotension Including Patient-reported Intradialytic Symptom Score. BMC Nephrol. 2019 05 14;20(1):164. PubMed PMID: 31088398.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between quality of life and various aspects of intradialytic hypotension including patient-reported intradialytic symptom score. AU - Kuipers,Johanna, AU - Oosterhuis,Jurjen K, AU - Paans,Wolter, AU - Krijnen,Wim P, AU - Gaillard,Carlo A J M, AU - Westerhuis,Ralf, AU - Franssen,Casper F M, Y1 - 2019/05/14/ PY - 2018/09/26/received PY - 2019/04/30/accepted PY - 2019/5/16/entrez PY - 2019/5/16/pubmed PY - 2020/7/4/medline KW - Haemodialysis KW - Intradialytic hypotension KW - Patient reported outcome measures KW - Quality of life SP - 164 EP - 164 JF - BMC nephrology JO - BMC Nephrol VL - 20 IS - 1 N2 - BACKGROUND: There is increasing awareness that, besides patient survival, Quality of Life (QOL) is a relevant outcome factor for patients who have a chronic disease. In haemodialysis (HD) patients, intradialytic hypotension (IDH) is considered one of the most frequent complications, and this is often accompanied by symptoms. Several studies have investigated QOL in dialysis patients, however, research on the association between intradialytic symptoms and QOL is minimal. The goal of this study was to determine whether the occurrence of IDH has an influence on the perception of QOL. METHODS: During 3 months, haemodynamic data, clinical events, and interventions of 2623 HD-sessions from 82 patients were prospectively collected. The patients filled out a patient-reported intradialytic symptom score (PRISS) after each HD session. IDH was defined according to the EBPG as a decrease in SBP ≥20 mmHg or in MAP ≥10 mmHg associated with a clinical event and need for nursing interventions. Patient's self-assessment of QOL was evaluated by the 36-Item Short-Form Health Survey. RESULTS: There were no significant associations between the mental summary score or the physical summary score and the proportion of dialysis sessions that fulfilled the full EBPG definition. A lower PRISS was significantly associated with the proportion of dialysis sessions that fulfilled the full EBPG definition (R = - 0.35, P = 0.0011), the proportion of dialysis sessions with a clinical event (R = - 0.64, P = 0.001), and the proportion of dialysis sessions with nursing interventions (R = - 0.41, P = 0.0001). The physical component summary and mental component summary were significantly negatively associated with the variable diabetes and positively with PRISS (P = 0.003 and P = 0.005, respectively). UF volume was significantly negatively associated with mental health (P = 0.02) and general health (P = 0.01). CONCLUSIONS: Our findings suggest that the EBPG definition of IDH does not capture aspects of intradialytic symptomatology that are relevant for the patient's QOL. In contrast, we found a significant association between QOL and a simple patient-reported intra-dialytic symptom score, implying that how patients experience HD treatment influences their QOL. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/31088398/Association_between_quality_of_life_and_various_aspects_of_intradialytic_hypotension_including_patient_reported_intradialytic_symptom_score_ L2 - https://www.biomedcentral.com/1471-2369/20/164 DB - PRIME DP - Unbound Medicine ER -