Measuring disease severity in patients with end-stage renal disease: validity of the Craven et al. ESRD Severity Index

1995 ◽  
Vol 25 (1) ◽  
pp. 189-193 ◽  
Author(s):  
K. W. Griffin ◽  
R. Friend ◽  
N. K. Wadhwa
Keyword(s):  
Renal Disease ◽  
Disease Severity ◽  
End Stage Renal Disease ◽  
Burden Of Illness ◽  
Severity Index ◽  
Entire Group ◽  
Psychological Burden ◽  
Severity Scores ◽  
Stage Renal Disease ◽  
End Stage

SynopsisThe validity of a recently developed measure of disease severity, the End-stage Renal Disease Severity Index (Craven et al. 1991) was examined in haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients (total N = 82). Scores on the ESRD Severity Index were compared with three commonly identified components of disease severity: physiological indices of severity, functional status, and psychological burden of illness. For the entire group of subjects, scores on the ESRD Severity Index were negatively associated with functional ability and positively related to physiological severity. ESRD Severity Index scores showed a weaker relationship with psychological burden of illness which depended in part on treatment mode. Disease severity scores were positively related to depression in CAPD patients but not in HD patients. These findings suggest that the ESRD Severity Index is a valuable research tool with construct validity.

Depression, Perception of Illness and Mortality in Patients with End-Stage Renal Disease

1991 ◽  
Vol 21 (4) ◽  
pp. 343-354 ◽  
Author(s):  
Rolf A. Peterson ◽  
Paul L. Kimmel ◽  
Carol R. Sacks ◽  
Mary Louise Mesquita ◽  
Samuel J. Simmens ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Early Recognition ◽  
Additional Measure ◽  
Treatment Of Depression ◽  
Severity Scores ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

A role of depression in affecting outcome in patients with end stage renal disease (ESRD) has been suggested but few have assessed psychological parameters and medical factors thought to influence survival simultaneously and prospectively. To assess whether depression or perception of illness influences survival in patients treated for ESRD, we prospectively evaluated fifty-seven patients with ESRD treated with hemodialysis (HD, n = 43) or continuous ambulatory peritoneal dialysis (CAPD, n = 14). Patients were interviewed and completed the Beck Depression Inventory (BDI) and the Illness Effects Questionnaire (IEQ). An ESRD severity coefficient was used to measure chronic illness severity. A cognitive item subset of the BDI (CDI) was used as an additional measure of depression. One and two years later, records were examined to determine survival. When initial results of the assessment of survivors and non-survivors were compared, at one year follow-up, there were no differences in mean age, duration of dialysis, severity scores, BDI or IEQ scores. The initial mean CDI scores in the group of non-survivors, however, were significantly greater than the scores in the survivor group. At two year follow-up, CDI scores were significantly different between groups, and were significant in a hazards regression. Disease severity, age and duration of dialysis were also significantly related to mortality at two year follow-up. We conclude cognitive depression is an important, early, indicator of grave prognosis in patients treated for ESRD. Early recognition of and therapeutic efforts directed toward the treatment of depression might modify outcome in ESRD patients.

scholarly journals Non-adherence to hemodialysis, perception of the illness, and severity of advanced nephropathy

2020 ◽  
Author(s):  
Lianna Gonçalves Dantas ◽  
Mario Seixas Rocha ◽  
Constança Margarida Sampaio Cruz
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Illness Perception ◽  
Severity Index ◽  
Clinical Aspects ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Interdialytic Weight Gain ◽  
Stage Renal Disease ◽  
End Stage

Abstract Introduction: Hemodialysis (HD) is a complex therapy that imposes several changes in the patient's life. Failure to follow therapy recommendations is called non-adherence (NA). The patient's illness perception, severity of chronic kidney disease, and individual strategies for coping with HD can have an impact on NA to the demands of therapy. Methods: This was a cross-sectional study with end-stage renal disease patients on conventional HD in Salvador, Bahia. We evaluated attendance to treatment and interdialytic weight gain (IDWG) as parameters of NA to HD, and investigated its association with clinical aspects and measures of disease perception (illness effects questionnaire - IEQ) and severity of nephropathy (end stage renal disease severity index - ESRD-SI), by analyzing Pearson or Spearman correlation. Results: 79 patients were evaluated, 57% male, aged 53.1 ± 12.3 years, with length of HD of 108 (89 - 131.5) months. Age correlated with ESRD-SI (r = 0.43) and NA parameters: negative correlation with relative IDWG (r = -0.41) and reduction in sessions (r = -0.31) and positive correlation with %HD performed (r = 0.25). The scores on the IEQ and ESRD-SI showed a positive correlation (r = 0.44; p <0.001), but did not show any correlation with the analyzed NA parameters. Conclusions: We did not find a correlation between illness perception and severity index of advanced nephropathy with the behaviors of NA to chronic HD. In this study, age correlated both with the perception of severity of advanced nephropathy and the parameters of NA to chronic HD.

scholarly journals Comparison of alpha5(IV) collagen chain expression in skin with disease severity in women with X-linked Alport syndrome.

1998 ◽  
Vol 9 (8) ◽  
pp. 1433-1440
Author(s):  
K Nakanishi ◽  
K Iijima ◽  
N Kuroda ◽  
Y Inoue ◽  
Y Sado ◽  
...  
Keyword(s):  
Basement Membrane ◽  
Renal Disease ◽  
Disease Severity ◽  
End Stage Renal Disease ◽  
Alport Syndrome ◽  
Expression Ratio ◽  
Female Patients ◽  
Stage Renal Disease ◽  
End Stage ◽  
Epidermal Basement Membrane

X-Linked Alport syndrome is caused by mutations in the type IV collagen alpha5 chain gene. Male patients usually develop end-stage renal disease, whereas female patients have more variable phenotypes from asymptomatic hematuria to end-stage renal disease. The variable phenotypes in female patients may be attributable to different X-chromosome inactivation patterns. Therefore, the correlation between disease severity and the degree of alpha5 chain expression in the epidermal basement membrane of female patients with X-linked Alport syndrome was examined. To estimate the disease severity in X-linked Alport syndrome, the ratios of protein to creatinine in single voided urine samples were used. Expression of the alpha5 chain in the epidermal basement membrane was examined by an indirect immunofluorescence method using an anti-alpha5 chain monoclonal antibody. A total of 25 female patients with X-linked Alport syndrome from 17 families was examined. Multiple regression analysis using disease severity as the response variable, and age, family history of nephritis, female and male family history of end-stage renal disease, serum creatinine concentration, and alpha5(IV) expression ratio in the epidermal basement membrane as explanatory variables showed that only alpha5(IV) expression ratio was a significant factor, and that it showed a highly significant negative association with disease severity (adjusted r2=0.71, P=0.0001). These findings suggest that variable alpha5 chain expression, possibly caused by different X-inactivation patterns, is responsible for the variable disease severity in female patients with X-linked Alport syndrome, and that immunohistochemical examination of alpha5 chain expression in the epidermal basement membrane may be a simple and useful method for predicting patient outcome.

Insomnia severity in chronic kidney disease patients with various therapies

Open Medicine ◽  
2012 ◽  
Vol 7 (1) ◽  
pp. 112-117 ◽  
Author(s):  
Marinela Knezevic ◽  
Vladimir Djordjevic ◽  
Ivana Bivolarevic ◽  
Jelena Jovic ◽  
Vidojko Djordjević
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Severity Index ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Insomnia Severity Index ◽  
Stage Renal Disease ◽  
End Stage ◽  
Insomnia Severity

AbstractThe prevalence of insomnia is greater in end-stage renal disease. The aim of our study was to determine the frequency of insomnia and subclinical insomnia in patients with various dialysis therapy and kidney transplant recipients, in order to assess the severity of insomnia and examine whether there is a difference in severity among groups. In cross-sectional study, we evaluated 120 patients with terminal renal failure. Based on therapy, patients were divided into four groups: hemodiafiltration, standard bicarbonate dialysis, peritoneal dialysis and kidney transplant recipients. The severity of insomnia was evaluated through the use of the Insomnia Severity Index (ISI). Most patients who reported any kind of insomnia problems with ISI were on conventional dialysis (80%), followed by hemodiafiltration (76.7%) and peritoneal dialysis (63.3%). Transplant recipients had least difficulties with insomnia (46.7%). Insomnia Severity Index showed that insomnia in end-stage renal patients is not very severe. Most of the patients had “no clinically significant insomnia”. Our findings indicate that patients on hemodiafiltration and transplant recipients have a significantly lower score on Insomnia Severity Index. Patients with end-stage renal disease have high frequency insomnia problems. However, our study shows that insomnia in these patients is not severe. Insomnia is the most frequent and severest in patients on standard bicarbonate dialysis.

scholarly journals Potential Hepatoprotective Role of Galectin-3 during HCV Infection in End-Stage Renal Disease Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ruzica Lukic ◽  
Nevena Gajovic ◽  
Ivan Jovanovic ◽  
Milena Jurisevic ◽  
Zeljko Mijailovic ◽  
...  
Keyword(s):  
Renal Disease ◽  
Disease Severity ◽  
End Stage Renal Disease ◽  
Chronic Renal Disease ◽  
Hcv Infection ◽  
Galectin 3 ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Hepatitis C virus infection (HCV), one of the greatest causes of liver disease, is a frequent complication in patients with end-stage renal disease (ESRD) on dialysis. ESRD is defined as decreased glomerular filtration and also accompanied by impaired function of the immune system. Galectin-3 is aβ-galactoside-binding lectin, involved in various biological processes including pathogenesis of chronic renal disease. The aim of our study was to estimate disease severity in ESRD HCV+patients and analyze the serum concentrations of IL-1β, IL-4, IL-23, and IL-6; anti-HCV antibodies; and galectin-3. Also, we attempted to determine potential correlation between galectin-3 level and parameters of disease severity ALT and AST. Our results showed decreased levels of ALT and AST (p=0.00), demonstrating less liver destruction in ESRD HCV+patients in comparison to HCV+patients. Increased levels of IL-6 (p=0.03) implicate a hepatoprotective role of IL-6 in these patients. Also, level of galectin-3 (p=0.00) in the serum of ESRD HCV+patients was higher than that of HCV+patients. This alteration was accompanied with negative correlation between galectin-3 and AST and ALT, respectively (p=0.029;p=0.033). The presence of increased systemic levels of IL-6 and Gal-3 in ESRD HCV+patients may be an attempt to counteract or limit ongoing proinflammatory processes and to downregulate chronic inflammation, suggesting the new aspects of HCV infection in ESRD patients.

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