Peripheral neuropathy: an important contributor to physical limitation and morbidity in stages 3 and 4 chronic kidney disease

2021 ◽  
Author(s):  
Ria Arnold ◽  
Timothy J Pianta ◽  
Tushar Issar ◽  
Adrienne Kirby ◽  
Caoimhe M K Scales ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Peripheral Neuropathy ◽  
Kidney Disease ◽  
Physical Function ◽  
Walking Speed ◽  
Short Form ◽  
Important Contributor ◽  
Diabetes Status ◽  
Sf 36 ◽  
Patient Reported

Abstract Background Impaired physical function drives adverse outcomes in chronic kidney disease (CKD). Peripheral neuropathy is highly prevalent in CKD, though its contribution to physical function in CKD patients is unknown. This study examined the relationships between peripheral neuropathy, walking speed and quality of life (QoL) in stages 3 and 4 CKD. Methods This was a prospective observational study investigating neuropathy in CKD patients with an estimated glomerular filtration rate (eGFR) 15–60 mL/min/1.73 m2. A total of 109 patients were consecutively recruited. The presence and severity of peripheral neuropathy was determined using the total neuropathy score. Walking speed was assessed at both usual and maximal speed, and QoL was assessed using the Short- Form 36 (SF-36) questionnaire. Results Peripheral neuropathy was highly prevalent: 40% demonstrated mild neuropathy and 37% had moderate–severe neuropathy. Increasing neuropathy severity was the primary predictor of reduced walking speed (R2 = −0.41, P < 0.001) and remained so after multivariable analysis adjustment for diabetes. This association was evident for both usual and maximal walking speeds. Neuropathy correlated significantly with low scores on multiple domains of SF-36 including physical function (r = −0.570, P < 0.001). Subanalysis according to diabetic status revealed a high prevalence of neuropathy both with and without diabetes; relationships to walking speed remained evident in subgroup analysis. However, those with diabetes demonstrated greater severity of neuropathy, slower walking speed and lower scores in QoL. Conclusions Moderate to severe peripheral neuropathy was common in stages 3 and 4 CKD, associated with reduced walking speed independent of diabetes status and was correlated with patient-reported QoL. This suggests that neuropathy is an important contributor to declining physical function in CKD irrespective of diabetes status. Targeted diagnosis and management of peripheral neuropathy during CKD progression may improve functional outcomes and QoL.

scholarly journals Validity and internal consistency of EQ-5D-3L quality of life tool among pre-dialysis patients with chronic kidney disease in Sri Lanka, a lower middle-income country

2019 ◽  
Author(s):  
Sameera Senanayake ◽  
PKB Mahesh ◽  
Nalika Gunawardena ◽  
Nicholas Graves ◽  
Sanjeewa Kularatna
Keyword(s):  
Chronic Kidney Disease ◽  
Psychological Distress ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Internal Consistency ◽  
Short Form ◽  
Economic Evaluations ◽  
Cronbach Alpha ◽  
Sf 36 ◽  
D 20

AbstractObjectiveEQ-5D-3L is a generic QOL tool used mainly in economic evaluations. Burden of Chronic Kidney Disease (CKD) is rising in Sri Lanka. Assessing the validity of generic QOL tools creates new opportunities of their utilization among patients with CKD.MethodsA cross-sectional study was conducted among 1036 CKD patients, selected using the simple random sampling technique. The validity was tested with six a-priori hypotheses. These included construct validity assessments, evaluating convergent validity and performing known group comparisons. EQ-5D-3L, Short Form-36 (SF-36), Center for Epidemiological Studies Depression Scale (CES-D-20) and General Health Questionnaire-12 (GHQ-12) were used to assess QOL, presence of depression and psychological distress respectively. Internal consistency of the whole tool and when each item is removed was assessed by Cronbach alpha.ResultsThe response rate was 99.2%. Majority of participants were males (n=646,62.4%) in the age category of 41-60 (n=530; 51.2%). Most were in either stage 4 or 5 of CKD (n=646,75.1%). The summary measures of SF-36, positively and significantly correlated with the EQ-5D-3L index and VAS scores (p<0.001). EQ-5D-3L QOL scores were significantly different between the group with depression and without as measured by CES-D-20 (p<0.001). Assessed using GHQ-12, similar significance was detected between the group with psychological distress and without (p<0.001). The Cronbach alpha was 0.834 and when each item was removed, ranged from 0.782 to 0.832.ConclusionEQ-5D-3L is a valid generic QOL tool with satisfactory internal consistency to be used among CKD patients in the pre-dialysis stage.

scholarly journals Cross-Cultural Adaptation, Translation, and Validation of the Toronto Extremity Salvage Score for Extremity Bone and Soft Tissue Tumor Patients in Netherlands

Sarcoma ◽  
2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Julie J. Willeumier ◽  
C. W. P. G. van der Wal ◽  
Robert J. P. van der Wal ◽  
P. D. S. Dijkstra ◽  
Thea P. M. Vliet Vlieland ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Physical Function ◽  
Short Form ◽  
Intraclass Correlation ◽  
Retest Reliability ◽  
Sf 36 ◽  
Toronto Extremity Salvage Score ◽  
Patient Reported ◽  
Test Retest Reliability ◽  
Extremity Salvage

Purpose. The aim of this study was to translate and culturally adapt the Toronto Extremity Salvage Score (TESS) to Dutch and to validate the translated version. Methods. The TESS lower and upper extremity versions (LE and UE) were translated to Dutch according to international guidelines. The translated version was validated in 98 patients with surgically treated bone or soft tissue tumors of the LE or UE. To assess test-retest reliability, participants were asked to fill in a second questionnaire after one week. Construct validity was determined by computing Spearman rank correlations with the Short Form- (SF-) 36. Results. The internal consistency (0.957 and 0.938 for LE and UE, resp.) and test-retest reliability (intraclass correlation coefficients 0.963 and 0.969 for LE and UE, resp.) were good for both questionnaires. The Dutch LE and UE TESS versions correlated most strongly with the SF-36 physical function dimension (r=0.737 for LE, 0.726 for UE) and the physical component summary score (r=0.811 and 0.797 for LE and UE). Interpretation. The Dutch TESS questionnaire for lower and upper extremities is a consistent, reliable, and valid instrument to measure patient-reported physical function in surgically treated patients with a soft tissue or bone tumor.

Effect of Golimumab on Patient-reported Outcomes in Rheumatoid Arthritis: Results from the GO-FORWARD Study

2012 ◽  
Vol 39 (6) ◽  
pp. 1185-1191 ◽  
Author(s):  
MARK C. GENOVESE ◽  
CHENGLONG HAN ◽  
EDWARD C. KEYSTONE ◽  
ELIZABETH C. HSIA ◽  
JACQUELINE BUCHANAN ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Function ◽  
General Health ◽  
Short Form ◽  
Health Assessment ◽  
Medical Outcomes ◽  
Chronic Illness Therapy ◽  
Sf 36 ◽  
Patient Reported ◽  
Questionnaire Disability

Objective.To evaluate the effect of golimumab on physical function, general health, and fatigue in patients with active rheumatoid arthritis (RA) despite methotrexate (MTX) therapy.Methods.In the multicenter, randomized, placebo-controlled GO-FORWARD study, 444 adults with active RA despite MTX received subcutaneous placebo + MTX (crossover to golimumab 50 mg at Week 24), golimumab 100 mg + placebo, golimumab 50 mg + MTX, or golimumab 100 mg + MTX every 4 weeks. Physical function and general health were assessed using the Health Assessment Questionnaire-Disability Index (HAQ-DI) and Physical and Mental Component Summary (PCS, MCS) scores of the Medical Outcomes Study Short Form-36 questionnaire (SF-36), respectively, through Week 52. Fatigue was measured through Week 24 using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) questionnaire.Results.Mean improvements from baseline in HAQ-DI, SF-36 PCS, and FACIT-Fatigue scores (Weeks 14 and 24) were significantly greater for golimumab 50 mg + MTX and 100 mg + MTX versus placebo + MTX. Significantly greater proportions of patients treated with golimumab + MTX achieved clinically meaningful improvements from baseline to Weeks 14 and 24 in HAQ-DI, PCS, and FACIT-Fatigue scores. Mean improvements in SF-36 PCS (Week 14), MCS (Week 24), and FACIT-Fatigue (Weeks 14 and 24) scores were significantly greater for golimumab 100 mg + placebo versus placebo + MTX. Mean improvements from baseline in HAQ-DI, SF-36 PCS, and MCS scores through Week 24 were sustained through Week 52.Conclusion.Patients with active RA despite MTX had significant improvement in physical function, general health, and fatigue following golimumab + MTX therapy; improvements in physical function and general health were maintained through Week 52. (Clinical Trials Registration NCT00264550)

scholarly journals Longitudinal Evaluation of PROMIS-29 and FACIT-Dyspnea Short Forms in Systemic Sclerosis

2014 ◽  
Vol 42 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Monique E. Hinchcliff ◽  
Jennifer L. Beaumont ◽  
Mary A. Carns ◽  
Sofia Podlusky ◽  
Krishna Thavarajah ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Health Status ◽  
Physical Function ◽  
Short Form ◽  
Functional Limitations ◽  
Measurement Information ◽  
Change Scores ◽  
Short Forms ◽  
Sf 36 ◽  
Patient Reported

Objective.To assess the sensitivity of the Patient-Reported Outcomes Measurement Information System 29-item Health Profile (PROMIS-29) and the Functional Assessment of Chronic Illness Therapy-Dyspnea 10-item short form (FACIT-Dyspnea) for measuring change in health status and dyspnea in systemic sclerosis (SSc).Methods.One hundred patients with SSc completed the PROMIS-29, FACIT-Dyspnea, and traditional instruments [Medical Research Council Dyspnea Score, St. George’s Respiratory Questionnaire (SGRQ), Health Assessment Questionnaire-Disability Index (HAQ-DI), and Medical Outcomes Study Short Form-36 (SF-36)] at baseline and 1-year visits. PROMIS-29, FACIT-Dyspnea, and traditional instrument change scores were compared across composite modified Medsger Disease Severity and modified Rodnan Skin score (mRSS) change groups.Results.Moderately high Spearman correlation coefficients were observed between FACIT-Dyspnea and SGRQ (r = 0.57), FACIT-Dyspnea functional limitations and SF-36 physical component summary (PCS; r = 0.51), PROMIS-29 physical functioning and HAQ-DI (r = 0.50), and SF-36 PCS (r = 0.52) change scores. In most validity comparisons, PROMIS-29, FACIT-Dyspnea, HAQ-DI, and SF-36 scores performed similarly. While PROMIS-29 covers more content areas than SF-36 (e.g., sleep), it may do so at the expense of responsiveness of its 4-item physical function scale as compared to the multiitem-derived SF-36 PCS. Statistically significant increases in SF-36 role physical (p = 0.01) and physical component scale (p = 0.016), but not PROMIS-29, were observed in patients with mRSS improvement.Conclusion.PROMIS-29 and FACIT-Dyspnea are valid instruments to measure health status and dyspnea in patients with SSc. In physical function assessment, longer PROMIS short forms or computer adaptive testing should be considered to improve responsiveness to the effect of skin disease changes on physical function in patients with SSc.

scholarly journals Comparison of the EQ-5D 3L and the SF-6D (SF-36) contemporaneous utility scores in patients with chronic kidney disease in Sri Lanka: a cross-sectional survey

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024854
Author(s):  
Sanjeewa Kularatna ◽  
Sameera Senanayake ◽  
Nalika Gunawardena ◽  
Nicholas Graves
Keyword(s):  
Chronic Kidney Disease ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Short Form ◽  
Classification Systems ◽  
Health State ◽  
Cross Sectional ◽  
Life Years ◽  
Sf 36 ◽  
Utility Scores

ObjectivesThe aim of this study was to compare utility weights of EuroQoL-five-dimension-3 levels (EQ-5D-3L) and Short-Form six-dimension (SF-6D) in a representative cohort of patients with chronic kidney disease (CKD). A cost–utility analysis (CUA) is designed to report the change to costs required to achieve an estimated change to quality-adjusted life years (QALYs). The quality component of a QALY is measured by utility. Utility represents the preference of general population for a given health state. Classification systems of the multi-attribute utility instruments (MAUIs) are used to define these health states. Utility weights developed from different classification systems can vary and may affect the conclusions from CUAs.DesignA community-based cross-sectional study.SettingAnuradhapura, a rural district in Sri Lanka.ParticipantsA representative sample of 1096 patients with CKD, selected using the population-based CKD register, completed the EQ-5D-3L and SF-36. SF-6D was constructed from the SF-36 according to the published algorithm. The study assessed discrimination, correlation and differences across the two instruments.ResultsStudy participants were predominantly male (62.6%). Mean EQ-5D-3L utility score was 0.540 (SD 0.35) compared with 0.534 (SD 0.09) for the SF-6D (p=0.588). The correlation (r) between the scores was 0.40 (p<0.001). Utility scores were significantly different in both males and females between the two tools, but there was no difference in age and educational categories. Both MAUI scores were significantly lower (p<0.001) among those who were in more advanced stages of the disease and the corresponding utility scores of the two instruments in different CKD stages were also significantly different (p<0.05). The largest effect size was seen among the patients on dialysis.ConclusionsThe correlation between the scores was moderate. SF-6D had the lowest floor and ceiling effect and was better at detecting different stages of the disease. Thus, based on the evidence presented in this study, SF-6D appears to be more appropriate to be used among patients with CKD.

Performance of PROMIS Instruments in Patients With Shoulder Instability

2016 ◽  
Vol 45 (2) ◽  
pp. 449-453 ◽  
Author(s):  
Chris A. Anthony ◽  
Natalie A. Glass ◽  
Kyle Hancock ◽  
Matt Bollier ◽  
Brian R. Wolf ◽  
...  
Keyword(s):  
Physical Function ◽  
Upper Extremity ◽  
Shoulder Instability ◽  
Short Form ◽  
Patient Reported Outcome ◽  
Excellent Correlation ◽  
Sf 36 ◽  
Patient Reported ◽  
Ceiling Effects ◽  
Pro Instruments

Background: Shoulder instability is a relatively common condition occurring in 2% of the population. PROMIS (Patient-Reported Outcome Measurement Information System) was developed by the National Institutes of Health in an effort to advance patient-reported outcome (PRO) instruments by developing question banks for major health domains. Purpose: To compare PROMIS instruments to current PRO instruments in patients who would be undergoing operative intervention for recurrent shoulder instability. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 74 patients with a primary diagnosis of shoulder instability who would be undergoing surgery were asked to fill out the American Shoulder and Elbow Surgeons shoulder assessment form (ASES), Marx shoulder activity scale (Marx), Short Form–36 Health Survey Physical Function subscale (SF-36 PF), Western Ontario Shoulder Instability Index (WOSI), PROMIS physical function computer adaptive test (PF CAT), and PROMIS upper extremity item bank (UE). Correlation between PRO instruments was defined as excellent (>0.7), excellent-good (0.61-0.7), good (0.4-0.6), and poor (0.2-0.3). Results: Utilization of the PROMIS UE demonstrated excellent correlation with the SF-36 PF ( r = 0.78, P < .01) and ASES ( r = 0.71, P < .01); there was excellent-good correlation with the EQ-5D ( r = 0.66, P < .01), WOSI ( r = 0.63, P < .01), and PROMIS PF CAT ( r = 0.63, P < .01). Utilization of the PROMIS PF CAT demonstrated excellent correlation with the SF-36 PF ( r = 0.72, P < .01); there was excellent-good correlation with the ASES ( r = 0.67, P < .01) and PROMIS UE ( r = 0.63, P < .01). When utilizing the PROMIS UE, ceiling effects were present in 28.6% of patients aged 18 to 21 years. Patients, on average, answered 4.6 ± 1.8 questions utilizing the PROMIS PF CAT. Conclusion: The PROMIS UE and PROMIS PF CAT demonstrated good to excellent correlation with common shoulder and upper extremity PRO instruments as well as the SF-36 PF in patients with shoulder instability. In patients aged ≤21 years, there were significant ceiling effects utilizing the PROMIS UE. While the PROMIS PF CAT appears appropriate for use in adults of any age, our findings demonstrate that the PROMIS UE has significant ceiling effects in patients with shoulder instability who are ≤21 years old, and we do not recommend use of the PROMIS UE in this population.

Muscle Strength and Muscle Endurance During the First Year of Treatment of Polymyositis and Dermatomyositis: A Prospective Study

2018 ◽  
Vol 45 (4) ◽  
pp. 538-546 ◽  
Author(s):  
Helene Alexanderson ◽  
Malin Regardt ◽  
Christina Ottosson ◽  
Li Alemo Munters ◽  
Maryam Dastmalchi ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Disease Activity ◽  
Physical Function ◽  
Muscle Function ◽  
Short Form ◽  
First Year ◽  
Sf 36 ◽  
Patient Reported ◽  
Reported Health ◽  
Muscle Impairment

Objective.To investigate muscle impairment (isometric and dynamic) and disease activity during the first year after diagnosis of polymyositis (PM) and dermatomyositis (DM), and to study the relationship between muscle impairment, patient-reported health, and disease activity.Methods.Seventy-two patients enrolled in the Swedish Myositis Register, 2003–2010, were followed prospectively. The Manual Muscle test (MMT-8; isometric muscle strength), the Functional Index of myositis test (FI-2; dynamic, repetitive muscle function), and disease activity (6-item core set) were retrieved at the time of diagnosis, and after 6 and 12 months. Self-reported health (Medical Outcomes Study Short Form-36; SF-36) was retrieved at 12 months.Results.At the time of diagnosis, median (Q1–Q3) for the FI-2 was 27.2% (7.9–60.5%) of maximal score compared to 93.8% (92.5–98.8%) of maximal MMT-8. At 12 months, the FI-2 and the MMT-8 improved to 29.4% (16.5–60.7%; p < 0.05) and 96.1% (88.1–99.4%), respectively (p < 0.01). At 12 months, 45% of patients improved ≥ 20%, and 27% worsened ≥ 20% in FI-2 score, while 10% improved ≥ 20% in MMT-8. Physician’s global visual analog scale (VAS), Health Assessment Questionnaire, and creatine phosphokinase levels improved significantly at 12 months (p < 0.05–0.001) while patient’s global and extramuscular VAS remained unchanged. The SF-36 physical function correlated strongly with the FI-2 (rs = 0.74; CI 0.55–0.85) and moderately with the MMT (rs = 0.54; CI 0.27–0.73), with lower correlations between muscle function and other SF-36 domains.Conclusion.Patients with PM/DM were characterized by impaired dynamic repetitive muscle function (DRMF) that correlated well with patient-reported physical function. Assessment of DRMF adds information regarding muscle impairment in these patients.

scholarly journals Hubungan anemia dengan kualitas hidup pasien penyakit ginjal kronik yang sedang menjalani hemodialisis reguler

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Cindy R. Senduk ◽  
Stella Palar ◽  
Linda W. A. Rotty
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Short Form ◽  
Life Quality ◽  
Average Score ◽  
Cross Sectional ◽  
Consecutive Sampling ◽  
Sf 36

Abstract: The objective of this study is to determine the correlation between anemia and quality of life in chronic kidney disease patients undergoing regular hemodialysis. This was an observational analytical study with a cross-sectional design. Samples were obtained by using consecutive sampling. Patients’ quality of life was assessed with short-form 36 questionnaires (SF-36) while their Hb levels data were taken from the medical records. There were 60 samples, with a majority age range of 50-59 years old (33.33%) adn the dominant gender was males (68,3%). There were 13 non-anemia patients (22%), 27 mild anemia patients (45.0%), 15 moderate anemia patients (25.0%) and 5 severe anemia patients (8%). The highest quality of life score obtained was 90.70 with an average score 61.99. The Spearman correlation test showed a correlation between anemia and life quality (p=0.000). Conclusion: There was a significant correlation between anemia and quality of life in chronic kidney disease patients undergoing regular hemodialysis.Keywords: chronic kidney disease, hemodialysis, anemia, quality of life Abstrak: Tujuan dari penelitian ini untuk mengetahui hubungan anemia dengan kualitas hidup pasien PGK yang sedang menjalani hemodialisis reguler. Desain penelitian yang digunakan adalah analitik observasional dengan rancangan studi potong silang (cross sectional study). Teknik pengambilan sampel yang digunakan yaitu consecutive sampling. Data kualitas hidup pasien diukur dengan pertanyaan dalam kuesioner Short Form (SF-36) sedangkan kadar Hb diambil dari rekam medik. Hasil dari penelitian ini didapatkan sampel 60 orang, usia terbanyak 50-59 tahun (33,3%), jenis kelamin terbanyak adalah laki-laki (68,3%), tidak anemia 13 orang (22%), anemia ringan 27 orang (45,0%), 15 orang (25,0%) anemia sedang dan sisanya 5 orang (8%) anemia berat. Skor kualitas hidup tertinggi 90,70 dengan rata-rata 61,99. Uji korelasi spearman didapatkan hubungan antara anemia dengan kualitas hidup (p=0,000). Simpulan: Terdapat hubungan yang signifikan antara anemia dengan kualitas hidup pasien PGK yang sedang menjalani hemodialisis reguler.Kata kunci: penyakit ginjal kronik, hemodialisis, anemia, kualitas hidup

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