scholarly journals Exercise Intolerance in Kidney Diseases: Physiological Contributors and Therapeutic Strategies

2020 ◽  
Author(s):  
Danielle L Kirkman ◽  
Natalie Bohmke ◽  
Salvatore Carbone ◽  
Ryan S. Garten ◽  
Paula Rodriguez-Miguelez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Kidney Diseases ◽  
Exercise Intolerance ◽  
Dietary Interventions ◽  
Increased Risk ◽  
Related Quality ◽  
Stage Renal Disease ◽  
End Stage

Exertional fatigue, defined as the overwhelming and debilitating sense of sustained exhaustion that impacts the ability to perform activities of daily living, is highly prevalent in chronic kidney disease (CKD) and end stage renal disease (ESRD). Subjective reports of exertional fatigue are paralleled by objective measurements of exercise intolerance throughout the spectrum of the disease. The prevalence of exercise intolerance is clinically noteworthy as it leads to increased frailty, worsened quality of life and an increased risk of mortality. The physiological underpinnings of exercise intolerance are multifaceted and still not fully understood. This review aims to provide a comprehensive outline of the potential physiological contributors, both central and peripheral, to kidney disease related exercise intolerance and highlight current and prospective interventions to target this symptom. In this review the kidney disease-related metabolic derangements, cardiac and pulmonary dysfunction, altered physiologic responses to oxygen consumption, vascular derangements and sarcopenia are discussed in the context of exercise intolerance. Lifestyle interventions to improve exertional fatigue, such as aerobic and resistance exercise training, are discussed and the lack of dietary interventions to improve exercise tolerance is highlighted. Current and prospective pharmaceutical and nutraceutical strategies to improve exertional fatigue are also broached. An extensive understanding of the pathophysiological mechanisms of exercise intolerance will allow for the development of more targeted therapeutic approached to improve exertional fatigue and health related quality of life in CKD and ESRD.

scholarly journals Effect of Exercise on Health-Related Quality of Life in Patients with End-Stage Renal Disease

2021 ◽  
Author(s):  
Dhanya Michael ◽  
Joseph S. Fidelis ◽  
Sijo Joseph Pakalomattom
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Fitness Function ◽  
Well Being ◽  
Related Quality ◽  
Health Related ◽  
Stage Renal Disease ◽  
End Stage

Chronic kidney disease (CKD) is becoming more common around the world. Chronic kidney disease (CKD) is linked to a wide range of other health problems, such as diabetes, hypertension, stroke, and pulmonary illness. Patients with CKD tend to lead sedentary lives for a variety of reasons. Dialysis patients, on the other hand, are much less active than the general population. All of these factors raise the likelihood of future morbidity and mortality, while also lowering the overall quality of life for people who are ill (HRQoL). Regular physical activity (PE) has been shown to increase overall well-being and HRQoL. Here, we discuss several PEs and their effects on CKD patients\' physical fitness, function, and HRQoL, as well as the significance of haematocrit normalisation and the influence on their serum phosphorus levels. We have discussed the advantages of PE for this particular population of individuals as well as the side effects of intradialytic PE. There have also been discussions on factors that contribute to impaired physical function in CKD patients and the impact of PEs on different bodily systems.

Periodontitis is associated with oral health‐related quality of life in individuals with end‐stage renal disease

2020 ◽  
Vol 47 (3) ◽  
pp. 319-329 ◽  
Author(s):  
Leandro M. Oliveira ◽  
Daniélli Sari ◽  
Caroline Schöffer ◽  
Samantha S. Santi ◽  
Raquel P. Antoniazzi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Stage Renal Disease ◽  
End Stage

Impact of First Dialysis Modality on Outcome of Patients Contraindicated for Kidney Transplant

2006 ◽  
Vol 26 (2) ◽  
pp. 231-239 ◽  
Author(s):  
Luc Frimat ◽  
Pierre-Yves Durand ◽  
Carole Loos–Ayav ◽  
Emmanuel Villar ◽  
Victor Panescu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Role Limitation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Incident Cases

Background We compared, in patients contraindicated for kidney transplant, outcomes between those patients who were only on hemodialysis (HD) and those who were given peritoneal dialysis (PD) as first renal replacement therapy (RRT). Design Prospective, population-based cohort study of incident cases of end-stage renal disease between June 1997 and June 1999. Setting A network of dialysis care: NEPHROLOR, that is, all the renal units in Lorraine, one of the 22 French administrative regions (population over 2.3 million people). Participants 387 patients were contraindicated for kidney transplant during the first 2 years of RRT: 284 were on HD, 103 on PD. Mean age was 67.6 ± 11.3 years for HD patients and 70.8 ± 11.4 years for PD patients ( p = 0.015). Main Outcome Measures Mortality until June 2003, hospitalization over the 2 first years of RRT, and Kidney Disease and Quality of Life Short Form (KDQOL-SF) 6 and 12 months after initiation of RRT. Results HD patients were more likely to die from cardiac or cerebrovascular causes, PD from cachexia or withdrawal from dialysis. Whatever mode of RRT, the unadjusted 2-year and 5-year survival rates were similar ( p = 0.98). The rate of total duration of hospital stay per month of RRT was similar in HD and PD groups: 2.7 ± 4.5 and 2.9 ± 4.2 days respectively ( p = 0.7). PD was associated with better quality of life than HD. The dimensions Role limitation due to emotional function, Burden of kidney disease, and Role limitation due to physical function ranked first, second, and third for PD. Conclusion In Lorraine, end-stage renal disease patients who were given PD as first-line RRT had no excess of death risk or hospitalizations, and better quality of life the first year of RRT.

scholarly journals Quality of life predicts risks of end-stage renal disease and mortality in patients with chronic kidney disease

2010 ◽  
Vol 26 (1) ◽  
pp. 392-392
Author(s):  
Y.-C. Tsai ◽  
C.-C. Hung ◽  
S.-J. Hwang ◽  
S.-L. Wang ◽  
S.-M. Hsiao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Health-Related Quality of Life in End-Stage Renal Disease Patients: How Often Should We Ask and What Do We Do with the Answer?

2016 ◽  
Vol 41 (1-3) ◽  
pp. 218-224 ◽  
Author(s):  
Shan Shan Chen ◽  
Saleem Al Mawed ◽  
Mark Unruh
Keyword(s):  
Quality Of Life ◽  
Patient Reported Outcomes ◽  
Dialysis Patients ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: End-stage renal disease (ESRD) patients have poor health-related quality of life (HRQOL) comparing to general population and comparable HRQOL to patients with other major chronic diseases. Poor HRQOL is associated with shorter survival. There is a limited threshold to which dialysis dose and parameters management can improve HRQOL in ESRD patients. Numerous studies have sought to find interventions to improve HRQOL. This article is to review the symptoms associated with poor HRQOL and how frequent the quality of life (QOL) should be evaluated to improve the outcome. Summary: It is required by the Center for Medicare and Medicaid Services to evaluate HRQOL of dialysis patients annually. KDIGO recommends the symptoms to be assessed regularly and the treatment is redirected toward a patient-centered care model. Studies have shown that measuring patient-reported outcomes frequently, from 4 times a day to every 3-6 months, without intervention did not improve the HRQOL significantly. Appropriate intervention of the symptoms may improve the quality of life (QOL). Studies in oncology have also showed a similar result. The commonly used tools to evaluate the HRQOL in dialysis patients take up to 30 min for completion. Therefore, frequent assessment of all the symptoms can provide more burden than benefit to the patients. In addition to the annual HRQOL measurements, more frequent evaluation of targeted symptoms can be helpful. For appropriate intervention of the symptoms, effective communication between providers, as well as a multidisciplinary approach, is essential to improve HRQOL and outcomes in dialysis patients. Key Messages: Measurement of patient-reported outcomes may provide an opportunity to improve outcomes in ESRD. The frequent measurement of symptoms and QOL may be burdensome. Consider targeted measurement of symptoms to complement HRQOL measurement. Improved communication and the use of a multidisciplinary team provide mechanisms to improve HRQOL in ESRD.

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