scholarly journals Evaluation of Exercise Tolerance in Dialysis Patients Performing Tai Chi Training: Preliminary Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Wioletta Dziubek ◽  
Katarzyna Bulińska ◽  
Mariusz Kusztal ◽  
Joanna Kowalska ◽  
Łukasz Rogowski ◽  
...  
Keyword(s):  
Exercise Capacity ◽  
Exercise Tolerance ◽  
Tai Chi ◽  
Perceived Exertion ◽  
Dialysis Patients ◽  
Stage Renal Disease ◽  
End Stage ◽  
6 Minute Walk Test ◽  
Esrd Patients

Introduction. Patients with end-stage renal disease (ESRD) have poor physical performance and exercise capacity due to frequent dialysis treatments. Tai Chi exercises can be very useful in the area of rehabilitation of people with ESRD. Objectives. The aim of the study was to assess exercise capacity in ESRD patients participating in 6-month Tai Chi training.Patients and Methods. Twenty dialysis patients from Wroclaw took part in the training; at the end of the project, 14 patients remained (age69.2±8.6years). A 6-minute walk test (6MWT) and spiroergometry were performed at the beginning and after 6 months of training. Results. After 6 months of Tai Chi, significant improvements were recorded in mean distance in the 6MWT (387.89 versus 436.36 m), rate of perceived exertion (7.4 versus 4.7), and spiroergometry (8.71 versus 10.08 min).Conclusions. In the ESRD patients taking part in Tai Chi training, a definite improvement in exercise tolerance was recorded after the 6-month training. Tai Chi exercises conducted on days without dialysis can be an effective and interesting form of rehabilitation for patients, offering them a chance for a better quality of life and fewer falls and hospitalisations that are the result of it.

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.

Efficacy of Tai Chi on Patients With Chronic Kidney Disease

2021 ◽  
pp. 109980042110479
Author(s):  
Mei Ha ◽  
Yuhui Yang ◽  
Yu Shi ◽  
Ya Lu ◽  
Kun Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tai Chi ◽  
Gene Profile ◽  
Positive Effects ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Previous systematic reviews elucidate the efficacy of Tai Chi on the rehabilitation and treatment for various chronic diseases. Yet, no consensus has been reached on its efficacy and safety from those with chronic kidney disease (CKD). Therefore, we conducted a systematic review to critically summarize what is already known about the prevailing benefits of Tai Chi for CKD patients. There was no evidence that Tai Chi had adverse effects on CKD patients. Long-term Tai Chi exercises could improve quality of life, cardiorespiratory fitness, and physical motor function for the end-stage renal disease (ERSD) patients undergoing dialysis. Regular Tai Chi exercises might exert modest influences in delaying CKD progression for mild–moderate CKD patients. However, there is insufficient evidence to demonstrate positive effects of Tai Chi exercises on bone health of the ESRD patients. Accordingly, rigorously designed, longer-term studies of Tai Chi are warranted to identify its efficacy on CKD patients across different stages, especially targeting potential mechanisms in terms of Tai Chi altering biological gene profile expressions.

scholarly journals Emergent Dialysis and its Impact on Quality of Life in Undocumented Patients with End-Stage Renal Disease

2017 ◽  
Vol 27 (1) ◽  
pp. 39 ◽  
Author(s):  
Andrew N. Hogan ◽  
William R. Fox ◽  
Lynn P. Roppolo ◽  
Robert E. Suter
Keyword(s):  
Quality Of Life ◽  
United States ◽  
End Stage Renal Disease ◽  
The United States ◽  
Dialysis Patients ◽  
Study Population ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

<p class="Pa7"><strong>Objective: </strong>This study aimed to define the ethnographic composition and assess the health-related quality of life (HRQoL) of a large population of undocumented patients with end-stage renal disease (ESRD) seeking emergent dialysis in the emergency depart­ment (ED) of a large public hospital in the United States.</p><p class="Pa7"><strong>Design: </strong>All ESRD patients presenting to the hospital’s main ED were identified during a 4-week consecutive enrollment period. Consenting patients completed two surveys—an ethnographic questionnaire and the validated kidney disease quality of life-36 (KDQOL-36) instrument.</p><p class="Pa7"><strong>Setting: </strong>The study was conducted at a large county hospital in Dallas, Texas. In 2013, the hospital recorded &gt;50,000 ED visits and administered approximately 6,000 dialysis treatments to ED patients.</p><p class="Pa7"><strong>Participants: </strong>88 of 101 unfunded patients presenting to the ED during the study period consented to participate, resulting in an 87.1% response rate. 65 of these patients were undocumented immigrants.</p><p class="Pa7"><strong>Main Outcome Measures: </strong>Quantitative scores for the 5 subscales of the KDQOL-36 were calculated for the study population.</p><p class="Pa7"><strong>Results: </strong>Measures of physical and mental health in our study population were lower than those published for scheduled dialysis patients. 79.5% of our patients lost employ­ment due to their dialysis requirements. At least 71.4% of the study patients were unaware that they required dialysis before immigrating to the United States.</p><p class="Pa7"><strong>Conclusions: </strong>Quality of life scores were found to be low among our population of undocumented emergent dialysis patients. Our data also provide some evidence that availability of dialysis at no cost is not a primary driver of illegal immigration of ESRD patients to the United States.</p><p class="Pa7"><em>Ethn Dis. </em>2017;27(1):39-44; doi:10.18865/ed.27.1.39.</p>

scholarly journals Kidney Transplant in an Old Woman-A Case Report and Review of the Literature

2015 ◽  
Vol 12 (1) ◽  
pp. 62-64
Author(s):  
Lidija Orlic ◽  
Ivana Mikolasevic ◽  
Branka Sladoje-Martinovic ◽  
Ivan Bubic and Sanjin Racki
Keyword(s):  
Quality Of Life ◽  
Renal Transplantation ◽  
Elderly Patients ◽  
End Stage Renal Disease ◽  
Older Patients ◽  
Review Of The Literature ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract The number of elderly patients with chronic kidney disease (CKD) as well as those with end-stage renal disease (ESRD) are increasing worldwide. Renal transplantation is now the treatment of choice for all ESRD patients, including those that are aged 65 or over. Namely, there is a growing evidence that elderly patients, in the absence of contraindications, have better outcomes after renal transplantation than alternative forms of RRT. Although survival, quality of life and economic advantages have been shown after transplantation, renal transplantation is still infrequently offered to older patients. Hereby, we present a case of an old woman who was transplanted in 1994 when “senior” program was still not established and when kidney transplantation at this age was rarity in many countries. She lived 16 years and 8 months with a well-functioning graft and died at the age of 89.

scholarly journals Variation in end-stage renal disease patient outcomes: what we know, what should we know, and how do we find it out?

1993 ◽  
Vol 3 (11) ◽  
pp. 1738-1747
Author(s):  
P Kurtin ◽  
A R Nissenson
Keyword(s):  
Patient Outcomes ◽  
Outcome Measure ◽  
Disease Patient ◽  
Patient Specific ◽  
Quality Cost ◽  
Current State ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

The size and expense of the ESRD program exceed all predictions made when the program was first initiated. Although the effectiveness of dialytic therapy is unquestioned, its value (quality/cost) is actively debated in this era of constricting resources. To better evaluate the quality of the ESRD program, it is essential to first define and quantitate the outcomes of dialytic care. Although mortality is a convenient outcome measure, it may be affected by many patient-specific as well as other factors that must be considered when evaluating and comparing new and existing technologies or advances. Quality of life is only beginning to be used in depth as an outcome measure, and much work is needed to standardize research methodology and thus move this area forward. The following review describes the current state of knowledge regarding outcomes of ESRD patients and proposes areas for future investigation, which should help increase the understanding of the value of the ESRD program to patients, providers, and payors.

scholarly journals Long Pentraxin 3 as a Broader Biomarker for Multiple Risk Factors in End-Stage Renal Disease: Association with All-Cause Mortality

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Maria João Valente ◽  
Susana Rocha ◽  
Susana Coimbra ◽  
Cristina Catarino ◽  
Petronila Rocha-Pereira ◽  
...  
Keyword(s):  
End Stage Renal Disease ◽  
Renal Fibrosis ◽  
Pentraxin 3 ◽  
Dialysis Patients ◽  
Inflammatory Biomarker ◽  
Multiple Risk Factors ◽  
All Cause Mortality ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Persistent inflammation in end-stage renal disease (ESRD) patients is known to underlie the progression of chronic kidney disease and to be associated with multiple risk factors including malnutrition, atherosclerosis, and cardiovascular disease (CVD). The acute-phase protein pentraxin 3 (PTX3) has a proven potential as a local inflammatory biomarker, but its clinical utility in ESRD remains unclear. Circulating levels of PTX3 and classical inflammatory mediators, including the clinical prototypical C-reactive protein (CRP), were assessed in 246 ESRD patients on dialysis and analysed in relation to the lipid profile, adipokine levels, and nutritional, cardiac, and renal fibrosis markers. Occurrence of deaths was recorded for the following year. Contrarily to the classical inflammatory markers, PTX3 levels were negatively correlated with nutritional markers and associated with a less atherogenic lipid profile. Levels of the cardiac and renal fibrosis markers and of the oxidized LDL/LDL-C ratio were found to be independent determinants of PTX3 concentration. When comparing inflammatory mediators, the increase in the PTX3 levels was the only predictor of all-cause mortality in dialysis patients in a survival model adjusted to all markers under study, other than the inflammatory ones, besides common confounding factors in dialysis. Data support the clinical applicability of PTX3 as a broader inflammatory biomarker than the classical ones, presenting a close association with inflammation, malnutrition, CVD, and renal fibrosis and a great potential to predict all-cause mortality in dialysis patients. The pleiotropic character of PTX3 may be of clinical relevance, and it could be targeted to ameliorate the high morbidity and mortality associated with ESRD.

A Comparison of the Effect of Enalapril and Metoprolol on Renal Function, Potassium Balance, Lipid Profile, Cardiac Function, Exercise Tolerance and Quality of Life in Hypertensive Dialysis Patients

1995 ◽  
Vol 18 (12) ◽  
pp. 757-762 ◽  
Author(s):  
K.C. Wong ◽  
K.S. Woo ◽  
W.K. Lam ◽  
K.T. Li ◽  
K.N. Lai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Function ◽  
Cardiac Function ◽  
Lipid Profile ◽  
Exercise Tolerance ◽  
Renal Diseases ◽  
Dialysis Patients ◽  
Potassium Balance ◽  
End Stage

26 patients with hypertension while on hemodialysis or continuous ambulatory peritoneal dialysis for end-stage renal diseases were treated first with enalapril and then changed to metoprolol. Both drugs were shown to be similarly effective in controlling blood pressure. There was no difference between the two drugs in their effects on renal function, potassium balance, lipid profile, cardiac function, exercise tolerance, and quality of life. Mild worsening of anemia was observed during treatment with enalapril. No serious side effects were reported. Use of enalapril is safe in the treatment of hypertension in dialysis patients.

scholarly journals Lipid status association with 25-hydroxy vitamin D: Cross sectional study of end stage renal disease patients

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Neda Milinković ◽  
Marija Sarić ◽  
Snežana Jovičić ◽  
Duško Mirković ◽  
Višnja Ležaić ◽  
...  
Keyword(s):  
Vitamin D ◽  
Peritoneal Dialysis ◽  
End Stage Renal Disease ◽  
Density Lipoprotein ◽  
Dialysis Patients ◽  
25 Hydroxy Vitamin D ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Lipid Parameters

SummaryBackgroundSome observational studies indicate an association of 25-hydroxy vitamin D (25(OH)D) insufficiency and atherogenic cholesterol concentrations. The aim of this study was to investigate relationship between 25(OH)D concentrations and lipid parameters in end stage renal disease (ESRD) patients, separately for predialysis, hemodialysis and peritoneal dialysis patients.MethodsWe have adjusted 25(OH)D concentrations for seasonal variability with cosinor analysis, and performed all further analysis using these corrected 25(OH)D concentrations. Concentrations of 25(OH)D and the lipid parameters were determined in 214 ESRD patients and 50 control group participants. The analysis included the measurement of 25(OH)D by HPLC, apolipoprotein (Apo) AI, ApoB and Lp(a) by nephelometry, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) by spectrophotometry and manually calculated ApoB/ApoAI and LDL-C/HDL-C ratio.ResultsESRD patients with adjusted 25(OH)D concentrations of ≤ 50 nmol/L had significantly higher TC (P = 0.005) and ApoAI (P = 0.049). Significantly higher HDL-C (P = 0.011) and ApoAI (P = 0.020) were found in hemodialysis patients with the 25(OH)D concentrations of ≤ 50 nmol/L. The other analyzed lipid parameters differed significantly between predialysis, hemodialysis and peritoneal dialysis patients with 25(OH)D concentrations of < 50 nmol/L.ConclusionsOur study indicate the significant relationship between 25(OH)D repletion and optimal concentrations of lipid parameters in ESRD patients. Further research is necessary to explain whether joint evaluation of vitamin D status and lipid abnormalities could improve cardiovascular outcome in ESRD patients.

scholarly journals Quality of Life and Depression in Patients With End-stage Renal Disease: a Comparison of Renal Replacement Therapy Modalities

2021 ◽  
Author(s):  
Fei Yang ◽  
Zheng Yang ◽  
Lu Cheng ◽  
Jiayu Tong ◽  
Pusheng Wang
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Renal Replacement Therapy ◽  
End Stage Renal Disease ◽  
Sf 36 ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients ◽  
Component Scores

Abstract Purpose. Patients with end-stage renal disease (ESRD) face various physical and mental limitations resulting from different renal replacement therapy (RRT) modalities. Renal transplantation (Tx) is considered as the treatment that impacts most on health-related quality of life (HRQOL). This study aimed to analyze and compare the HRQOL and depression levels of patients undergoing hemodialysis (HD), peritoneal dialysis (PD) and Tx.Methods. A single-center cross-sectional sample of 112 HD patients, 68 PD patients and 97 Tx patients participated in our questionnaire survey. The HRQOL and depression levels were assessed through the 36-Item Short-Form Health Survey (SF-36) and Mental Health Inventory (MHI-5), respectively. The multiple linear regression model was performed to examine the factors associated with each of the HRQOL scale scores. Results. The SF-36 HRQOL of Tx patients differed significantly from that in HD and PD groups in all eight dimensions and two components (all P<0.001). More than 45% of patients in each group were facing depressive symptoms. HD patients (63.4%) and PD (67.6%) patients were more depressive compared with Tx patients (45.4%, P =0.006). Depression in ESRD patients contributed to a worse quality of life (P<0.001). Patients ranging in age from 31 to 50, having full-time jobs, receiving Tx and without depression were associated with better HRQOL in the domain of Physical Component Scores (PCS). Patients with unemployment, dismissal or being looking for a job, receiving Tx and without depression were associated with better HRQOL in the domain of Mental Component Scores (MCS).Conclusions. Tx patients had better HRQOL and less depressive symptoms than HD and PD patients. Depression was related to an impaired HRQOL, which was common in ESRD patients. The severity of depression in ESRD patients and the effectiveness of Tx on HRQOL improvement need to be underscored.

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