Sleep disorders in dialysis patients

2008 ◽  
Vol 31 (11) ◽  
pp. 919-927 ◽  
Author(s):  
G.C. Kosmadakis ◽  
J.F. Medcalf
Keyword(s):  
Sleep Disorders ◽  
Central Sleep Apnea ◽  
Poor Sleep ◽  
Dialysis Patients ◽  
Periodic Limb Movement Disorder ◽  
Sleep Related Breathing Disorders ◽  
Breathing Disorders ◽  
Stage Renal Disease ◽  
End Stage

Poor sleep and sleep-related breathing disorders are common in patients with end-stage renal disease (ESRD) but are often unrecognized and undertreated. Sleep disorders are known negative prognostic factors for morbidity and mortality. The most frequent sleep disorders seen in patients with ESRD are conditioned insomnia, excessive daytime sleepiness, obstructive or central sleep apnea (SA), as well as restless legs syndrome (RLS) and periodic limb movement disorder (PLMD). Several uremic and nonuremic factors are thought to participate in the pathogenesis of sleep disorders in patients with ESRD. The therapy of sleeping disorders includes nonpharmacological and pharmacological measures that can improve the functionality and quality of life in patients with ESRD.

scholarly journals Management of Insomnia in Hemodialysis Patients: A Literature Review

2020 ◽  
Vol 13 (2) ◽  
pp. 93-99
Author(s):  
Nisrina Nur Aini ◽  
Arina Maliya
Keyword(s):  
Literature Review ◽  
Sleep Disorders ◽  
Hemodialysis Patients ◽  
Pharmacological Therapy ◽  
Dialysis Patients ◽  
Pharmacological Management ◽  
Results Management ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Hemodialysis (HD) therapy is the most common therapy for patients with End Stage Renal Disease (ESRD). Insomnia prevalent among dialysis patients which affects their quality of life and death. Although hemodialysis therapy has been proven to prolong survival, the action of hemodialysis therapy has complications that cause symptoms, one of which is sleep disturbance. Complaints of sleep disorders that are often encountered in dialysis units are experienced by 50-80% of dialysis patients. Of the various sleep disorders, insomnia is one of the symptoms that is often experienced by ESRD patients. Methods: A literature review comparing several literatures through the search of accredited journal sites such as PubMed, Elsevier, ResearchGate, and Neliti with the keywords management insomnia in hemodialysis patients in the 2015-2020 period. Research Results: Management of insomnia is reviewed with the aim of providing guidance to encourage treatment. In the six journals reviewed, education on sleep hygiene, CBT-I, relaxation therapy, massage therapy, and drug administration (with caution) improving the quality of sleep for hemodialysis patients. Conclusions: Pharmacological and non-pharmacological management to overcome insomnia in hemodialysis patients can be given by considering the factors that influence it. Management is advised to use a nonpharmacological approach first. The administration of pharmacological therapy is recommended only for short-term use, used with caution in hemodialysis patients.

scholarly journals Prevalence of Depression and Sleep Disorders in Patients on Dialysis: A Cross-Sectional Study in Qatar

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Fadwa Al-Ali ◽  
Mostafa Elshirbeny ◽  
Abdullah Hamad ◽  
Ahmad Kaddourah ◽  
Tarek Ghonimi ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Poor Sleep ◽  
Sectional Study ◽  
Dialysis Patients ◽  
Cross Sectional ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Patients with end-stage renal disease treated with dialysis have poor quality of life (QOL). Improving QOL in these patients with multiple comorbidities is a large challenge. We performed a cross-sectional study to evaluate the prevalence and associated factors of depression and sleep disorders in this population. Our primary aim was to evaluate QOL measures in dialysis patients in Qatar through a series of validated questionnaires mainly concerning depression and sleep disorders. Our secondary aim was to study the associations of age, sex, and comorbid conditions with the QOL measures. We hypothesized that end-stage renal disease (ESRD) patients on dialysis would have disturbed QOL due to both ESRD and dialysis and comorbidities. This prospective cross-sectional study included adult ESRD patients receiving either hemodialysis (HD) or peritoneal dialysis (PD) in the main tertiary dialysis unit in Qatar. We administered two surveys to evaluate depression (the Center for Epidemiologic Studies Depression Scale, http://www.bmedreport.com/archives/7139) and sleep disorders (the Pittsburgh Sleep Quality Index, https://www.sleep.pitt.edu/instruments/). We also reviewed patient demographics, comorbidities, and laboratory test results to evaluate any associated factors. We randomly studied 253 patients (62% on HD and 38% on PD). Overall, 48% of patients had depression, while 83.8% had sleep disorders. The PD had more poor sleepers than the HD group (89.1% versus (vs.) 75%, p = 0.003 ). Most of our dialysis patients had poor sleep, but it was more significant in the elderly group 109 (90%) than in the young group 103 (78%) ( p = 0.009 ). Patients with diabetes mellitus (DM) had significantly more prevalence of poor sleep (131 (88.5%)) than those without DM (81 (77.1%), p = 0.01 ). More female patients had depression than male patients (52% vs. 25%, p < 0.0001 ; odds ratio: 3.27 (95% confidence interval: 1.9–5.6), p < 0.0001 ). This is the first study in Qatar to evaluate depression and sleep disorders in patients on dialysis therapy.

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.

Vascular Access Planning in Peritoneal Dialysis Patients

2008 ◽  
Vol 28 (6) ◽  
pp. 585-590 ◽  
Author(s):  
Giusy Chiarelli ◽  
Monica Beaulieu ◽  
Mario Cozzolino ◽  
Suneet Singh ◽  
Mercedeh Kiaii ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Vascular Access ◽  
Specific Area ◽  
Dialysis Patients ◽  
Significant Group ◽  
Stage Renal Disease ◽  
End Stage ◽  
Guidelines And Recommendations ◽  
Current Guidelines

Peritoneal dialysis (PD) is a well-established renal replacement therapy for end-stage renal disease patients. Nonetheless, on an annual basis, at least 10% of patients shift from PD to hemodialysis for a variety of reasons. Thus the issue of vascular access creation needs to be addressed for this small but significant group of patients. Despite the relatively consistent number of dropouts, the creation of an arteriovenous fistula prior to transfer remains suboptimal, and variable from center to center. Literature for this specific area is poor and dated. Guidelines seem to suggest vascular access creation in high-risk failure patients, but they have no detailed criteria to select patients that would likely fail PD and therefore take advantage of a backup access. There is a need to better understand and predict patients that require conversion to hemodialysis to develop a plan that focuses on wellness and maximum quality of life in the lifecycle of PD patients. This review addresses the issue of vascular access planning in adult PD patients, presents the available literature on the topic and the current guidelines and recommendations, and describes a research agenda to guide decision making in clinical practice.

scholarly journals Duchenne Smile is Associated with Quality of Life and Survival in Hemodialysis Patients

2020 ◽  
Vol 44 (3) ◽  
pp. 313-325
Author(s):  
Mabel Aoun ◽  
Ghassan Sleilaty ◽  
Leony Antoun ◽  
Racha Dib ◽  
Dania Chelala
Keyword(s):  
Quality Of Life ◽  
Hemodialysis Patients ◽  
Physical Component Score ◽  
Dialysis Patients ◽  
Duchenne Smile ◽  
Health Related Qol ◽  
Health Related ◽  
Stage Renal Disease ◽  
End Stage

Objectives: Hemodialysis is the most used renal replacement modality for end-stage renal disease patients. Dialysis patients are usually assessed for quality of life (QoL) but smiling was never studied. Duchenne smile is a genuine expression of joy, associated with better survival in some groups of the general population. In this study, we aimed to evaluate whether the smile of dialysis patients can predict their QoL and mortality. Methods: All hemodialysis patients in Saint-George Hospital were included in this prospective study. Patients were interviewed using the Health-Related QoL questionnaire and followed for 10 days for smile screening. Those who smiled more than 34% of time were considered as smiling, then followed for death over 2 years. Results: Overall, 71 patients were studied. Duchenne smile was associated with death at 1 and 2 years (HR = 0.194 [95% CI 0.039-0.958], p = .044) but not with sex or diabetes. Smiling showed a statistically significant correlation with older age, fewer hospitalizations, vitality, physical component score, several QoL scores and general health. Conclusions: A simple observation of patients' Duchenne smile by nephrologists in hemodialysis units can give an idea about their QoL and 2-year survival.

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 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>

Serum Thiamine Values in End-Stage Renal Disease Patients under Maintenance Hemodialysis

2015 ◽  
Vol 85 (5-6) ◽  
pp. 348-355 ◽  
Author(s):  
Masamitsu Ubukata ◽  
Nobuyuki Amemiya ◽  
Kosaku Nitta ◽  
Takashi Takei
Keyword(s):  
Thiamine Deficiency ◽  
Risk Index ◽  
Nutritional Risk ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Significant Difference ◽  
Nutritional Risk Index ◽  
Serum Aspartate Aminotransferase ◽  
Stage Renal Disease ◽  
End Stage

Abstract. Objective: Hemodialysis patients are prone to malnutrition because of diet or many uremic complications. The objective of this study is to determine whether thiamine deficiency is associated with regular dialysis patients. Methods: To determine whether thiamine deficiency is associated with regular dialysis patients, we measured thiamine in 100 patients undergoing consecutive dialysis. Results: Average thiamine levels were not low in both pre-hemodialysis (50.1 ± 75.9 ng/mL; normal range 24 - 66 ng/mL) and post-hemodialysis (56.4 ± 61.7 ng/mL). In 18 patients, post-hemodialysis levels of thiamine were lower than pre-hemodialysis levels. We divided the patients into two groups, the decrease (Δthiamine/pre thiamine < 0; - 0.13 ± 0.11) group (n = 18) and the increase (Δthiamine/pre thiamine> 0; 0.32 ± 0.21)) group (n = 82). However, there was no significance between the two groups in Kt/V or type of dialyzer. Patients were dichotomized according to median serum thiamine level in pre-hemodialysis into a high-thiamine group (≥ 35.5 ng/mL) and a low-thiamine group (< 35.4 ng/mL), and clinical characteristics were compared between the two groups. The low-thiamine value group (< 35.4 ng/ml; 26.8 ± 5.3 ng/ml) exhibited lower levels of serum aspartate aminotransferase and alanine aminotransferase than the high-thiamine value group (≥ 35.4 ng/ml; 73.5 ± 102.5 ng/ml) although there was no significance in nutritional marker, Alb, geriatric nutritional risk index , protein catabolic rate and creatinine generation rate. Conclusion: In our regular dialysis patients, excluding a few patients, we did not recognize thiamine deficiency and no significant difference in thiamine value between pre and post hemodialysis.

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