scholarly journals Quality of Life and Health Status Among Patients Receiving Renal Replacement Therapy in Trinidad and Tobago, West Indies

2021 ◽  
Vol Volume 14 ◽  
pp. 173-192
Author(s):  
Sharlene Sanchez ◽  
Surujpal Teelucksingh ◽  
Ronan Ali ◽  
Henry Bailey ◽  
George Legall
2021 ◽  
Author(s):  
Sharlene Maria Sanchez ◽  
Surujpal Teelucksingh ◽  
Ronan Ali ◽  
Henry Bailey ◽  
George Legall

Abstract Purpose:The determinants of quality of life for patients on renal replacement therapy vary across the world. In this cross sectional study, the factors accounting for a good quality of life in the resource-constrained twin-island of Trinidad and Tobago will be explored.Patients and methods:Five hundred and fifty three patients met inclusion criteria for the study. From the 103 patients receiving renal transplants, 100 participated and among the 84 on peritoneal dialysis, 80 took part in the study. Among the 1000-odd patients who were receiving hemodialysis, 350 were studied using convenience sampling. To be included, one had to be on renal replacement therapy for 3 months or more and at least 18 years of age. The Kidney Disease Quality of Life (KDQOL-36) and the EuroQol (EQ-5D-3L) instruments were administered after demographic data was collected. Transplant recipients were further evaluated with the Kidney Transplant Questionnaire (KTQ). Inferential analysis of data included 95% confidence intervals, ordinary least squares regression, analysis of variance, pairwise correlation and Pearson’s bivariate analysis. SPSS24, STATA14 and MINITAB18 were used.Results:Of the 530 patients, 52.5% were male, 37.5% were in the 56-65 years age group and 51.3% were of Indo-Trinbagonian descent. Hypertension (25.5%) and type 2 diabetes mellitus (62.0%) were reported as the main causes of kidney disease in the dialysis group. In the transplant category, chronic glomerulonephritis (45%) was the main aetiology of kidney disease. The KDQOL-36 domain scores and significantly associated variables included modality of renal replacement, Charlson’s Comorbidity Index, ethnicity, income and employment status. Transplant patients performed the best in the KDQOL-36 and EQ-5D-3L. Patients on peritoneal dialysis had a better quality of life than hemodialysis patients. Increasing patients’ access to renal transplantation or peritoneal dialysis will markedly improve health status for the number of years on renal replacement therapy. Among patients on hemodialysis, an arteriovenous fistula or graft significantly impacted on quality of life.Conclusion:Renal transplant recipients enjoy the best quality of life and health state among patients on renal replacement therapy in Trinidad and Tobago. Given the limitations in resources, patients on peritoneal dialysis also enjoy a good quality of life while the presence of an arteriovenous fistula or graft improved quality of life scores for those receiving hemodialysis. Policies should be implemented to achieve an acceptable quality of life for all patients receiving renal replacement therapy.


2020 ◽  
Author(s):  
Sharlene Maria Sanchez ◽  
Surujpal Teelucksingh ◽  
Ronan Ali ◽  
Henry Bailey ◽  
George Legall

Abstract Background A cross sectional study was conducted over a 1-year period in order to evaluate quality of life and health state for patients receiving renal replacement therapy in a resource constrained Caribbean island of Trinidad and Tobago. Methods Five hundred and thirty patients were enlisted in the study. For those who had received renal transplants (n=100) and for those on peritoneal dialysis (n=80), all were included. Among the 1000-odd patients who were receiving haemodialysis 350 were studied using convenience sampling. To be included, one had to be on renal replacement therapy for 3 months or more and at least 18 years of age. The Kidney Disease Quality of Life (KDQOL-36) and the EuroQol (EQ-5D-3L) instruments were administered after demographic data were collected. Transplant recipients were further evaluated with the Kidney Transplant Questionnaire (KTQ). Inferential analysis of data included 95% confidence intervals, hypothesis testing, multiple regression and analysis of variance. SPSS24, STATA14 and MINITAB18 were used. Results Of the 530 patients, 52.5% were male and 37.5% were in the 56-65 years age group. Hypertension (68.9%) and type 2 diabetes mellitus (50.5%) were reported as the main causes of kidney disease. The KDQOL-36 domain scores and significantly associated variables included modality of renal replacement (p=0.000), age (p=0.001), Charlson’s Comorbidity Index (p=0.001), income (p=0.000) and employment status (p=0.000). Transplant patients performed the best in the KDQOL-36. The mean visual analogue scale and index scores from the EQ-5D-3L were highest among renal transplant recipients (p=0.000). Conclusion Renal transplant recipients enjoy the best quality of life and health state among patients on renal replacement therapy in Trinidad and Tobago.


2009 ◽  
Vol 12 (2) ◽  
pp. 136-140 ◽  
Author(s):  
Taru Hallinen ◽  
Erkki J. O. Soini ◽  
Janne A. Martikainen ◽  
Risto Ikäheimo ◽  
Olli-Pekka Ryynänen

2005 ◽  
Vol 31 (9) ◽  
pp. 1222-1228 ◽  
Author(s):  
Annika Åhlström ◽  
Minna Tallgren ◽  
Seija Peltonen ◽  
Pirjo Räsänen ◽  
Ville Pettilä

2001 ◽  
Vol 16 (8) ◽  
pp. 1675-1680 ◽  
Author(s):  
Pablo Rebollo ◽  
Francisco Ortega ◽  
José María Baltar ◽  
Fernando Álvarez‐Ude ◽  
Rafael Alvarez Navascués ◽  
...  

2009 ◽  
Vol 7 (5) ◽  
pp. 780-786 ◽  
Author(s):  
S. M. SIBONI ◽  
P. M. MANNUCCI ◽  
A. GRINGERI ◽  
M. FRANCHINI ◽  
A. TAGLIAFERRI ◽  
...  

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
MARIA PAZ CASTRO FERNÁNDEZ ◽  
LUIS GUILLERMO PICCONE SAPONARA ◽  
Agustin Carreno ◽  
Diego Siedel ◽  
NANCY GIOVANNA URIBE HEREDIA ◽  
...  

Abstract Background and Aims Elderly patients and comorbidity present more frequently deterioration of their cognitive and / or functional capacity, and consequently worse quality of life related to health and the need for help to perform their basic activities. It has been described in the literature that peritoneal dialysis (PD) is a protective factor in the patient's survival against hemodialysis (HD). Quality of life is an important parameter in patients undergoing renal replacement therapy, which influences the choice of dialysis modality. We analyzed and compared the degree of functional dependence of patients on PD versus HD. Method Descriptive and cross-sectional study. A total of 84 patients belonging to the General University Hospital of Ciudad Real were included. Demographic variables (age, sex), associated comorbidity, etiology of CKD, among others, were collected. To assess the degree of dependence, the Barthel index and Lawton and Brody were performed. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and have been compared using the Chi2 test. Quantitative variables are expressed as mean +/- standard deviation, and the T-student was used to compare them. Statistical significance for a value of p <0.05. Results Of the 84 patients, 40.5% received PD and 59.5% HD. 60.7% were male and 39.3% female, with an average age of 60.90 years. 75% were hypertensive, 38.1% diabetic, 61.9% dyslipidemic, 27.4% obese and 61.9% had peripheral vasculopathy. The most frequent causes of CKD were diabetic nephropathy (22.6%), glomerular etiology (21.4%), unfiltered (20.2%) and nephroangiosclerosis (14.3%), among others. The degree of functional dependence according to the Barthel index was 63.1.9% for total independence, 29.8% mild dependence, 4.8% moderate dependence and 1.2% total dependence; and for the Lawton and Brody index, 42.9% total independence, 14.3% mild dependence, 27.4% moderate dependence, 11.9% severe dependence and 3.6% total dependence. When comparing the degree of functional dependence between both dialysis techniques, we observed that patients in PD had a lower degree of functional dependence compared to patients in HD, these differences being statistically significant (Lawton and Brody 73.5% in PD vs. 22% in HD, p <0.001 and Barthel index 85.3% in PD vs 48% in HD, p = 00.4). Conclusion In our experience, the degree of functional dependence in patients in PD is lower compared to patients in HD with less comorbidity, being able to condition the choice of the technique of renal replacement therapy.


2005 ◽  
Vol 25 (6) ◽  
pp. 903-923 ◽  
Author(s):  
KEVIN J. McKEE ◽  
STUART G. PARKER ◽  
JENNIFER ELVISH ◽  
VINCE J. CLUBB ◽  
MEGUID EL NAHAS ◽  
...  

The use of age as a criterion for the allocation of medical resources has been extensively debated internationally. This paper describes a study of the significance of age for the quality of life (QoL) of older and younger people with end-stage renal failure (ESRF) and in receipt of renal replacement therapy (RRT). The study has two components: a structured literature review to characterise the QoL and health-status measurement instruments that have been developed for use with all or specifically older RRT patients; and a longitudinal survey of the QoL domains nominated by older RRT patients by their age and duration of treatment. The literature review found that no validated QoL instrument had been developed specifically for use with older RRT patients. Moreover, there was little correspondence between the QoL domains used in the instruments described in the published literature and those mentioned by the survey participants. Older and younger patients nominated different domains, and their nominations changed with the duration of treatment. No significant differences in QoL scores were found between older and younger patients, but the scores improved significantly between 6–12 and 18–24 months of treatment. The findings suggest that using older age as a criterion for refusing full access to healthcare resources in ESRF is a simplistic and potentially erroneous strategy.


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