scholarly journals Sexual Dysfunction Among Patients with End-Stage Renal Disease Undergoing Hemodialysis: Prevalence and Associated Factors

Author(s):  
Mansour Shakiba ◽  
Nour-Mohammad Bakhshani ◽  
Zohre Soorgi ◽  
Shahab Lotfinia

Background: Chronic renal disease is a worldwide concern. The number of patients on hemodialysis increases every year. These patients have several physiological and psychological problems like sexual dysfunction that can affect their mental health and treatment course. Objectives: This study first aimed to assess the prevalence of sexual dysfunction in end-stage renal disease (ESRD) patients on hemodialysis compared to healthy people. Then, it evaluated factors associated with sexual dysfunction in both groups. Methods: This cross-sectional study recruited a total of 142 participants in two groups selected by a convenience sampling method. Group one included 71 ESRD patients from two hemodialysis centers in Zahedan, Southeast of Iran, recruited between September 2018 and September 2019. Group two included 71 healthy individuals matched for age, weight, and educational status. The two groups were assessed based on psychiatric interviews, the International Index of Erectile Function (IIEF), and the index of female sexual function (IFSF). The SPSS 24 software was used for data analysis. The bivariate Pearson correlation test, Cramer V, and independent-t-test were used to analyze the data. Results: All female patients and 90% of healthy females had various levels of sexual dysfunction, and there was no significant difference between them (P = 0.21). However, 84.6% of male patients and 33.3% of healthy males had various levels of sexual dysfunction and there was a significant difference between the two groups (P < 0.001). The duration of hemodialysis was not correlated with sexual dysfunction. Age, weight, educational status, and marriage duration showed the most correlations with sexual dysfunction, especially in females. Conclusions: As the findings showed, sexual dysfunction had a high prevalence among hemodialysis patients. As many of these patients must be on hemodialysis for long periods, we need to pay attention to sexual dysfunction when assessing and planning for their treatment.

2021 ◽  
Vol 33 (1) ◽  
pp. 52-56
Author(s):  
Ratan Das Gupta ◽  
Syed Mahbub Morshed ◽  
Abdullah Al Mamun ◽  
HAM Nazmul Ahsan ◽  
Mirzul Hasan ◽  
...  

Background: The widespread use of hemodialysis to prolong life of end-stage renal disease (ESRD) patients has been a remarkable achievement, preventing death from uremia in these patients. The aim of the study was to find out the outcomes of haemodialysis patients with end-stage renal disease (ESRD) in low Income County. Methods: A hospital based prospective observational study was performed in the of Department of Nephrology, Shaheed Suhrawardy Medical College. Total 189 patients who stated dialysis during study period were included. All patients were monthly followed up and appropriate investigation done. All data recorded in a case record form. Study protocol approved by Ethical committeeof institute. Data analyzed in SPSS software version 25. Results: Among 189 ESRD patients on MHD selected with mean age 49.16 years (15-82), male was 60.3% and female 39.7%.Eighty eight 46.5% patient died and 39.15%(74) patient discontinue dialysis due to lack of financial support or helping assistant or social support. Three (1.6%) patients underwent renal transplantation and five patients (2.6%) transfer to other dialysis center. Average life span in dialysis 256 day (16-786 days). Most of the paints was on twice weekly dialysis 84%. Vascular access of stating dialysis was 73.8% by catheter and only 32.2% stated with AV fistula. Conclusion: A large group of patients leave dialysis due to financial or helping personal or social supportwithin 3-4 months of stating dialysis. A significant number of patients died due to multiple risk factors within 8-9 months. Identification of risk factors for early mortalityis essential and appropriatemeasure should take to prevent discontinuation at community and national level. Bangladesh J Medicine July 2022; 33(1) : 52-56


2018 ◽  
Vol 6 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Muhammad Ali Khalid ◽  
Jawaid Iqbal ◽  
Hassan Liaquat Memon ◽  
Farina M. Hanif ◽  
Muhammad Osama Tariq Butt ◽  
...  

Abstract Background and Objectives Gastrointestinal symptoms are common in patients with end stage renal disease (ESRD) among which dyspepsia is frequently observed. The aim of the study was to determine the frequency and associations of dyspepsia in ESRD patients using the Leeds questionnaire. Methods All ESRD patients on maintenance hemodialysis were consecutively enrolled in the study. Leeds questionnaire was used to interrogate the patients for the assessment of dyspepsia. Mean and standard deviation were calculated for age, body mass index (BMI), disease duration and number of hemodialysis sessions. Independent t-test and Chi square tests were used for statistical analysis. Results Total number of patients was 200, out which 118 (59.3%) were male. The mean age was of 41.4 years. According to the Leeds questionnaire, dyspepsia was present in 62 (63.9%) patients. Younger patients (age 20–40 years) more frequently had dyspeptic symptoms (61.5% patients), retrosternal pain (156 patients, 78.0%), regurgitation (127 patients, 63.5%), dysphagia (67 patients, 33.5%), and nausea (142 patients, 71.0%). Patients presented with intermittent pattern of symptoms in 179 (89.5%) cases, while continuous symptoms in 6 (3.0%). Dyspepsia was associated with aspartate aminotransferase (AST) levels > 25 U/L (P = 0.001), alanine aminotransferase (ALT) levels > 28U/L (P = 0.000) and gamma glutamyl transferase (GGT) levels > 34 U/L (P = 0.002). On multivariate analysis, urea, creatinine, and presenting symptoms of dysphagia and belching showed significant statistical association with dyspepsia. Conclusion Dyspepsia is a common problem affecting patients with end stage renal disease and is associated with raised serum AST, ALT and GGT in such patients.


2020 ◽  
Vol 7 (2) ◽  
pp. 53-57
Author(s):  
Mehdi Khazaei ◽  
Zainab Eslami Hasan Abadi ◽  
Mohammad Keshvari Delavar ◽  
Morteza Shamsizadeh

Background and aims: Hemodialysis (HD) is considered as the main method of renal replacement therapy (RRT) for end-stage renal disease (ESRD) patients in many countries including Iran. Given the limited number of epidemiological studies in this regard at the provincial level across the country, the present study aimed to describe the demographic and clinical characteristics of ESRD patients and determine the most important causes of ESRD in Hamadan Province. Methods: This cross-sectional study was conducted on 508 HD patients in Hamadan province in January 2017. The checklist used to gather information comprised of the patient’s demographic and clinical information. The analysis was carried out using descriptive analysis including frequency tables and charts and the chi-square statistic test was used to compare the groups using Stata software, version 12. Results: The prevalence rate of HD treatment was 288.9 per million population (PMP). Further, most under HD patients were married, illiterate, and urban residents. The mean age of patients at the diagnosis was 47.64 ± 15.17 years. Hypertension (37.4%), diabetes (28.74%), and glomerulonephritis (10.63%) were the common causes of ESRD. Eventually, there was a significant difference between ESRD causes according to gender and residency (P<0.05). Conclusion: In general, the prevalence rate of HD in Hamadan was relatively similar to that of developing countries although it was lower than the national average. Furthermore, hypertension and diabetes were the common causes of ESRD in Hamadan Province. Therefore, preventive strategies should be taken to modify their risk factors.


Author(s):  
Dary Gunawan ◽  
Theodore Dharma Tedjamartono

Introduction: The number of patients with End Stage Renal Disease (ESRD) is increasing every year, as well as those who have to undergo hemodialysis. Most hemodialysis must be undertaken in a long time. Long term hemodialysis is known to be associated with the incidence of Carpal Tunnel Syndrome (CTS). Method: This study aimed to systematically review factors contributing in the mentioned problem. Literature research was done using three search engines, consist of Google Scholar, Pubmed and ProQuest. Journals used are limited to the last 5 years or those deemed to be relevant. The studies obtained were further read and and appraised critically. Result and Discussion: From a total of 423 journals, 4 articles were selected based on inclusion and exclusion criteria. The prevalence of CTS was found to be higher in ESRD patients undergoing maintenance hemodialysis (MHD). Age, Gender, MHD Duration, β2-Microglobulin are factors that have long been known to play a role. Several other factors such as serum prealbumin, serum albumin, Blood Lead Levels, hepatitis infection, wrist injury, predialytic urea serum and BMI have been implicated in the incidence of CTS in ESRD patients undergoing MHD in some literatures. Conclusion: The factors mentioned earlier were found to have different roles and it is interesting for further reviewed. However, unfortunately there is still very little research that discuss these matters and more research needs to be done related to the factors above.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hadith Rastad ◽  
Hanieh-Sadat Ejtahed ◽  
Gita Shafiee ◽  
Anis Safari ◽  
Ehsan Shahrestanaki ◽  
...  

Abstract Background The extent to which patients with End-stage renal disease (ESRD) are at a higher risk of COVID-19-related death is still unclear. Therefore, the aim of this study was to identify the ESRD patients at increased risk of COVID-19 -related death and its associated factors. Methods This retrospective cohort study was conducted on 74 patients with ESRD and 446 patients without ESRD hospitalized for COVID-19 in Alborz province, Iran, from Feb 20 2020 to Apr 26 2020. Data on demographic factors, medical history, Covid-19- related symptoms, and blood tests were obtained from the medical records of patients with confirmed COVID-19. We fitted univariable and multivariable Cox regression models to assess the association of underlying condition ESRD with the COVID-19 in-hospital mortality. Results were presented as crude and adjusted Hazard Ratios (HRs) and 95% confidence intervals (CIs). In the ESRD subgroup, demographic factors, medical history, symptoms, and blood parameters on the admission of survivors were compared with non-survivors to identify factors that might predict a high risk of mortality. Results COVID-19 patients with ESRD had in-hospital mortality of 37.8% compared to 11.9% for those without ESRD (P value < 0.001). After adjusting for confounding factors, age, sex, and comorbidities, ESRD patients were more likely to experience in-hospital mortality compared to non-ESRD patients (Adjusted HR (95% CI): 2.59 (1.55–4.32)). The Log-rank test revealed that there was a significant difference between the ESRD and non-ESRD groups in terms of the survival distribution (χ2 (1) = 21.18, P-value < 0.001). In the ESRD subgroup, compared to survivors, non-survivors were older, and more likely to present with lack of consciousness or O2 saturation less than 93%; they also had lower lymphocyte but higher neutrophil counts and AST concentration at the presentation (all p –values < 0.05). Conclusions Our findings suggested that the presence of ESRD would be regarded as an important risk factor for mortality in COVID-19 patients, especially in those who are older than age 65 years and presented with a lack of consciousness or O2 saturation less than 93%.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S275-S275
Author(s):  
Yu-Hsuan Wang ◽  
Susan Enguidanos

Abstract The United States has the third highest prevalence and the second highest incidence of End-Stage Renal Disease (ESRD). ESRD is associated with high mortality and lower quality of end-of-life experiences. Having an advance directive (AD) is associated with better care at the end of life. Although past ACP completion rates in ESRD patients has been studied, little is known about its timing differences between ESRD and cancer patients. This study investigates the timing difference of AD completion between ESRD and cancer patients We conducted logistic regression to analyze data from the Health and Retirement Study, a nationally representative longitudinal survey of older adults. The analytic sample included exit interviews from 2012 to 2016 among 971 proxies of deceased with ESRD or cancer. Among the sample, 47% of decedents completed an AD; 44% of cancer patients and 48% of ESRD patients. Being a racial minority (OR=0.38, p&lt;0.001), and lower education (OR= 0.63, p=0.001) were associated with lower AD completion rates. No significant differences in AD completion rates were found between cancer patients and ESRD patients. Compared to cancer patients, ESRD patients were more likely to complete ADs more than one year before death (OR=3.15, p=0.001). However, there were no significant difference between cancer patients and ESRD patients in AD completion rates in the three months before death. Although both samples had comparable rates of AD completion, compared to cancer patients, ESRD patients tend to document care preferences earlier. Further studies are needed to investigate factors related to early documentation of ADs.


2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Muhammad Ali Khalid ◽  
Jawaid Iqbal ◽  
Hassan Liaquat Memon ◽  
Farina M. Hanif ◽  
Muhammad Osama Tariq Butt ◽  
...  

Abstract Background and Objectives Gastrointestinal symptoms are common in patients with end stage renal disease (ESRD) among which dyspepsia is frequently observed. The aim of the study was to determine the frequency and associations of dyspepsia in ESRD patients using the Leeds questionnaire. Methods All ESRD patients on maintenance hemodialysis were consecutively enrolled in the study. Leeds questionnaire was used to interrogate the patients for the assessment of dyspepsia. Mean and standard deviation were calculated for age, body mass index (BMI), disease duration and number of hemodialysis sessions. Independent t-test and Chi square tests were used for statistical analysis. Results Total number of patients was 200, out which 118 (59.3%) were male. The mean age was of 41.4 years. According to the Leeds questionnaire, dyspepsia was present in 62 (63.9%) patients. Younger patients (age 20–40 years) more frequently had dyspeptic symptoms (61.5% patients), retrosternal pain (156 patients, 78.0%), regurgitation (127 patients, 63.5%), dysphagia (67 patients, 33.5%), and nausea (142 patients, 71.0%). Patients presented with intermittent pattern of symptoms in 179 (89.5%) cases, while continuous symptoms in 6 (3.0%). Dyspepsia was associated with aspartate aminotransferase (AST) levels > 25 U/L (P = 0.001), alanine aminotransferase (ALT) levels > 28U/L (P = 0.000) and gamma glutamyl transferase (GGT) levels > 34 U/L (P = 0.002). On multivariate analysis, urea, creatinine, and presenting symptoms of dysphagia and belching showed significant statistical association with dyspepsia. Conclusion Dyspepsia is a common problem affecting patients with end stage renal disease and is associated with raised serum AST, ALT and GGT in such patients.


2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 298-302
Author(s):  
Robert H. Mak ◽  
Wai Cheung

Cachexia is common in end-stage renal disease (ESRD) patients, and it is an important risk factor for poor quality of life and increased mortality and morbidity. Chronic inflammation is an important cause of cachexia in ESRD patients. In the present review, we examine recent evidence suggesting that adipokines or adipocytokines such as leptin, adiponectin, resistin, tumor necrosis factor α, interleukin-6, and interleukin-1β may play important roles in uremic cachexia. We also review the physiology and the potential roles of gut hormones, including ghrelin, peptide YY, and cholecystokinin in ESRD. Understanding the molecular pathophysiology of these novel hormones in ESRD may lead to novel therapeutic strategies.


Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.


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