Does Adequate Hemodialysis Prevent Symptoms?: A National Cross-Sectional Survey

Abstract

The aim of this study was to identify the relationship between dialysis adequacy and the incidence of symptoms in subjects treated with HD. This descriptive and cross-sectional study was conducted at two HD centers. The data were collected with the ‘Descriptive Characteristics Form of the Participants’ and the ‘Dialysis Symptom Index (DSI)’. The study was reported according to the STROBE Declaration. The study was completed with 120 patients. The most common symptom reported was feeling tired or decreased energy and the least common was difficulty concentrating. No statistically significant relationship was found between DSI results and the Kt/V or urea reduction rate levels used to evaluate dialysis adequacy. Dialysis-related symptoms can also be seen in patients with adequate dialysis levels. It is therefore necessary to query the symptoms experienced by the patients at regular intervals.

Keywords

hemodialysis hemodialysis adequacy nurse symptom

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References

Akgöz

Arslan

(2017). Examination of symptoms in patients who are on hemodialysis treatment. Journal of Nephrology Nursing, 1(12), 20–28.

Almutary

Bonner

Douglas

(2013). Symptom burden in chronic kidney disease: A review of recent literature. Journal of Renal Care, 39(3), 140–150. https://doi.org/10.1111/j.1755-6686.2013.12022.x

Almutary

Bonner

Douglas

(2016). Which patients with chronic kidney disease have the greatest symptom burden? A comparative study of advanced CKD stage and dialysis modality. Journal of Renal Care, 42(2), 73–82. https://doi.org/10.1111/jorc.12152

Antoniazzi

A. L.

Bigal

M. E.

(2009). Expert opinion: Headaches and haemodialysis. Headache, 49(3), 463–466. https://doi.org/10.1111/j.1526-4610.2009.01359.x

Aramwit

Supasyndh

(2015). Uremic pruritus; its prevalence, pathophysiology and management. In: Suzuki

(Ed.), Updates in Hemodialysis. InTechOpen.http://www.intechopen.com/books/updates-in-hemodialysis/uremic-pruritus-its-prevalence-pathophysiology-and-management

Bossola

Tazza

(2012). Xerostomia in patients on chronic hemodialysis. Nature Reviews Nephrology, 8(3), 176–182. https://doi.org/10.1038/nrneph.2011.218

Bossola

(2019). Xerostomia in patients on chronic hemodialysis: An update. Seminars in Dialysis, 32(5), 467–474. https://doi.org/10.1111/sdi.12821

Caplin

Kumar

Davenport

(2011). Patients’ perspective of haemodialysis-associated symptoms. Nephrology, Dialysis, Transplantation, 26(8), 2656–2663. https://doi.org/10.1093/ndt/gfq763

Claxton

R. N.

Blackhall

Weisbord

S. D.

Holley

J. L.

(2010). Undertreatment of symptoms in patients on maintenance hemodialysis. Journal of Pain and Symptom Management, 39(2), 211–218. https://doi.org/10.1016/j.jpainsymman.2009.07.003

10.

Davenport

(2008). Practical guidance for dialyzing a haemodialysis patient following acute brain injury. Hemodialysis International, 12(3), 307–312. https://doi.org/10.1111/j.1542-4758.2008.00271.x

11.

Davenport

(2009). Can advances in hemodialysis machine technology prevent intradialytic hypotension? Seminars in Dialysis, 22(3), 231–236. https://doi.org/10.1111/j.1525-139X.2009.00614.x

12.

Davison

S. N.

Jhangri

G. S.

(2005). The impact of chronic pain on depression, sleep, and the desire to withdraw from dialysis in hemodialysis patients. Journal of Pain and Symptom Management, 30(5), 465–473. https://doi.org/10.1016/j.jpainsymman.2005.05.013

13.

Davison

S. N.

Jhangri

G. S.

(2010). Impact of pain and symptom burden on the health-related quality of life of hemodialysis patients. Journal of Pain and Symptom Management, 39(3), 477–485. https://doi.org/10.1016/j.jpainsymman.2009.08.008

14.

Galain

A. I.

Dapueto

J. J.

Alvarez

Gadola

(2019). Prevalence of symptoms and symptom clusters of patients on dialysis in Uruguay. Value in Health Regional Issues, 20, 28–35. https://doi.org/10.1016/j.vhri.2018.10.003

15.

Garzoni

Keusch

Kleinoeder

Martin

Dhondt

Cremaschi

Tatsis

Ibrahim

Boer

Kuehne

Claus

Zahn

Schuemann

Engelmann

Hickstein

Wojke

Gauly

Passlick-Deetien

(2007). Reduced complications during hemodialysis by automatic blood volume controlled ultrafiltration. The International Journal of Artificial Organs, 30(1), 16–24.

16.

Göksel

B. K.

Torun

Karaca

Karatas

Tan

Sezgin

Benli

Sezer

Ozdemir

(2006). Is low blood magnesium level associated with hemodialysis headache? Headache, 46(1), 40–45. https://doi.org/10.1111/j.1526-4610.2006.00295.x

17.

Hintistan

Deniz

(2018). Evaluation of symptoms in patients undergoing hemodialysis. Bezmialem Science, 6, 112–118. https://doi.org/10.14235/bs.2018.1530

18.

Jesus

A. C.

Oliveira

H. A.

Paixão

M. O.

Fraga

T. P.

Barreto

F. J.

Valençe

M. M.

(2009). Clinical description of hemodialysis headache in end-stage renal disease patients. Arquivos de Neuro-Psiquiatria, 67(4), 978–981. https://doi.org/10.1590/s0004-282x2009000600003

19.

Kalender

Tosun

(2014). Determination of the relationship between adequacy of dialysis and quality of life and self-care agency. Journal of Clinical Nursing, 23(5–6), 820–828. https://doi.org/10.1111/jocn.12208

20.

Koç

Ünsal

Sakacı

Baştürk

Yılmaz

Ahbap

Nezaket

Ciğerli

. (2010). Should carnitine treatment be used for all hemodialysis patients? Turkish Nephrology, 19(1), 29–34.

21.

Leinau

Murphy

T. E.

Bradley

Fried

(2009). Relationship between conditions addressed by hemodialysis guidelines and non-ESRD-specific conditions affecting quality of life. Clinical Journal of the American Society of Nephrology, 4(3), 572–578. https://doi.org/10.2215/CJN.03370708

22.

Liu

H. E.

(2006). Fatigue and associated factors in hemodialysis patients in Taiwan. Research in Nursing and Health, 29(1), 40–50. https://doi.org/10.1002/nur.20109

23.

Milinkovic

Zidverc-Trajkovic

Sternic

Trbojevic-Stankovic

Maric

Milic

Andric

Nikic

Jovanovic

Rosic

Stojimirovic

(2009). Hemodialysis headache. Clinical Nephrology, 71(2), 158–163. https://doi.org/10.5414/cnp71158

24.

Ministry of Health and Turkish Society of Nephrology. (2017). Registry of the Nephrology. Dialysis and Transplantation in Turkey, 2017. http://www.nefroloji.org.tr/folders/file/18104_REGISTRY2017_kontrol_v1.pdf

25.

Moledina

D. G.

Perry Wilson

(2015). Pharmacologic treatment of common symptoms in dialysis patients: A narrative review. Seminars in Dialysis, 28(4), 377–383. https://doi.org/10.1111/sdi.12378

26.

Morsch

C. M.

Gonçalves

L. F.

Barros

(2006). Health-related quality of life among haemodialysis patients—relationship with clinical indicators, morbidity and mortality. Journal of Clinical Nursing, 15(4), 498–504. https://doi.org/10.1111/j.1365-2702.2006.01349.x

27.

Murtagh

F. E.

Addington-Hall

Higginson

I. J.

(2007). The prevalence of symptoms in end-stage renal disease: A systematic review. Advances in Chronic Kidney Disease, 14(1), 82–99. https://doi.org/10.1053/j.ackd.2006.10.001

28.

National Kidney Foundation. (2015). KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. American Journal of Kidney Diseases, 66(5), 884–930. https://doi.org/10.1053/j.ajkd.2015.07.015

29.

Önsöz

H. B.

Usta Yeşilbalkan

. (2013). Reliability and validity of the Turkish version of the dialysis symptom index in chronic hemodialysis patients. Turkish Nephrology, 22(1), 60–67. https://doi.org/10.5262/tndt.2013.1001.08

30.

Özdemir

. (2011). Identifying the symptom clusters of patients on dialysis treatment. Master thesis, Baskent University, Ankara, Turkey.

31.

Senanayake

Gunawardena

Palihawadana

Bandara

Haniffa

Karunarathna

Kumara

(2017). Symptom burden in chronic kidney disease; a population based cross sectional study. BMC Nephrology, 18(1), 228. https://doi.org/10.1186/s12882-017-0638-y

32.

Sexton

D. J

Lowney

A. C.

O’Seaghdha

C. M.

Murphy

O’Brien

Casserly

L. F.

McQuillan

Plant

W. D.

Eustace

J. A.

Kinsella

S. M.

Conlon

P. J.

(2016). Do patient-reported measures of symptoms and health status predict mortality in hemodialysis? An assessment of POS-S Renal and EQ-5D. Hemodialysis International, 20(4), 618–630. https://doi.org/10.1111/hdi.12415

33.

Steyaert

Holvoet

Nagler

Malfait

Van Biesen

(2019). Reporting of “dialysis adequacy” as an outcome in randomised trials conducted in adults on haemodialysis. PLoS One, 14(2), e0207045. https://doi.org/10.1371/journal.pone.0207045

34.

Szeto

C. C.

Wong

T. Y.

Chow

K. M.

Leung

C. B.

Law

M. C.

Wang

A. Y.

Lui

S. F.

P. K.

(2001). Impact of dialysis adequacy on the mortality and morbidity of anuric Chinese patients receiving continuous ambulatory peritoneal dialysis. Journal of the American Society of Nephrology, 12(2), 355–360.

35.

Tannor

E. K.

Archer

Kapembwa

van Schalkwyk

S. C.

Davids

M. R.

(2017). Quality of life in patients on chronic dialysis in South Africa: A comparative mixed methods study. BMC Nephrology, 18(1), 4. https://doi.org/10.1186/s12882-016-0425-1

36.

Türkmen

(2002). Hemodialysis Seminar Handbook. Istanbul; Turkey: Deniz Ofset Press.

37.

Ünal

Bilge

(2005). Evaluation of mental health status and quality of life end-stage renal disease patients treated with hemodialysis. Ege Journal of Medicine, 44(1), 35–38.

38.

Weisbord

S. D.

Fried

L. F.

Arnold

R. M.

Rotondi

A. J.

Fine

M. J.

Levenson

D. J.

Switzer

G. E.

(2004). Development of a symptom assessment instrument for chronic hemodialysis patients: The dialysis symptom index. Journal of Pain and Symptom Management, 27(3), 226–240. https://doi.org/10.1016/j.jpainsymman.2003.07.004

39.

Weisbord

S. D.

Fried

L. F.

Mor

M. K.

Resnick

A. L.

Unruh

M. L.

Palevsky

P. M.

Levenson

D. J.

Cooksey

S. H.

Fine

M. J.

Kimmel

P. L.

Arnold

R. M.

(2007). Renal provider recognition of symptoms in patients on maintenance hemodialysis. Clinical Journal of the American Society of Nephrology, 2(5), 960–967. https://doi.org/10.2215/CJN.00990207

40.

I. C.

Huang

J. Y.

Tsai

Y. F.

(2012). Symptom cluster among hemodialysis patients in Taiwan. Applied Nursing Research, 25(3), 190–196. https://doi.org/10.1016/j.apnr.2010.11.002