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Elsayed MM, Abdelkader MM, ElKazaz AM, Elgohary IE. The impact of predialytic oral protein-based supplements on nutritional status and quality of life in hemodialysis patients: a randomized clinical trial. BMC Nephrol 2025; 26:103. [PMID: 40011815 PMCID: PMC11866819 DOI: 10.1186/s12882-025-03999-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 02/03/2025] [Indexed: 02/28/2025] Open
Abstract
BACKGROUND Administration of oral nutritional supplements (ONS) inside hemodialysis (HD) units before sessions is an increasingly adopted option. Our aim was to assess the effects of predialytic ONS on nutritional status and quality of life (QOL) in HD patients. METHODS One hundred HD patients were enrolled in this prospective, multicentric randomized clinical trial. Patients were assigned to receive ONS (25 gm protein powder) 1 h prior to the start of the HD session (predialytic) or maintained on their routine nutrition regimen for 3 months. RESULTS At study end, supplemented patients showed a significant increase in serum albumin (p < 0.001), and a non-significant decrease in the median subjective global assessment (SGA) score. While in the control group, serum albumin remained stable, and the median SGA score increased significantly (p < 0.001). Body mass index and anthropometric measures did not differ between both groups. The supplemented patients showed significant improvement in three subscales of the Kidney Disease Quality of Life-36, without a significant change in QOL in control patients. Supplemented patients had significantly higher blood pressure (BP) (p = 0.037), lower urea reduction ratio (p = 0.020) and Kt/V (p = 0.021), higher serum calcium, lower total cholesterol and lower CRP (p = 0.047) levels compared to controls. There was no significant difference between groups regarding serum sodium, potassium, or phosphorus or adverse events. CONCLUSIONS Predialytic ONS administration may contribute to improvements in serum albumin, and QOL. The effects on BP, CRP, and the reduction in dialysis adequacy, should be carefully considered while adopting such strategy. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov NCT05952570. FIRST REGISTRATION DATE 2/07/2023.
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Affiliation(s)
- Mohamed Mamdouh Elsayed
- Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mohamed Magdy Abdelkader
- Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amr Mohamed ElKazaz
- Internal Medicine Department, El Qabbary General Hospital, Ministry of Health, Alexandria, Egypt
| | - Iman Ezzat Elgohary
- Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
- Internal Medicine Department, Faculty of Medicine, Alexandria University, Alkhartoom Square, El Azareeta, Alexandria, 21131, Egypt.
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Woei Ling T, Khuan L, Baharom A, Arshad MM. Exploring the lived and coping experiences of patients with kidney failure undergoing haemodialysis in Malaysian private hospitals. J Res Nurs 2024; 29:228-240. [PMID: 38883246 PMCID: PMC11179604 DOI: 10.1177/17449871241235627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Abstract
Background Chronic kidney disease is associated with structural and functional abnormalities in the kidney caused by a range of different aetiologies. Purpose The study's purpose was to explore the lived and coping experiences of patients with kidney failure undergoing haemodialysis in three private hospitals in Malaysia. Methods Applying an interpretative phenomenological analysis using a hermeneutic phenomenological design to derive common meaning from participants lived and coping experiences. In the study, data were collected using a semi-structured interview guide from 15 purposefully sampled patients with kidney failure. Data were analysed using the interpretative phenomenological analysis principles. Results Patients with kidney failure reported emotional distress, life limitations, financial burdens, knowledge deficits and varying perceptions of the haemodialysis treatment. Body image changes, financial assistance, social support and hope were coping strategies used by patients with kidney failure. It was identified that patients with kidney failure used unique coping strategies such as applying perfume and using clothes to conceal the impact of haemodialysis on their bodies, which is not comprehensively discussed in published literature. Conclusion Nurses who deliver care to patients with kidney failure should focus on mitigating emotional distress, increasing knowledge related to kidney failure and improving perception of the haemodialysis treatment. Delivering and providing social support are indispensable nursing roles to help patients cope with haemodialysis treatment.
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Affiliation(s)
- Tan Woei Ling
- PhD candidate, Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Lee Khuan
- Senior Nursing Lecturer, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Anisah Baharom
- Senior Medical Lecturer, Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mohd Mursyid Arshad
- Senior Lecturer, Department of Professional Development & Continuing Education, Faculty of Educational Studies, University Putra Malaysia, Serdang, Selangor, Malaysia
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Japiong M, Landy CK, Fox MT, Mensah J, Adatara P. Factors affecting access to dialysis for patients with end-stage kidney disease in Sub-Saharan Africa: A scoping review. Nurs Open 2023; 10:6724-6748. [PMID: 37596727 PMCID: PMC10495707 DOI: 10.1002/nop2.1970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 07/05/2023] [Accepted: 08/02/2023] [Indexed: 08/20/2023] Open
Abstract
AIMS This scoping review examined the factors affecting access to dialysis for patients with end-stage kidney disease in Sub-Saharan Africa. DESIGN Scoping review. METHODS The scoping review is conducted following the Joanna Briggs Institute methodology for scoping reviews and modelled by Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review. RESULTS A descriptive content analysis of 30 included articles revealed three main findings affecting access and use of dialysis: Health system-related factors, health provider-related factors and patient factors. PATIENT OR PUBLIC CONTRIBUTION Equity in renal replacement therapy access and use will require concerted advocacy for good public policy, healthcare delivery, workforce capacity and education.
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Affiliation(s)
- Milipaak Japiong
- Department of Nursing, School of Nursing and MidwiferyUniversity of Health and Allied SciencesHoGhana
- School of Nursing, Faculty of HealthYork UniversityTorontoOntarioCanada
| | | | - Mary T. Fox
- School of Nursing, Faculty of HealthYork UniversityTorontoOntarioCanada
| | - Joseph Mensah
- Department of Geography, Faculty of Environmental and Urban ChangeYork UniversityTorontoOntarioCanada
| | - Peter Adatara
- Department of Nursing, School of Nursing and MidwiferyUniversity of Health and Allied SciencesHoGhana
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AlRowaie F, Alaryni A, AlGhamdi A, Alajlan R, Alabdullah R, Alnutaifi R, Alnutaifi R, Aldakheelallah A, Alshabanat A, Bin Shulhub A, Moazin O, Qutob R, Alsolami E, Hakami O. Quality of Life among Peritoneal and Hemodialysis Patients: A Cross-Sectional Study. Clin Pract 2023; 13:1215-1226. [PMID: 37887085 PMCID: PMC10605737 DOI: 10.3390/clinpract13050109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/16/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The quality of life (QoL) of patients with end-stage kidney disease (ESKD) who undergo dialysis is a reliable predictor of their long-term survival. Hemodialysis is the most common form of kidney replacement therapy for ESKD, followed by peritoneal dialysis. This study aimed to identify the factors affecting QoL in ESKD patients treated with peritoneal dialysis (PD) or hemodialysis (HD) in Riyadh, Saudi Arabia. METHODS A cross-sectional study was conducted between June and July 2021 to assess the QoL of patients with ESKD who underwent peritoneal dialysis and hemodialysis. Patients who had been on dialysis for at least one year were included. The Arabic version of the Quality of Life Index-Dialysis (QLI-D) version III was used to measure the QoL. RESULTS A total of 210 patients completed the questionnaire. The overall QLI score was 21.73 ± 4.2, with subscales for health and functioning (20.35 ± 5.2), social and economic (20.20 ± 4.8), psychological/spiritual (23.94 ± 4.9), and family (24.95 ± 4.5). The QLI scores for PD and HD patients were 21.80 ± 4.4 and 21.72 ± 4.1, respectively. SOCSUB (p = 0.031) was significantly associated with group and income, whereas QLI (p = 0.003), HFSUB (p = 0.013), SOCSUB (p = 0.002), and PSPSUB (p = 0.003) were significantly correlated with group and years of dialysis. CONCLUSION The study found that patients were most satisfied with their family, health and functioning, and social/economic subscales. Income and years of dialysis were found to be predictive factors of QoL. Overall, peritoneal patients in this study demonstrated a better QoL than HD patients.
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Affiliation(s)
- Fadel AlRowaie
- Nephrology Department, King Fahad Medical City, Riyadh 12231, Saudi Arabia;
| | - Abdullah Alaryni
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Abdullah AlGhamdi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Renad Alajlan
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Razan Alabdullah
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Raed Alnutaifi
- College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Raneem Alnutaifi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Amani Aldakheelallah
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Alanoud Alshabanat
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Abdullah Bin Shulhub
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Othillah Moazin
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Rayan Qutob
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
| | - Enad Alsolami
- Department of Internal Medicine, College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia;
| | - Osamah Hakami
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh 11623, Saudi Arabia; (A.A.); (A.A.); (R.A.); (R.A.); (A.A.); (A.A.); (A.B.S.); (O.M.); (R.Q.); (O.H.)
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Elsayed MM, Zeid MM, Hamza OMR, Elkholy NM. Dialysis recovery time: associated factors and its association with quality of life of hemodialysis patients. BMC Nephrol 2022; 23:298. [PMID: 36050656 PMCID: PMC9434841 DOI: 10.1186/s12882-022-02926-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/24/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Post-dialysis fatigue is a common and distressing complaint in patients on hemodialysis (HD). The dialysis recovery time (DRT) is a recent and reliable method of Post-dialysis fatigue assessment. We aimed to identify factors affecting the DRT and its relation with HD patients’ quality of life. Material and methods This is a cross-sectional study carried out on end-stage renal disease patients on regular HD. All participants underwent detailed history taking and complete physical examination, and data on dialysis and laboratory investigations were also collected. Patients were asked “How long does it take you to recover from a dialysis session?” to calculate the DRT. We used the Malnutrition-Inflammation Score (MIS) and KDQOL-36 questionnaire to assess patients’ nutritional status and quality of life, respectively. Results Two hundred and ten patients were screened and 191, with a median age of 47 years, completed the study. Patients had a median DRT of 300 minutes (range: 0.0–2880.0), with 55% of patients reporting a DRT of > 240 minutes and 22.5% of them reporting a DRT of < 30 minutes. Patients had a median MIS score of 7 (range: 0–17). There was a statistically significant negative relation between the DRT and symptom/ problem list (p < 0.001), effects of kidney disease (p < 0.001), burden of kidney disease (p < 0.001), SF-12 physical composite (p = 0.001), and SF-12 mental composite (p < 0.001) of KDQOL. The results of multivariate analyses showed that dialysate Na (p = 0.003), and the number of missed sessions (p < 0.001) were independently correlated with the DRT. Conclusions Decreased dialysate Na, and increased number of missed sessions were predictors of prolonged DRT. Patients with prolonged DRT were associated with poorer quality of life. Further randomized clinical trials are needed to assess strategies to minimize the DRT and, perhaps, enhance clinical outcomes. Trials registration ClinicalTrials.gov Identifier: NCT04727281. First registration date: 27/01/2021.
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Affiliation(s)
- Mohamed Mamdouh Elsayed
- Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alkhartoom square, El azareeta, Alexandria, 21131, Egypt.
| | - Montasser Mohamed Zeid
- Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alkhartoom square, El azareeta, Alexandria, 21131, Egypt
| | - Osama Mohamed Refai Hamza
- Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alkhartoom square, El azareeta, Alexandria, 21131, Egypt
| | - Noha Mohamed Elkholy
- Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alkhartoom square, El azareeta, Alexandria, 21131, Egypt
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Mei J, Yang L, Wang D, Wang H. Efficacy and safety of Shenkang injection in the treatment of chronic renal failure: A protocol of a randomized controlled trial. Medicine (Baltimore) 2021; 100:e27748. [PMID: 35049168 PMCID: PMC9191390 DOI: 10.1097/md.0000000000027748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Chronic renal failure (CRF) is the final outcome of the development of multiple kidney diseases, and there is no effective method at home and abroad. Traditional Chinese medicine is found to play a major role in the treatment of the non-replacement stage of CRF. Shenkang injection can not only nourish the kidney, but also promote blood circulation and remove blood stasis, which is suitable for the treatment of CRF. This study aims to explore the efficacy and safety of Shenkang injection for CRF and provide evidence for clinical practice. METHODS This was a prospective randomized controlled trial. One hundred four patients with CRF were randomly divided into treatment groups and control groups according to 1:1, with 52 patients in each group. The control group received basic treatment of western medicine and the treatment group was given Shenkang injection intravenously on the basis of control group. Both groups were given standard treatment for 4 weeks with concurrent follow-up for 1 month. The outcome indicators included: total efficiency, symptom scores, creatinine clearance rate, serum creatinine, blood urea nitrogen, CystatinC, liver function, blood routine, urine routine, incidence of adverse reactions, etc. Data analysis was performed using SPSS 25.0 software. DISCUSSION This study will evaluate the efficacy and safety of Shenkang injection for CRF, and the results of this trial will provide clinical evidence for the treatment of CRF. TRIAL REGISTRATION OSF Registration number: DOI 10.17605/OSF.IO/K9C5T.
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