BACKGROUND AND OBJECTIVESQuality of life (QoL) in end-stage renal disease (ESRD) patients is an important outcome for both physicians and patients in selecting dialysis modality. We conducted a comparison between regular maintenance hemodiaylsis and regular peritoneal dialysis patients in two tertiary referral hospitals in King Saud University in Saudi Arabia. We hypothesize that there might be cultural and socioeconomic factors modifying QoL in dialysis patients.DESIGN AND SETTINGCross-sectional study on hemodialysis and peritoneal dialysis patients.PATIENTS AND METHODSTwo hundred dialysis patients participated in the study, one hundred in each group of dialysis modality, from July 2007 to July 2008. We used a cross-sectional design and collected the date using the Kidney Disease Quality of Life (KDQoL SF) questionnaire.RESULTSPatients in both groups had similar sociodemographic characteristics (age, marital status, and education). Mean age (SD) in the hemodialysis group was 47.5 (13.8) years and 51.0 (13.5) years in the peritoneal dialysis group. Males represented 53% and 43%, respectively. Mean duration of dialysis was 77.2 (75.5) months in the hemodialysis group and 34.1 (26.9) months in the peritoneal dialysis group. The mean (SD) score was 49.5 (13.7) in the hemodialysis group and 61.3 (12.4) in the peritoneal dialysis group. QoL mean scores were significantly higher among peritoneal dialysis in all domains and in the total QoL, with the exception of the score of physical QoL, which was higher in the hemodialysis patients, compared to peritoneal dialysis patients, although the difference was not statistically significant. Multiple regression analysis indicated that hemodialysis was a negative predictor of QoL score, compared to peritoneal dialysis. Also, age, male gender, and dialysis duration were negative predictors of QoL score.CONCLUSIONIn the unique culture of Saudi Arabia, peritoneal dialysis patients have better QoL, compared to hemodialysis patients, validating the findings of research reports from other countries.
We conducted this study on 15 chronic haemodialysis patients to evaluate the efficacy of i.v. calcitriol over a 1-year period in the treatment of severe secondary hyperparathyroidism (HPT), in particular its effect on bone mineral density (BMD) and parathyroid gland mass. Mean age was 39 ± 11.9 (20-65) years and dialysis duration was 58 ± 3 (19-130) months, i.v. calcitriol was given at a dose of 1 µg post-dialysis 3 times/week for 3 weeks; the dose was then adjusted to maintain the total serum calcium at less than 2.88 mmol/l. The maximum dose was 3 µg 3 times/week. Serum calcium (Ca) and phosphorus (P) were determined prior to treatment, then weekly for 6 weeks and every 2 weeks thereafter. Skeletal survey, dual photon densitometry and parathyroid ultrasound (US) were done prior to treatment and after 1 year. Bone biopsy was done in 10 patients at the beginning of treatment. There was a significant reduction (p < 0.01) in pre-treatment mid-region serum parathyroid hormone (PTH) from 1,476 ± 895 to 489 ± 485 P mol/l, as well as alkaline phosphatase (p < 0.04) from 236.5 ± 221 to 116.3 ± 49 U/l. This was without a significant increase in serum Ca (2.15 ± 0.25 to 2.44 ± 0.26 mmol/l, p = 0.08). Three patients had recurrent hypercalcaemia which responded to reduction of Ca in dialysate. There was a significant increase in BMD over the spine from 1.071 ± 0.25 to 1.159 ± 0.22 g/cm2 (p < 0.003) with a percent increase of 9.3 ± 8.9% as well as over the femoral neck from 0.834 ± 0.002 to 0.89 ± 0.09 g/ cm2 (p < 0.001) with a percent increase of 7.45 ± 6.81%. Five patients had enlarged parathyroid glands by US and in 3 of these, there was a significant reduction to normal with treatment. Bone biopsy was done in 10 patients. Six patients had predominant hyperparathyroid bone disease and 4 had mixed uraemic osteodystrophy. In conclusion, long-term i.v. treatment with calcitriol is effective in the treatment of severe secondary HPT. PTH decreased without a significant increase in serum Ca. BMD also increases during this therapy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.