Objective: The objective of the study was to determine the demographic factors affecting Quality Of Life (QOL) of hemodialysis (HD) patients. Methods: This observational study was conducted at Shalamar Hospital, Lahore. Patients of End Stage Renal Disease (ESRD) and on maintenance HD for more than three months were included during the period March to June 2012. Patient of ESRD not on dialysis and Acute Renal Failure were excluded. One hundred and twenty five patients who fulfilled the criteria were included. Demographic data containing age, sex, residence, socio economic status, education, mode of traveling for dialysis, total time consumed in dialysis were collected by the investigators. QOL index was measured using 26 items, WHO QOL BREF. Results: There were 89(71.2%) male and 36(28.8%) female patients. Environmental domain score was highest (p=0.000) than all other domains in HD Patients. In overall analysis age, marital status and total time consumed in getting HD effect QOL significantly (p=<0.05). In domain wise analysis, male has better QOL in social relationship domain than female. Age has negative relationship with physical health and psychological health domain. QOL of unmarried and literate patients is significantly better (p=<0.05) in physical health domain. Employed patients have better QOL in physical, psychological and social relationship domain (p=<0.05) than unemployed patients. Patients of residence of rural areas have better QOL in physical and environment domain. Financial status of HD patients affect QOL in social domain. Distance covered to reach hospital effect QOL in psychological domain (p=<0.05). Patients traveling in private transport have better QOL in environmental domain (p=<0.05). Total time consumed in getting HD effect social relation in QOL (p=<0.05). According to linear regression model, marital status is positive predictor and unemployment is negative predictor of QOL in physical health domain. Age is negative predictor of QOL in psychological domain, monthly income is positive predictor of QOL in domain. Unemployment is positive predictor of QOL in social relation domain. Monthly income and place of residence is positive predictor of QOL in environment domain. Conclusion: Gender, age, marital status, unemployment, residence of rural area, economical status, distance covered to reach hospital, mode of transport, total time consumed in getting HD, effect QOL in HD patient. Education level is a positive factor for improving QOL of HD patients.
Objective: To determine the efficacy of Hepatitis B vaccination among the candidates of maintenance hemodialysis due to chronic kidney disease and to measure the impact of ageing and Hepatitis C infection upon immune seroconversion. Study Design: Cross-sectional study. Place and Duration of Study: Nephrology Department, Multan Institute of Kidney Diseases (MIKD), Multan Pakistan from Jan to Jun 2020. Methodology: Two hundred male and female patients diagnosed with end-stage kidney disease on maintenance dialysis (more than three months) with the range of age, 15 to 70 years, were selected by non-probability consecutive sampling. Already treated patients of HB virus and those with HB virus detectable by ELISA were excluded from the study. Data was accessed through hospital management software records. Three months after the three or four completed doses, antiHBs titer was assessed by ELISA. Cut off the value of anti-Hbs titer was 10U/L to differentiate between responders and non-responders of HBV. Results: Among the 117 responders, 109 (93%) cases received four double doses of the vaccine, while only 8 (7%) were those who received three double doses. Among 83 non-responders, 52 (63%) were above age 40 years, while 31 (37%) were of age 40 years or below. In addition, among the non-responders, 63 (76%) were Hep C positive, while 20 (24%) were Hep C negative patients. Conclusions: Four double-dose vaccines have been effective for haemodialysis patients with end-stage kidney disease. Vaccine response is inversely correlated with age and Hepatitis C virus.
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