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BackgroundHealth-related quality of life is a crucial outcome for the chronic kidney disease population, the Kidney Disease Quality of Life (KDQOL) questionnaire is commonly used as an integral part of clinical evaluations. The abbreviated version of the KDQOL-36™ has been translated into Mandarin Chinese, but has not been tested for use in the Chinese patients. The aim of the study was to evaluate the validity and reliability of the KDQOL-36™ with a sample of Chinese patients.MethodsThe Mandarin Chinese version of the KDQOL-36™ has been translated by Amgen, Inc. and the MAPI Institution following the instrument translation specifications provided by the RAND health. The translated instrument was further reviewed by a Chinese expert panel for content validity and translational equivalence. The KDQOL-36™ along with Beck depression Inventory-II were administrated to 103 chronic renal disease patients recruited through convenience sampling procedure from the renal wards and an outpatient dialysis clinic. The convergent validity was determined through investigating the correlational evidence of the KDQOL-36™ with the Beck depression Inventory-II and the overall health rating. Known-group validity was supported by the evidence that the instrument could differentiate subgroups of patients. The internal consistency was estimated using Cronbach’s α and test-retest reliability was examined using an intraclass correlation coefficient.ResultsFor the convergent validity, there were positive correlations between the overall health rating and most of the KDQOL-36™ subscales, and the Beck depression inventory score was inversely correlated with the mental component summary score and disease-specific scores of the scale. Significant correlations were noted between disease-targeted and generic dimensions of the KDQOL-36™. The results of the known-group comparisons indicated females, the unemployed, and patients had a longer dialysis history reported a worse quality of life. With regard to the reliability, the Cronbach’s alpha ranged from 0.69 to 0.78, and the intraclass correlation test-retest was higher than 0.70.ConclusionsThe Mandarin Chinese version of the KDQOL-36™ is a brief, valid, and reliable instrument for use in examining the quality of life of chronic kidney disease patients in China.

SUMMARY Background Most elderly people undergoing peritoneal dialysis (PD) treatment have a high incidence of frailty, cognitive impairment and emotional disturbance leading to a significant impact on families. The burden experienced by the family caregivers could affect their physical and emotion health. The objective of this study was to examine the level of burden on family caregivers of elderly adults receiving PD and to identify any contributing factors. Materials and Methods This was a cross‐sectional study employing convenience sampling. Patient–caregiver dyads were recruited from the outpatient clinic of a university hospital in China in 2019. Caregivers provided information on their perceived burden and health‐related quality of life. The elderly patients reported their functional dependence and depressive symptoms in the same interview. Linear regression analyses were used to determine the factors contributing to caregivers’ burden. Results Sixty patient–caregiver dyads were recruited. The patients had a mean age of 70.7 ± 7.4 years. The caregivers reported moderate levels of burden having ZBI score of 30.5 ± 15.9. Multivariate analyses showed that being female, perceiving one's financial status as insufficient, a low level of social support for the caregiver, depressive symptoms in the patients and disability in carrying out the instrumental activities of daily life were statistically significant predictors of caregiver burden (adjusted R2 = 0.46, p < 0.001). Conclusion Elderly adults receiving PD who experience physical dependence and depressive symptoms are a burden for caregivers. In response to this challenge, interventions designed with the goal of supporting the emotional and mental wellbeing of caregivers are warranted.

Background: Body composition monitoring is the only clinically available method for distinguishing among the three body components. This study aimed to determine the relationship between body composition and all-cause mortality in Chinese hemodialysis patients and examine whether the lean tissue index (LTI) derived from body composition monitoring can accurately diagnose malnourished patients. Methods: Hemodialysis patients (n ¼ 123) with nutritional and body composition assessment records in 2015 were examined. Body composition was assessed using a body composition monitor machine. Results: Fifty-seven patients (46.3%) had low LTI (LTI less than the 10th percentile of the respective normal distribution). Significant differences in the fat tissue index (FTI) were observed, with the low LTI group having a higher FTI (10.8 kg/m 2 vs. 9.0 kg/m 2 , p¼ .007). The kappa coefficient of agreement between LTI and subjective global assessment (SGA) was 0.26 for the presence of malnutrition. During the mean observation period of 26.7 months, 20 of 123 (16.3%) patients died. Low LTI remained highly predictive of survival in the Cox regression analysis (hazard ratio: 3.24, 95% confidence interval 1.06-9.91, p¼ .04). Malnourishment defined by SGA predicted survival in the Kaplan-Meier analysis (log-rank v 2 ¼4.05; p¼ .04) but not in the multivariate analysis. Conclusions: LTI is a predictor of mortality, and its predictive power was not affected when FTI, SGA, and hydration status were included in the multivariate analysis. However, SGA may not be adequate to identify patients at a risk of death among Chinese hemodialysis patients.

Physical exercise in a clinical arena should not be considered the exclusive domain of physical therapists; the team could collaborate with nurses to play a core role in making physical exercise for patients an essential practice of care in a multidisciplinary team.