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 frequency of hepatitis-C in dialysis patients at start of hemodialysis, seroconversion from HCV negative to HCV positive over study duration and factors affecting seroconversion. Methods: This descriptive prospective observational study done in dialysis center of DHQ hospital Sheikhupura, Punjab, Pakistan. The study was conducted from October 2016 to October 2017. Data was collected on Performa and later followed prospectively in same cohort of patients. All the patients on maintenance hemodialysis for more than one month were included in the study. Patients with acute kidney disease and on dialysis less than one month were excluded. Patients were analyzed by dividing them in three groups, group-I patients who were HCV positive at start of dialysis, Group-II who were negative and seroconvert to HCV positive, Group-III who were negative and remained negative. All seronegative patients were followed at one, three, six and twelfth months on being hemodialysis for seroconversion. Results: Out of 230 surveyed patients 52 were HCV positive at start of dialysis and 19 were loss of follow up. Out of remaining 159 HCV negative patients 95 became HCV positive, only 64 patients remained HCV negative by end of study. Conclusion: Frequency of HCV seroconversion among chronic hemodialysis patient is found to be 53.37%. Arteriovenous access, number of dialysis, reuse of dialyzer and blood transfusions are important risk factors. How to cite this:Hussain Y, Shahzad A, Azam S, Munawar N. Hepatitis-C and it’s seroconversion in end stage kidney disease patients on maintenance hemodialysis and factors affecting it. Pak J Med Sci. 2019;35(1):66-70. doi: https://doi.org/10.12669/pjms.35.1.366 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
There is no difference on the outcome of dialysis patients on the basis referral to nephrologist. Factors affecting overall mortality in both groups were financial status, metabolic acidosis, and temporary access for dialysis. Most of the patients were referred late to the nephrologists.
Haemodialysis (HD) is one of the most common type of renal replacement therapy (RRT) used for end stage kidney disease (ESKD). Hepatitis-C is the most frequent infection in haemodialysis. Early detection of this viral infection can lead to early treatment, lesser morbidity and mortality. PCR test is being used instead of Elisa in centres where HCV infection is more prevalent as PCR for HCV RNA is considered more reliable than Eliza in haemodialysis patients. Objective: To assess the accuracy of Eliza and PCR method for the detection of Hepatitis-C viral infection in haemodialysis patients. Study design: Cross-sectional Study. Settings: Dialysis centre of DHQ hospital Sheikhupura, Punjab, Pakistan in January 2018. Materials and Methods: All patients who were on maintenance haemodialysis for more than six months were included in the study. Patients with acute kidney disease and on dialysis less than six months were excluded. All patients were tested by enzymes linked immune-sorbent essay (ELIZA) and polymerase chain reaction (PCR) method for HCV status. Results: Out of 152 haemodialysis patients tested, 94 (61.84%) cases were positive by both ELIZA and PCR methods while 6 (3.94%) cases with negative ELIZA were PCR positive. Number of dialysis, blood transfusions and serology were important risk factors with significant p value. (<0.05) Conclusion: In centres where Hepatitis-C is more prevalent, PCR for HCV RNA should be preferred over ELIZA method for early detection of HCV viral infection.
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