Poor sleep and reduced quality of life were associated with symptom distress in patients receiving maintenance hemodialysis

Abstract

BackgroundThe quality of life in patients receiving chronic hemodialysis is compromised despite of the substantial achievements in treatments. Quality of life in hemodialysis patients have been shown to be associated with decreased survival and increased hospitalization. Therefore, it is necessary to incorporate the managements of symptoms and patient self-perceived well-being as measurements of effective treatments for these patients.MethodsA survey of symptom distress, quality of sleep and quality of life was performed in 301 maintenance hemodialysis patients using Dialysis Symptom Index, Short Form-36, and Pittsburgh Quality of Sleep Index table. Patients were recruited from five hospitals in Guangdong area of China by convenience sampling.ResultsThe prevalence of various symptoms in maintenance hemodialysis patients was between 23.3 and 80.4 %. These patients had compromised sleep and poor quality of life. Moreover, poor quality of sleep and impaired quality of life were associated with high symptom burden of these patients.ConclusionThe patients receiving chronic hemodialysis generally have heavy symptom distress, which could contribute to the disturbed sleep and impaired quality of life of these patients. Measurements of clinical outcomes for hemodialysis patients should include the management of symptoms and morbidity. The ultimate goal of treatments is to improve patient self-perceived quality of life.

Lower urinary tract symptoms impair the quality of life in maintenance hemodialysis patients

“…This seems to be related to the fact that there were no significant differences between the two groups in the other three domains. However, the five domains are closely related to representative factors that impair the QOL of MHD patients, such as nighttime waking, deciding behavioral desire, and mental instability [1][2][3]. Therefore, LUTS should be recognized as an important QOL disease in MHD patients same as the general population.…”

“…Approximately 45% of MHD patients experience sleep disorders, and 90% of the reported disorders are nighttime waking [1][2][3][8][9][10][11][12][13][14][15][16][17][18][19][20]. Sleep disorders have been linked to decreased survival, perceived decrease of health-related QOL, and poor adherence to hemodialysis [18][19][20].…”

“…It is very important to evaluate LUTS as a cause of sleep disorder in MHD patients and to consider whether their sleep disorders might be improved by urological interventions. QOL improvement would be expected to directly improve both adherence to treatment and the survival of MHD patients [1][2][3][18][19][20]. MHD patients with perceived problems of daily living may experience feelings of depression, unstable behavior, or insomnia [1][2][3][18][19][20].…”

“…Improvement in the quality of life (QOL) of maintenance hemodialysis (MHD) patients is important because poor QOL correlates with mortality and poor adherence to hemodialysis [1][2][3]. In particular, nighttime waking, declining behavioral desire, and mental instability are reported as representative poor QOL in MHD patients [1][2][3].…”

“…Improvement in the quality of life (QOL) of maintenance hemodialysis (MHD) patients is important because poor QOL correlates with mortality and poor adherence to hemodialysis [1][2][3]. In particular, nighttime waking, declining behavioral desire, and mental instability are reported as representative poor QOL in MHD patients [1][2][3]. As a cause of these, uremic toxin such as creatinine, inflammatory substances such as C-reactive protein (CRP) and interleukin-6 (IL-6), anemia, and intact parathyroid hormone (iPTH) have been reported [1][2][3], but the cause is still unknown.…”