Give In Honor. Kidney disease itself is often invisible until the late stages; once it progresses to kidney failure, patients need dialysis or a transplant to live. People living with kidney disease and kidney failure tell us they often feel that others do not understand what they are going through, both physically and emotionally.
Several common themes emerged. Here are the four things kidney patients most wish others would understand. And I think my family and friends get tired of hearing that. Those who agreed to answer and participate were given the questions. The exclusion criteria were as follows: a pregnancy, b presence of malignancy, c undergoing fracture treatment, and d serious mobility or eye problems.
The study was conducted from June to November The Open University of Japan ethics committees approved the study protocol approval number 8. A text-based description of the research and consent form were distributed to the six dialysis-related facilities. After being informed about the purpose of the research, patients gave their written consent.
They were also informed that their participation was voluntary. The study participants completed four sets of fatigue assessment tools: the newly developed PDF scale, recovery time, visual analog scale VAS , and the fatigue scale.
The score was reversed for the analysis. The fatigue scale used 8 out of the 64 items of the questionnaire developed by Koyama [ 9 ]. In order to evaluate whether or not PDF affects dialysis treatment, we used several indicators, as described in this section [ 1 ].
The serum albumin level was used in this study because it has been reported to affect fatigue levels [ 8 ].. C-reactive protein was used because the inflammatory response may be involved in PDF [ 7 ]. Hemoglobin was used because of a report that it is related to feelings of exhaustion [ 14 ]. Since fatigue symptoms affect the nutritional status, we used the normalized protein catabolic rate nPCR [ 16 ], which is important as a nutritional assessment and prognostic factor [ 5 ]. In addition, we used the geriatric nutritional risk index GNRI , which is the nutritional disorder risk standard of dialysis patients [ 18 ].
Continuous variables were presented as the mean standard deviation , and values not following a normal distribution were presented as the median first quartile, third quartile. Recovery time was examined by logarithm log-recovery time. In the binomial logistic regression analysis with SRH as the objective variable, model 1 included the age, gender, complications of diabetes, cardiovascular disease, fatigue from pre-dialysis, and physical functioning. In model 2, the PDF scale score was input into model 1.
Analyses were performed on a personal computer using the JMP software program, ver. The patients were The clinical characteristics of the patients are presented in Table 1. We did not recognize a ceiling or floor effect for any of the 14 items. The items were calculated using a principal factor analysis with promax rotation. One factor was calculated as a result of a principal factor analysis with promax rotation cumulative contribution rate; The correlation among the PDF scale, log-recovery time, VAS, fatigue scale, and each parameter was adjusted for age and gender.
Table 5 shows the results of the logistic regression analysis with SRH as the response variable. The PDF scale score odds ratio 1.
We developed a new scale for directly measuring PDF of hemodialysis patients and examined the reliability and validity. Our attempts to develop a scale for directly measuring PDF produced a sufficiently clinically applicable scale. Since there are no international guidelines on the PDF definition and measurement methods, we developed our new scale to directly PDF. Therefore, the contents defined in the present study were considered to be reasonable. Higher PDF scale and fatigue scale scores were associated with fatigue already present before dialysis.
The presence of fatigue from before dialysis started was considered to reflect not only PDF but also chronic fatigue. Although a previous study stated that fatigue can be expected to improve due to an increase in the hemoglobin value [ 14 ], we did not observe this in the present study. There were also no significant correlations between the PDF scale and intradialytic weight loss.
Patients with excessive intradialytic weight gain tend to receive a higher ultrafiltration rate [ 19 ]. In a previous study, a longer recovery time was associated with a greater intradialytic weight loss [ 15 ], suggesting that the ultrafiltration volume may play a role in causing PDF.
In addition, self-reported fatigue was associated with a particularly low mean arterial blood pressure post-dialysis [ 20 ]. It was intended for outpatients, it may have selected a high-quality patient.
Therefore, it is necessary to consider that the dry weights are appropriate. A high value on the PDF scale reflected a reduced physical functioning.
This result was similar to that reported by Lindsay et al. PDF was thought to influence the physical functioning of hemodialysis patients, even after adjusting for age and gender. A high value on the PDF scale was shown to be associated with worse chronic kidney disease-related symptoms, SRH, and life satisfaction.
Based on the present findings, PDF was suggested to be an important factor influencing various symptoms as well as the SRH and life satisfaction in hemodialysis patients. In addition, a high value on the PDF scale was shown to be associated with a reduced physical functioning, exacerbated chronic kidney disease-related symptoms, and a poor life satisfaction. It has been reported that the nutritional indicators of nPCR and serum albumin are associated with patient mortality risk [ 21 , 22 ].
Treating depressive symptoms has been reported to improve the nPCR and serum albumin levels [ 23 ]. However, the present study did not consider the mental factors of patients, so a future study will need to evaluate the mental health of subjects.
Nevertheless, the present findings indicate that the PDF scale has high construct validity. In previous studies, the recovery time was reportedly longer for patients with a poor quality of life than in those with a good quality of life [ 8 , 24 ]. Fatigue negatively impacts the health-related quality of life and is associated with both increased morbidity and mortality in patients suffering from many chronic illnesses [ 20 ]. However, only a few studies have been specifically designed and conducted to evaluate treatments for PDF.
Proposed treatment methods include managing the sodium concentration [ 15 ], delivering low-temperature dialysate [ 25 ], and encouraging walking [ 26 ] and exercise [ 27 , 28 ]. These small studies were not prospective, randomized, or controlled. The causes and pathogenesis of PDF are unclear at present.
However, since PDF is a risk factor influencing the quality of life and mortality expectancy, it must be dealt with promptly. PDF is suggested to influence the physical health of hemodialysis patients and is an important factor that must be considered in patient care.
First, this study involved a small number of subjects. Second, the patient population was restricted to those in the southwestern part of Saitama Prefecture.
Third, this study was intended for outpatients, it may have selected a high-quality patient. Fourth, this study design was cross-sectional. In the future, it will be necessary to expand and investigate more patients from other regions. Therefore, we should conduct follow-up surveys and assess the predictive validity and test-retest reliability. But in the early days of dialysis the early s , most people learned to do their own dialysis at home.
Decades later, some of those people are still doing well — in part, because they learned their job on dialysis. To do well on dialysis, your job is to become your own expert. You should learn to take care of yourself and maintain your own safety. While an at-home treatment will allow you to control your schedule, making it easier to keep a job and health insurance, you'll still have to do your job if you choose in-center hemodialysis.
Above all, your job is to use dialysis to make the most of your life, by resuming your normal activities or even starting new ones.
Get an overview about different dialysis treatments and how they help people continue a productive life. From tips to helping set up treatments when you travel, DaVita has resources to keep you on the move.
Download Now. How Will I Feel on Dialysis? Does dialysis hurt? Will I feel better after I start dialysis? Could my health get worse if I start dialysis? How do I know if I am getting enough dialysis? Some signs that you may not be getting enough dialysis include: Feeling weak and tired all the time A poor appetite, nausea or weight loss An ammonia taste in your mouth Yellow skin If you are not getting enough dialysis, ask your doctor if you should have your dose of dialysis increased.
Follow your diet and fluid limits Take your medicines Get regular exercise Take care of your access Do as much for yourself as you can, such as weighing in before hemodialysis, or learning to do your own needle sticks Get every minute of treatment you are prescribed Above all, your job is to use dialysis to make the most of your life, by resuming your normal activities or even starting new ones.
Share Print. Dialysis Treatments Get an overview about different dialysis treatments and how they help people continue a productive life.
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