Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T01:58:26.154Z Has data issue: false hasContentIssue false
  • English
  • Français

Identification of palliative care needs in hemodialysis patients: An update

Published online by Cambridge University Press:  02 July 2021

Ylian Serina Liem ,
Inge Eidemak ,
Sille Larsen ,
Per Sjøgren ,
Stig Molsted ,
Jonas Sørensen Open the ORCID record for Jonas Sørensen [Opens in a new window] ,
Louise Laursen  and
Geana Paula Kurita Open the ORCID record for Geana Paula Kurita [Opens in a new window]
Ylian Serina Liem*
Affiliation:
Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Inge Eidemak
Affiliation:
Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Sille Larsen
Affiliation:
Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Per Sjøgren
Affiliation:
Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Stig Molsted
Affiliation:
Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark
Jonas Sørensen
Affiliation:
Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Louise Laursen
Affiliation:
Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Geana Paula Kurita
Affiliation:
Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
*
Author for correspondence: Ylian Serina Liem, Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. E-mail: ylian.serina.liem@regionh.dk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

End-stage kidney disease and hemodialysis (HD) treatment are associated with a high symptom burden in many patients. This study aimed at updating patient-reported outcomes concerning quality of life, fatigue, anxiety, and depression in HD patients treated in a single center in order to assess the need for palliative care provision.

Method

A cross-sectional design, in which a sample of patients treated at a single HD department (Rigshospitalet, Denmark) between January and June 2019, was analyzed using the Kidney Disease Quality of Life Short Form, the Multidimensional Fatigue Inventory, and the Hospital Anxiety and Depression Scale. In addition, we compared the results with previously published data from the same department (2000) and with an age- and sex-matched sample from the Danish general population (1997/2014). Chi-square and t-tests were used for comparisons.

Results

Screened patients = 242, included = 141, analyzed = 131 (70.2% male, mean age = 61.3 years). HD patients reported low scores for quality of life, high scores for fatigue, and approximately 30% had anxiety/depression. Regarding quality of life, they had significantly lower scores on general health (P ≤ 0.000), vitality (P = 0.009), social functioning (P = 0.001), mental health (P = 0.007), and mental component (P = 0.005) compared with former data of HD patients. Moreover, they reported significantly poorer quality of life and worse fatigue compared with the general Danish population.

Significance of results

In the patients undergoing HD, quality of life was poor and worsened when compared with former HD patients’ data. Additionally, fatigue, depression, and anxiety in HD patients were prevalent. A clear need for palliative care provision was observed.

Keywords

DepressionFatigueHemodialysisPalliative careQuality of life
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 4 , August 2022 , pp. 505 - 511
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Artom, M, Moss-Morris, R, Caskey, F, et al. (2014) Fatigue in advanced kidney disease. Kidney International 86, 497–505.CrossRefGoogle ScholarPubMed
Bajwah, S, Oluyase, AO, Yi, D, et al. (2020) The effectiveness and cost-effectiveness of hospital-based specialist palliative care for adults with advanced illness and their caregivers. Cochrane Database of Systematic Reviews 9, CD012780.Google ScholarPubMed
Bjørner, JB, Damsgaard, MT, Watt, T, et al. (1997) Dansk manual til SF-36: et spørgeskema om helbredsstatus. Lif Lægemiddelindustriforeningen.Google Scholar
Boter, H, Mänty, M, Hansen, AM, et al. (2014) Self-reported fatigue and physical function in late mid-life. Journal of Rehabilitation Medicine 46, 684–690.CrossRefGoogle ScholarPubMed
Charlson, ME, Pompei, P, Ales, KL, et al. (1987) A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases 40, 373–383.CrossRefGoogle ScholarPubMed
Davison, SN, Levin, A, Moss, AH, et al. (2015) Kidney disease: Improving global outcomes: Executive summary of the KDIGO controversies conference on supportive care in chronic kidney disease: Developing a roadmap to improving quality care. Kidney International 88, 447–459.CrossRefGoogle ScholarPubMed
Efficace, F, Novik, A, Vignetti, M, et al. (2007) Health-related quality of life and symptom assessment in clinical research of patients with hematologic malignancies: Where are we now and where do we go from here? Haematologica 92, 1596–1598.CrossRefGoogle Scholar
Fleishman, TT, Dreiher, J and Shvartzman, P (2020) Patient-reported outcomes in maintenance hemodialysis: A cross-sectional, multicenter study. Quality of Life Research 29, 2345–2354.CrossRefGoogle ScholarPubMed
Gabbay, E, Meyer, KB, Griffith, JL, et al. (2010) Temporal trends in health-related quality of life among hemodialysis patients in the United States. Clinical Journal of the American Society of Nephrology 5, 261–267.CrossRefGoogle ScholarPubMed
Gelfand, SL, Schell, J and Eneanya, ND (2020) Palliative care in nephrology: The work and the workforce. Advances in Chronic Kidney Disease 27, 350–355.e1.CrossRefGoogle ScholarPubMed
Hansen, MB, Adsersen, M and Grønvold, M (2020) Dansk Palliativ Database: Årsrapport 2019. København: DMCG-PAL. Available at: https://www.sundhed.dk/content/cms/89/38089_endelig19062020aarsrapportdpd2019med3reglen.pdf (accessed 25 March 2021).Google Scholar
Hays, RD, Kallich, JD, Mapes, DL, et al. (1997) Kidney Disease Quality of Life Short Form (KDQOL-SF ™), Version 1.3: A Manual for Use and Scoring. Santa Monica, CA: RAND Corporation. Available at: https://www.rand.org/pubs/papers/P7994.html (accessed 20 April 2021).Google Scholar
Ishiwatari, A, Yamamoto, S, Fukuma, S, et al. (2020) Changes in quality of life in older hemodialysis patients: A cohort study on dialysis outcomes and practice patterns. American Journal of Nephrology 51, 650–658.CrossRefGoogle ScholarPubMed
Jablonski, K and Chonchol, M (2014) Recent advances in the management of hemodialysis patients: A focus on cardiovascular disease. F1000Prime Reports 6, 72.CrossRefGoogle ScholarPubMed
Jhamb, M, Liang, K, Yabes, J, et al. (2013) Prevalence and correlates of fatigue in chronic kidney disease and end-stage renal disease: Are sleep disorders a key to understanding fatigue? American Journal of Nephrology 38, 489–495.CrossRefGoogle ScholarPubMed
Kaasa, S, Loge, JH, Aapro, M, et al. (2018) Integration of oncology and palliative care: A Lancet Oncology Commission. The Lancet. Oncology 19, e588–e653.CrossRefGoogle ScholarPubMed
Knudsen, SDP, Eidemak, I and Molsted, S (2016) Health related quality of life in 2002 and 2015 in patients undergoing hemodialysis: A single center study. Renal Failure 38, 1234–1239.CrossRefGoogle Scholar
Mazairac, AH, de Wit, GA, Penne, EL, et al. (2011) Changes in quality of life over time – Dutch haemodialysis patients and general population compared. Nephrology Dialysis Transplantation 26, 1984–1989.CrossRefGoogle ScholarPubMed
Mollahosseini, A, Abdelrasoul, A and Shoker, A (2020) A critical review of recent advances in hemodialysis membranes hemocompatibility and guidelines for future development. Materials Chemistry and Physics 248, 122911.CrossRefGoogle Scholar
Molsted, S, Aadahl, M, Schou, L, et al. (2004) Self-rated health and employment status in chronic haemodialysis patients. Scandinavian Journal of Urology and Nephrology 38, 174–178.CrossRefGoogle ScholarPubMed
Molsted, S, Heaf, J, Prescott, L, et al. (2005) Reliability testing of the Danish version of the Kidney Disease Quality of Life Short Form. Scandinavian Journal of Urology and Nephrology 39, 498–502.CrossRefGoogle ScholarPubMed
Molsted, S, Prescott, L, Heaf, J, et al. (2007) Assessment and clinical aspects of health-related quality of life in dialysis patients and patients with chronic kidney disease. Nephron Clinical Practice 106, c24–c33.CrossRefGoogle ScholarPubMed
Murtagh, FE, Addington-Hall, J and Higginson, IJ (2007) The prevalence of symptoms in end-stage renal disease: A systematic review. Advances in Chronic Kidney Disease 14, 82–99.CrossRefGoogle ScholarPubMed
Patrick, DL, Ferketich, SL, Frame, PS, et al. (2004) National institutes of health state-of-the-science conference statement: Symptom management in cancer: Pain, depression, and fatigue, July 15–17, 2002. Journal of the National Cancer Institute Monographs 32, 9–16.Google Scholar
Smets, EM, Garssen, B, Bonke, B, et al. (1995) The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research 39, 315–325.CrossRefGoogle ScholarPubMed
Sundhedsstyrelsen (2011) Anbefalinger for den palliative indsats. Available at: https://www.sst.dk/-/media/Udgivelser/2011/Publ2011/SYB/Palliation/Anbefalinger-for-den-palliative-indsats-2011.ashx (accessed 25 March 2021).Google Scholar
United States Renal Data System (2018) 2018 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Available at: https://www.usrds.org/media/1738/v2_c11_intcomp_18_usrds.pdf (accessed 19 April 2021).Google Scholar
United States Renal Data System (2020) 2020 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Available at: https://adr.usrds.org/2020 (accessed 20 April 2021).Google Scholar
Zigmond, AS and Snaith, RP (1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 67, 361–370.CrossRefGoogle ScholarPubMed