Al wakeel J, Bayoumi M, Al Ghonaim M, Al Harbi A, Al Swaida A, Mashraqy A.

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Presentation transcript:

Al wakeel J, Bayoumi M, Al Ghonaim M, Al Harbi A, Al Swaida A, Mashraqy A.

End stage renal disease (ESRD) is a progressive irreversible deterioration in renal function in which the body’s ability to maintain metabolic and fluid electrolyte balance fails, resulting in uremia.

The condition may be caused by systemic diseases such as diabetes mellitus (leading cause), hypertension, chronic glomerulonephritis, pyelonephritis, obstruction of the urinary tract, heredity lesions as in polycystic kidney disease, vascular disorders, infections, medication, or toxic agents.

Hemodialysis (HD) and peritoneal dialysis (PD) are important renal replacement therapy in end stage renal disease (ESRD). It is worth noting that ESRD is a disease with serious effects on the patients' QoL, negatively affecting their social, financial and psychological well-being.

Regarding relevant research, renal patients undergoing HD or CAPD/PD treatment were found to experience QoL deficits.

Patients' quality of life is determined by their subjective interpretation of their losses and gains in the process of being ill.

Health related quality of life is a multidimensional concept that includes physical functioning, social and role functioning, mental health, and general health perceptions.

WHO has defined "QOL" as "individual’s perceptions of their position in life in the context of the culture and value systems where they live and in relation to their goals, expectations, standards and concerns”.

QoL decline over time, with the perception of the quality of physical health deteriorating more than mental health, however many patients continue to feel hopeless, anxious, and worry about finances, loss of sexual function, family burden, and loss of independence.

The reported annual incidence of end-stage renal disease in Saudi Arabia is 100 to 120 patients per million population (Shaheen & Souqiyyeh; 2004). The recent statistics for The saudi organ transplant center the total number for patients with ESRD more than 9500 on HD and 900 on PD. Assessment of quality of life is still a developing area of clinical research, with researchers continuing to refine the concept. Introduction

Recently, it has been recognized that patients’ quality of life and patient satisfaction with care are important domains that need to be understood better and addressed more fully.

Compare The Quality Of Life Between Hemodialysis And Peritoneal Dialysis Patients. AIM of the STUDY

RESEARCH DESIGN A cross-sectional descriptive design. SETTING king Khalid university hospital in dialysis unit, King Saud university, and security forces hospital in dialysis unit

All patient on hemodialysis and peritoneal dialysis in the aforementioned setting. Their total number was 100 patients on HD and 100 on PD. Age above 18 years old, both sex. Patients were excluded from the study if they had neurological illness.

An interview form was prepared and included two sections. The first was concerned with patient’s basic demographic data, as well as the main caregiver, and dialysis duration. The second section consisted of the Kidney Disease Quality of Life scale short form - KDQOL-SFTM-1.3 (Hays et al, 1994).

The KDQOL includes 36 items are categorized into six domains, namely: General health, Physical, Emotional, Social status, Illness impact, and Medical & Financial satisfaction. The scoring of the tool responses was done according to the guidelines of the KDQOL-SF TM (Hays et al, 1997). The scoring direction was done so that higher scores indicate better QoL.

Socio-demographic characteristics

R-square=0.40 Model ANOVA: F=34.25, p<0.001 Variables excluded by model: education, marital status, job status Best fitting linear regression model for the scores of quality of life of hemodialysis and peritoneal dialysis patients

Hemodialysis is a negative predictor of QoL score compared to peritoneal dialysis. A negative predictors effect of QoL score are age, sex, dialysis duration. Also male sex is a negative predictor, compared to female sex. Peritoneal dialysis patients more satisfied financial and with medical care compared to hemodialysis patients.

Patient QoL should be the main objective for doctors and nurses during care of dialysis patients. Develop Educational program for dialysis patient to improve all aspects of quality of life.

A family member or significant other should attend the educational program sessions to help dialysis patients to cope. A simple manual of guidelines of care for patients undergoing hemodialysis and peritoneal dialysis should be made available in all units and provided to newly admitted patients.

Design exercise program for both hemodialyis and peritoneal therapy to improve physical QoL. Further research is suggested to assess the effect on the QoL of children and adolescents.