QUALITY OF LIFE OF PATIENTS WITH DIABETIC NEPHROPATHY AND CALCIFICATION OF HEART VALVES RECEIVING HEMODIALYSIS
DOI:
https://doi.org/10.11603/1811-2471.2022.v.i1.12985Keywords:
hemodialysis, diabetic nephropathy, quality of life, calcification of heart valvesAbstract
SUMMARY. The aim – to examine the impact of diabetic nephropathy (DN) on the quality of life (QOL) of patients treated with programmed hemodialysis (HD) and to establish relationships between calcification of the heart valves and QOL in cohorts of HD patients with diabetes mellitus (DM).
Material and Methods. The study included 136 patients with chronic kidney disease of the VD stage who received HD (age of patients – 53.9±1.0 years; men – 78; duration of HD – 47.6±4.2 months). Clinical, demographic and instrumental data were evaluated. Calcification of the heart valves was verified by ultrasound examination. A QOL assessment questionnaire (KDQOL-SF ™ 1.3) was used to evaluate the quality of life (QOL).
Results. All HD patients were divided into two groups: group 1 – patients withuot DN (n = 88); group 2 – patients with DN (n = 48). It was found that patients with diabetes were more often diagnosed with coronary heart disease (1.5 times), heart failure (1.54 times), arrhythmias (1.75 times). The prevalence of calcification of the heart valves was higher (66.6 vs. 38.6 %, p = 0.002) in patients with DN compering with patients without diabetes. Analysis of QOL questionnaires (KDQOL-SF ™ 1.3) showed significantly lower QOL rates in patients with diabetes compared with patients without diabetes on scales such as disease symptoms, consequences of kidney disease, burden of kidney disease, work, sleep, general well-being, physical functioning, role functioning due to physical condition, body pain, general health, emotional well-being, role functioning emotional state, social function, energy / fatigue, sf-12 physical component, sf-12 emotional component. Correlations were found between the presence of calcification of the heart valves and QOL in both groups of patients with DN (Rs = -0.31-0.67) and without DN (Rs = -0.23-0.67), which received HD, and a significant associative relationship between the frequency of combined calcification of the heart valves and QOL indicators, in particular general well-being, emotional well-being, sleep, social support, were found only in people without diabetes.
Conclusion. DN reduces QOL of patients treated with HD. Calcification of the heart valves in patients with diabetes mellitus doesn`t have a huge impact on QOL, but significantly worsens its manifestations.
References
Allon, M. (2013). Evidence-based cardiology in hemodialysis patients. Journal of the American Society of Nephrology, 24(12), 1934-1943. DOI: 10.1681/asn.2013060632.
Krasniak, A., Drozdz, M., Pasowicz, M., Chmiel, G., Michalek, M., Szumilak, D., … & Sulowicz, W. (2006). Factors involved in vascular calcification and atherosclerosis in maintenance haemodialysis patients. Nephrology Dialysis Transplantation, 22(2), 515-521. DOI: 10.1093/ndt/gfl564.
de Jager, D.J. Grootendorst, D.C., & Jager, K.J. (2009). Cardiovascular and noncardiovascular mortality among patients starting dialysis. JAMA, 302(16), 1782. DOI: 10.1001/jama.2009.1488.
Cherney, D.Z.I., Repetto, E., Wheeler, D.C., Arnold, S.V., MacLachlan, S., Hunt, … & Kosiborod, M. (2019). Impact of cardio-renal-metabolic comorbidities on cardiovascular outcomes and mortality in type 2 diabetes mellitus. American Journal of Nephrology, 51(1), 74-82. DOI: 10.1159/000504558.
Bossola, M., Pepe, G., & Marzetti, E. (2017). Health-related quality of life of patients on chronic dialysis: The need for a focused effort. Seminars in Dialysis, 30(5), 413-416. DOI: 10.1111/sdi.12620.
Perl, J., Karaboyas, A., Morgenstern, H., Sen, A., Rayner, H.C., Vanholder, R.C., … & Tentori, F. (2016). Association between changes in quality of life and mortality in hemodialysis patients: Results from the Dopps. Nephrology Dialysis Transplantation. DOI: 10.1093/ndt/gfw233.
Khatib, S.T., Hemadneh, M.K., Hasan, S.A., Khazneh, E., & Zyoud, S.H. (2018). Quality of life in hemodialysis diabetic patients: A Multicenter cross-sectional study from Palestine. BMC Nephrology, 19(1). DOI: 10.1186/s12882-018-0849-x.
Barbosa, J.B., Moura, E.C., Lira, C.L., & Marinho, P.É. (2017). Quality of life and duration of hemodialysis in patients with chronic kidney disease (CKD): A cross-sectional study. Fisioterapia Em Movimento, 30(4), 781-788. DOI: 10.1590/1980-5918.030.004.ao13.
Al Salmi, I., Kamble, P., Lazarus, E.R., D’Souza, M.S., Al Maimani, Y., & Hannawi, S. (2021). Kidney disease-specific quality of life among patients on Hemodialysis. International Journal of Nephrology, 1-8. DOI: 10.1155/2021/8876559.
Sørensen, V.R., Mathiesen, E.R., Watt, T., Bjorner, J.B., Andersen, M.V., & Feldt-Rasmussen, B. (2007). Diabetic patients treated with dialysis: Complications and quality of life. Diabetologia, 50(11), 2254-2262. DOI: 10.1007/s00125-007-0810-1.
Gumprecht, J., Żelobowska, K., Gosek, K., Żywiec, J., Adamski, M., & Grzeszczak, W. (2009). Quality of life among diabetic and non-diabetic patients on maintenance haemodialysis. Experimental and Clinical Endocrinology & Diabetes, 118(03), 205-208. DOI: 10.1055/ s-0029-1192023.
Susla, O.B., Litovkina, Z.I., & Bushtynska, O.V. (2019). Strukturno-funktsionalni zminy sertsia u khvorukh na diabrtuchnu nefropatiiu,yaki perebuvaiut na khronichnomu hemodializi [Structural and functional changes of the heart in patients with diabetic nephropathy undergoing hemodialysis] Ukrainskyi zhurnal nefrolohii dializu – Ukrainian Journal of Nephrology and Dialysis, 4(64), 39-48. DOI: 10.31450/ukrjnd.4(64).2019.06 [in Ukrainian].
Ureña-Torres, P., D’Marco, L., Raggi, P., García–Moll, X., Brandenburg, V., Mazzaferro, S., & Bover, J. (2019). Valvular heart disease and calcification in CKD: More common than appreciated. Nephrology Dialysis Transplantation, 35(12), 2046-2053. DOI: 10.1093/ndt/gfz133.
Lopez Revuelta, K., Garcia Lopez, F.J., de Alvaro Moreno, F., & Alonso, J. (2004). Perceived Mental Health at the start of dialysis as a predictor of morbidity and mortality in patients with end-stage renal disease (Calvidia Study). Nephrology Dialysis Transplantation, 19(9), 2347-2353. DOI: 10.1093/ndt/gfh392.
Grincenkov, F.R., Fernandes, N., Pereira, B. dos Bastos, K., Lopes, A.A., Finkelstein, F. O., … & Bastos, M.G. (2015). Impact of baseline health-related quality of life scores on survival of incident patients on peritoneal dialysis: A cohort study. Nephron, 129(2), 97-103. DOI: 10.1159/000369139.
van Loon, I.N., Bots, M.L., Boereboom, F.T., Grooteman, M.P., Blankestijn, P.J., van den Dorpel, … & Hamaker, M.E. (2017). Quality of life as indicator of poor outcome in hemodialysis: Relation with mortality in different age groups. BMC Nephrology, 18(1). DOI: 10.1186/s12882-017-0621-7.
Maung, S.C., Sara, A.E., Chapman, C., Cohen, D., & Cukor, D. (2016). Sleep disorders and chronic kidney disease. World Journal of Nephrology, 5(3), 224. DOI: 10.5527/wjn.v5.i3.224.
Østhus, T.B., von der Lippe, N., Ribu, L., Rustøen, T., Leivestad, T., Dammen, T., & Os, I. (2012). Health-related quality of life and all-cause mortality in patients with diabetes on dialysis. BMC Nephrology, 13(1). DOI: 10.1186/1471-2369-13-78.
Kozlyuk, N.I., & Razvazhayeva, O.O. (2020). Nacionalnyi reyestr khvorykh na khronichnu khvorobu nyrok ta paciyentiv z hostrym poshkodzhennyam nyrok [National Register of Chronic Kidney Disease Patients and Patients with Acute Kidney Damage] – Kyiv, Derzhavna ustanova «Instytut nefrologiyi NAMN Ukrayiny» [in Ukrainian].
Susla, O., Litovkina, Z., & Yakubyshyna, I. (2020). Experience of magnesium and l-carnitine combine use for correction of structural and functional heart changes in type 2 diabetic patients with end-stage kidney disease. Journal of Education, Health and Sport, 10(12), 286-303. DOI: 10.12775/jehs.2020.10.12.029.
Susla, O.B. Kliniko-patohenetychne obhruntuvannya shlyakhiv optymizatsiyi diagnostyky, likuvannya i profilaktyky kaltsyfikatsiyi sercevo-sudynnoyi systemy u khvorykh na khronichnu khvorobu nyrok : dys. doktora med. nauk [Clinical and pathogenetic substantiation of ways to optimize the diagnosis, treatment and prevention of calcification of the cardiovascular system in patients with chronic kidney disease: dis. for the degree of Dr. Med. Science]. Ternopil [in Ukrainian].
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