The Influence of an Unexpected Switch of Hemodialysis Facilities on the Quality of Life (QOL) in Hemodialysis Patients

Abstract

Yoshio Shimizu,1,2 Keiichi Wakabayashi,1 Junichiro Nakata,3 Hiroaki Io,4 Chieko Hamada,5 Yasuhiko Tomino,6 Yusuke Suzuki3 1Department of Nephrology, Juntendo University Shizuoka Hospital, Izunokuni-shi, 410-2211, Japan; 2Shizuoka Medical Research Center for Disaster, Izunokuni-shi, 410-2211, Japan; 3Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, 113-8421, Japan; 4Division of Nephrology, Juntendo University Nerima Hospital, Tokyo, 117-8521, Japan; 5Juntendo University Faculty of Health Sciences and Nursing, Mishima-shi, 411-8787, Japan; 6Asian Pacific Renal Research Promotion Office, Medical Corporation SHOWAKI, Tokyo, 160-0023, JapanCorrespondence: Yoshio Shimizu, Division of Nephrology, Department of Internal Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni-shi, Shizuoka, 410-2211, Japan, Tel [phone], Fax [phone], Email [email protected]: We experienced a sudden breakdown of hemodialysis system during a clinical study of dermal itch and serum BNP concentrations.Patients and Methods: Forty-eight hemodialysis patients were enrolled in the itch-related study. It was intended to improve itch by lowering BNP with supportive communication between the patients and the dialysis staff. We planned to collect data, including visual analogue scale (VAS), dermatology life quality index (DLQI), blood samples and QOL score (KDQOL-SF), four times over a four week interval. The first data was obtained just prior to switching facilities due to a breakdown. The patients underwent hemodialysis in other facilities for two weeks and underwent determination of their clinical data, including QOL scores, three times.Results: While mean blood pressure showed no significant differences, serum albumin, iron and phosphate levels were worsened significantly between pre- and post-relocation. Serum BNP and DLQI showed no significant changes. VAS was significantly worsened. The mean values of the cognitive function in the KDQOL-SF and sleep and the role-physical, role-emotional, social function, dialysis staff’s encouragement in SF-36 analysis were identified as statistically significant items by MANOVA. Both SF-12 physical and mental composites were also statistically significant. Although SF-12 physical composites were significant among the patients under 66 yrs of age (median), eight factors were significant among those over 66 yrs. Independent analyses revealed every item that was detected worsened significantly after the switch of facilities.Conclusion: Unexpected switching of hemodialysis facilities severely impacts the QOL for a long duration as well as the patients’ symptom and laboratory data.Keywords: KDQOL-SF, switch of hemodialysis facilities, dermal itch

Keywords

• kdqol-sf
• switch of hemodialysis facilities
• dermal itch