الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 126 |  |  |
| | | from | 126 | | |
Abstract
ESRD is an irreversible kidney disease causing a high level of disability in different domains of the patients’ lives and necessitating treatment with dialysis for life or renal transplantation. Hemodialysis alters the life style of the patients and interferes with their lives; the physical, psychological and socioeconomic aspects of life are negatively affected leading to compromised QOL. Measurement of QOL could be a reflection of health status. HR-QOL is becoming an important outcome measure as patients’ perception of their wellbeing and need to be considered for today’s ESRD patients. It has been proven that the patient’s perception is more important than the clinical assessment in determining QOL.
The Kidney Disease Quality of Life (KDQOLTM) instrument was developed for individuals with CKD and on dialysis. It captures their perceptions about concerns of symptoms or problems, effects and burden of kidney disease, work status, sleep and cognitive, social and sexual functions. It also measures additional quality of life scales include: social support, dialysis staff encouragement and patient satisfaction.
The aim of the present work was to compare the quality of life among hemodialysis patients at three dialysis units affiliated to: University dialysis unit as Almoasah dialysis unit, Ministry of health dialysis unit as Sharq Almadinah dialysis unit and Private sector dialysis unit as Alshefaa dialysis unit.
This cross-sectional descriptive study was conducted on adult ESRD patients maintained on regular hemodialysis treatment for ≥3 moths. Exclusion criteria were: malignancy, signs of vascular access infection, occlusion, or steal phenomena, acute conditions as active infection, symptomatizing end stage organ diseases as hepatic insufficiency and heart failure which affect the QOL, serious intellectual impairment (consequent to stroke or related to dementia) and acute medical or surgical conditions that required hospitalization or operation within the prior month.
A validated Arabic form of kidney disease quality of life short form questionnaire was used as a self-report instrument to measure HRQOL. Scores ranging from 0 to 100, as higher scores indicate better QOL.
The study included 300 patients on regular HD, age ranged between 20 to 79 years, 188 of patients were males and 122 of patients were females, 230 of the all studied patients were married and 132 patients were not working.
Laboratory investigations were done and included serum i-PTH, serum creatinine, serum ionized calcium, serum calcium, serum phosphorus, serum hemoglobin, serum albumin and serum urea, which measured pre and post hemodialysis to calculate the URR.
Examinations were done and included measurement of blood pressure before dialysis, lower limb examination for edema and vascular access examination for any signs of infection and stenosis.
The patients were divided into three groups:
• University Hospital hemodialysis unit Group: This group included 100 patients on regular hemodialysis.
• Ministry of health hemodialysis (MOH) unit Group: This group included 100 patients on regular hemodialysis.
• Private sector hemodialysis unit Group: This group included 100 patients on regular hemodialysis.
In general, the predominant access type was AVF and vascular access examination revealed no signs of infection or stenosis. HTN was the primary cause of ESRD and the prevalent co-morbid disease in all HD patients.
Higher QOL scores recorded in males, younger age patients, single patients, employed patients and patients with high educational level.
MOH group had significant (P<0.0001) lower KDQOL-SF score (mean of 60.1 ± 19.6) and there was no significance difference between Private and University groups, scores were 70 ± 13.96, 69.7± 14.4, respectively.
Possible explanation for the lower scores in MOH group, may be due to lower percent of male patients in the three groups (52%), higher percent of illiterate patients in the three groups (21%), higher percent of hypertensive patients in the three groups (76%), higher percent of HCV patients in the three groups (34%) and/ or lower mean of URR in the three groups (60.1± 12.4).