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S 18 Parallel Session
Programme of the Session
Title: Haemodialysis
GS: Francisco Maduell (Spain)
High-volume online HDF increases survival in haemodialysis
O 36
Associations between appetite and quality of life or performance status in haemodialysis patients
Cristiana Matias (Portugal)
O 37
Pain following needle insertion into a fistula of individuals on haemodialysis and affecting factors
Dilek Arslan (Turkey)
O 38
Impacts of massage therapy during haemodialysis sessions on patients’ QoL: A pilot Study
Bayoumi Magda (Egypt)
Abstracts
GUEST SPEAKER
High-volume online HDF increases survival in haemodialysis
F. Maduell1
1Hospital Clínic, Barcelona, Spain
The introduc¬tion of online hemodiafiltration (OL HDF) using ultrapure dialysis fluid as the source of the replacement fluid has allowed the replacement volume to be increased and has significantly reduced the cost of the procedure. These techniques offer superior uremic toxins removal over a wider range of molecular sizes than other dialysis modalities. Randomized studies with small sample sizes and nonrandomized stud¬ies conducted during the last 20 years have shown that OL HDF improves control of hyperphos¬phoremia, malnutrition, inflammation, anemia, infectious complications, joint pain, amyloidosis associated with dialysis, intradialytic tolerance, insomnia, irritability, restless leg syndrome, poly¬neuropathy and itching.
Sev¬eral retrospective studies showed a mortality risk reduction between 20 to 50% in patients treated with high-efficiency OL HDF com¬pared with those treated with LF HD or HF HD. During the last few years, three large, prospec¬tive, randomized studies have been conducted in distinct European countries to compare major clinical outcomes in prevalent patients receiving conventional HD and OL HDF. The CONTRAST study randomized 714 patients to LF HD or OL HDF; at the end of the study, with a mean follow-up of 3 years, the two groups showed no difference in survival. Similarly, in the Turkish HDF study, 782 patients were randomized to HF HD or OL HDF; over a 2-year follow-up, the out¬come was not affected by treatment allocation. Finally, in Catalonia (Spain), the ESHOL study randomized 906 patients to HF-HD or OL HDF. In this clini¬cal trial, allocation to OL HDF was associated with a 30% reduction in all-cause mortality. Recently, several meta-analyses have confirmed reduced overall and cardiovascular mortality.
In all of these large, randomized studies the con¬vective volume seemed to be an important issue. Secondary analyses of these studies observed an association between convective volume and survival. Therefore, a minimum convective volume of 23 L per session was recommended until more conclusive scientific evidence became available.
BIOGRAPHY OF THE GUEST SPEAKER
O 36
Associations between appetite and quality of life or performance status in haemodialysis patients
C. Matias1, A. Macedo1, 2, H. Rosário1, 2, M. Fonseca1, J. Pinheiro1, 3, J. Fazendeiro Matos4, M.T. Parisotto5
1NephroCare Fafe, Fresenius Medical Care, Fafe, Portugal; 2Nurse School, Minho University, Braga, Portugal; 3Bioethics Institute, Portuguese Catholic University, Porto, Portugal; 4NephroCare Portugal, Fresenius Medical Care, Porto, Portugal; 5Care Value Management EMEA, Fresenius Medical Care, Bad Homburg, Germany
Background
The concept of Chronic Kidney Disease (CKD) describes a progressive and irreversible worsening of a person’s renal function. CKD is characterised by a slow and progressive loss of renal excretory capacity due to the gradual reduction of glomerular filtration main excretion of toxic solutes produced by the body This disease presents a set of clinical manifestations, such as, loss of appetite with decreased taste, changes in sleep patterns, including insomnia and daytime sleepiness (Durvasula Himmelfarb, 2011). Malnutrition, inflammation, and atherosclerosis often coexist in the case of CKD patients, and each of these risk factors independently predicts the outcome for these patients (Stenvinkel et al., 2000).
Objectives
Investigate the association between appetite and:
• Kidney disease specific quality of life;
• Performance status in haemodialysis patients.
Methods
91 people (46 males) who undergo haemodialysis participated in this cross sectional study. Data collection included the questionnaire KDQOL version 1.3 (Kidney Disease Quality of Life) and the Karnofsky Performance Status Scale. Nutritional status was assessed by collecting blood samples and included haemoglobin, serum albumin, creatinine, urea, c-reactive protein, calcium, phosphorus. Appetite was assessed by questionnaire.
Results
We found a positive correlation between appetite and physical health (p=0.009), even after controlling for confounders (p=0.044). This correlation was not found for mental quality of life. Appetite and Karnofsky were positively correlated (p<0.001). Using ANOVA statistical analysis we found a correlation between appetite and serum albumin (4.02 (0.312)), urea and appetite (135.16 (38.93)).
Conclusion/Application to practice
This study contributes to further support experimental studies to improve the quality of life in haemodialysis patients.
O 37
Pain following needle insertion into a fistula of individuals on haemodialysıs and affecting factors
D. Arslan1, N. Kiliç Akça1
1Nursing, Health School, Bozok University, Yozgat, Turkey
Objectives
This study was conducted to determine pain following needle insertion into a fistula and the affecting factors for individuals on haemodialysis treatment.
Methods
Descriptive study; 102 individuals between 24-84 years, with a fistula on haemodialysis treatment who agreed to participate. Data was collected on a descriptive characteristics information form, created by scanning the literature, other research and Visual Analog Scale. Descriptive statistics, t-test, one-way anova were used for data analysis and p<0.05 were considered significant.
Results
It was found out that mean age of the participants was 50.6±14.7, mean duration of haemodialysis was 5.8±4.1 years and mean duration of arterio-venous fistula 38.4±25.6 months. We found 54.9% of the individuals to use moisturizer in the fistula area and 49.0% of the individuals to practice strengthening exercises in the fistula area. Of indıvıduals on haemodialysis treatment 92.2% were found to experience moderate level pain score - 4.8±2.6 (min 0 - max 10) following needle insertion into a fistula. Age, sex, education, duration of haemodialysis and fistula was found not to have a statistically significant relationship between the pain experienced of individuals (p>0.05).
Conclusion/Application to practice
As a result, it was determined that haemodialysis patients experienced pain following needle insertion into a fistula. It is recommended to evaluate individuals experience of pain and to provide appropriate nursing interventions.
O 38
Impact of massage therapy during haemodialysis sessions on patients’ QoL: A pilot study
M. Bayoumi1
1Medical Surgical Nursing , Nursing Faculty, BSU, Cairo, Egypt
Background
The benefit of massage therapy is known to reduce stress, pain and depression in chronic diseases, however studies have shown the use of massage therapy in dialysis patient can relieve prurities and significantly improve anxiety levels. The Saudi Center for Organ Transplantation (SCOT) highlights approximately 11437 patients on haemodialysis therapy in Saudi Arabia.
Objectives
To evaluate the impact of massage therapy during haemodialysis sessions on QoL and physical fitness.
Methods
The study involved 16 patients with end stage renal disease who were undergoing haemodialysis treatment. They were randomly assigned to either a control group or an experimental group. The control group received only standard care for haemodialysis patients for eight weeks while the experimental group received massage therapy during the same period. Assessments were conducted on the participants both at the beginning of the study and at the end of the eight week treatment period. Researchers used the physical fitness Scale and KDQoL-SF 36. The scores of the participants at the start of the study were compared to their scores at the end.
Results
The pre-post physical fitness practice of intervention sessions’ activities among patients in the two groups were compared. Significant differences were found in the Chair (seconds), Arm curl (seconds), Chair sit & reach (cm), 8-foot up & go (count) and 2-min step test (count). Regarding to blood pressure and pulse changes, blood flow and session duration among patients in the two groups the systolic blood pressure was decreased and pulse, session duration and blood follow were increased. More interestingly the post KDQoL-SF showed that the sleep pattern was improved with massage therapy and reported patient satisfaction.
Conclusion/Application to practice
Based on these findings, the study researchers concluded that massage therapy can effectively benefit patients’ QoL and physical fitness and recommend that it be integrated into the standard care given to such patients.