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Patient’s response to a simple question on recovery after hemodialysis session strongly associated with scores of comprehensive tools for quality of life and depression symptoms

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Abstract

Purpose

Many maintenance hemodialysis patients do not feel well after the hemodialysis session and need a time to recover. The main objective of the study was to investigate whether a simple question about the need of some time to recover from hemodialysis was associated with scores of comprehensive tools of depression symptoms and health-related quality of life (HRQOL).

Methods

Cross-sectional evaluation of 800 Brazilian patients enrolled in the Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO). The KDQOL-SF was used for HRQOL and the 20-item CES-D and BDI for depression symptoms. Linear and logistic models were used for multivariable adjustments.

Results

Patients who reported some time to recover (30 %) had significantly (P < 0.001) higher depression symptoms scores (mean difference = 4.75 for CES-D and 4.48 for BDI). HRQOL scores were, in general, lower for patients who referred a time to recover, with mean differences larger than 4.0 (P < 0.05) both for physical and mental components. Strong associations of needing a time to recover and lower scores of several kidney disease-targeted HRQOL components were also observed. Differences in depression symptoms and HRQOL were largely reduced after adjustments for symptoms (muscle pain/cramps, faintness, fatigue, nausea/vomiting).

Conclusions

The results support the validity of a simple question on post-hemodialysis recovery as a proxy for scores of complex instruments for depression symptoms and HRQOL. The results suggest that the poorer HRQOL and higher depression probability in patients who need a time to recover from hemodialysis could be partially explained by the presence of hemodialysis-related symptoms.

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Acknowledgments

We are grateful for the support of the medical directors and staff at the following dialysis units: Clínica NEPHRON of Itapuã, Clínica NEPHRON of Barris, INED, and CLINIRIM. The PROHEMO has been supported by research grants from “The Brazilian National Council for Scientific and Technological Development (CNPq),” Grants #484743/2006-6 and #308068/2006-8. Preliminary results of this study were present as abstract in the Kidney Week 2011 of the American Society of Nephrology in Philadelphia, PA.

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Authors and Affiliations

  1. Núcleo de Epidemiologia Clínica e Medicina Baseada em Evidências, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil

    Gildete Barreto Lopes, Gustavo Behrens Pinto, Luiz Fernando Catto & Antonio Alberto Lopes

  2. Instituto de Nefrologia e Diálise (INED), Salvador, BA, Brazil

    Luciana Ferreira Silva

  3. Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, BA, Brazil

    Luciana Ferreira Silva

  4. Clínica do Rim e Hipertensão Arterial, Salvador, BA, Brazil

    Marcia Tereza Silva Martins

  5. Clínica NEPHRON, Salvador, BA, Brazil

    Margarida Maria Dantas Dutra

  6. Departamento de Medicina Interna e Apoio Diagnóstico, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil

    Antonio Alberto Lopes

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  1. Gildete Barreto Lopes
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  2. Luciana Ferreira Silva
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  3. Gustavo Behrens Pinto
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Correspondence to Antonio Alberto Lopes.

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Lopes, G.B., Silva, L.F., Pinto, G.B. et al. Patient’s response to a simple question on recovery after hemodialysis session strongly associated with scores of comprehensive tools for quality of life and depression symptoms. Qual Life Res 23, 2247–2256 (2014). https://doi.org/10.1007/s11136-014-0666-z

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  • DOI: https://doi.org/10.1007/s11136-014-0666-z

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