Quality of life and sleep in hemodialysis patients

The purpose of this study was to determine the quality of life and sleep of chronic hemodialysis (HD) patients. Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) and quality of life (QoL) was measured using the Medical Outcomes Study 36-item Short Form (SF-36) in 115 HD patients. One hundred (87%) patients were "poor sleepers" (global PSQI ≥5). The SF-36 mental component summary and physical component summary (PCS) scores were higher than 50 only in 43% and 32% of the subjects, respectively. No significant differences were found in QoL and sleep according to the patient′s gender, presence of diabetes and time on HD. Correlation between total SF-36 score and global PSQI was statistically significant (r = -0.227, P <0.05). Poor sleep is common in dialysis patients and is associated with lower QoL, especially with mental health component of life quality

Geriatric nutritional risk index: A mortality predictor in hemodialysis patients

Recently, the Geriatric Nutritional Risk Index (GNRI) has been introduced as a valuable tool to assess the nutritional status of hemodialysis (HD) patients. To determine the predictive value of the GNRI score for death in HD, we studied 145 chronic HD patients (%53 men, mean age 60 ± 16 years). The GNRI score was estimated by an equation involving serum albumin and individual′s weight and height. According to the highest positive likelihood and risk ratios, the cut-off value of the GNRI for mortality was set at 100. The survival of patients on HD was examined with the Cox proportional hazards model. Mortality was monitored prospectively over an 18-month period, during which 35 patients died. The GNRI (mean 102.6 ± 5.5) was significantly positively correlated with lean body mass, hematocrit, serum lipids and presence of metabolic syndrome. Multivariate Cox proportional hazards analysis demonstrated that the GNRI <100, serum ferritin ≥ 500 μ g/L and age 65 years or older were significant predictors for mortality (hazard ratio 3.691, 95% CI 1.751-7.779, P = 0.001; hazard ratio 3.105, 95% CI 1.536-6.277, P = 0.002; and hazard ratio 2.806, 95% CI 1.297-6.073, P = 0.009, respectively), after adjustment to gender and vintage time. It can be concluded that, in addition to old age, malnutrition (low GNRI) and inflammation (high ferritin) are identified as significant independent risk factors that predict all-cause mortality in HD patients