Functional Status of Patients on Maintenance Hemodialysis

Abstract

Factors associated with physical well being were examined in adults with end-stage renal disease (ESRD) in two large hemodialysis units of the Royal Medical Services in Jordan. Utilizing the Karnofski scale we measured the functional status of 200 Patients who had been on maintenance hemodialysis for at least 12 months. A Marnofski scale of less than 70 incidents frank disability (Inability to perform routine living activities without assistance), in addition current vocational status was assessed as well as any existing comorbid conditions. The mean age of the study group was 45.2 years (range 16 to 70) and included 108 (54%) males and 92 (46%) females, there were 39 (19.5%) diabetic patients and 27 (13.5%) patients were receiving erythropoietin (EPO). The mean hematocrit of the entire group was 27.8%. As measured by Karnofski scale, 64 (32%) of the patients were unable to perform routine living activity without assistance; dependence on wheelchair was reported by 9 (4.5%) patients. The mean comorbidity index of patients who scored less than 70 on the Karnofski scale was 1.5 compared to 0.7 for those who scored at least 70 on the same scale (p< 0.001). Analysis of factors showed that age and diabetes mellitus affected functional status. Of the laboratory variables measured, only serum albumin concentration correlated significant with Karnofski scale. Fourteen (21.8%) of the patients who scored below 70, had serum albumin concentration above 40g/L compared to 66 (48.5%) of the patients who scored at least 70 on the Karnofski scale (p< 0.001). We conclude that a significant proportion of patients on maintenance hemodialysis is functionally disabled. The elderly, diabetics, patients with high co-morbidity index and those with low serum albumin are most likely to have poor functional status