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Abstract Background Physical activity and emotional self-management has the potential to enhance health-related quality of life (HRQoL), but few people with chronic kidney disease (CKD) have access to resources and support. The Kidney BEAM trial aims to evaluate whether an evidence-based physical activity and emotional wellbeing self-management programme (Kidney BEAM) leads to improvements in HRQoL in people with CKD. Methods This was a prospective, multicentre, randomised waitlist-controlled trial, with health economic analysis and nested qualitative studies. In total, three hundred and four adults with established CKD were recruited from 11 UK kidney units. Participants were randomly assigned to the intervention (Kidney BEAM) or a wait list control group (1:1). The primary outcome was the between-group difference in Kidney Disease Quality of Life (KDQoL) mental component summary score (MCS) at 12 weeks. Secondary outcomes included the KDQoL physical component summary score, kidney-specific scores, fatigue, life participation, depression and anxiety, physical function, clinical chemistry, healthcare utilisation and harms. All outcomes were measured at baseline and 12 weeks, with long-term HRQoL and adherence also collected at six months follow-up. A nested qualitative study explored experience and impact of using Kidney BEAM. Results 340 participants were randomised to Kidney BEAM (n = 173) and waiting list (n = 167) groups. There were 96 (55%) and 89 (53%) males in the intervention and waiting list groups respectively, and the mean (SD) age was 53 (14) years in both groups. Ethnicity, body mass, CKD stage, and history of diabetes and hypertension were comparable across groups. The mean (SD) of the MCS was similar in both groups, 44.7 (10.8) and 45.9 (10.6) in the intervention and waiting list groups respectively. Conclusion Results from this trial will establish whether the Kidney BEAM self management programme is a cost-effective method of enhancing mental and physical wellbeing of people with CKD. Trial Registration NCT04872933. Registered 5th May 2021.

Background: Physical activity and emotional self-management has the potential to enhance health-related quality of life (HRQoL), but few people with chronic kidney disease (CKD) have access to resources and support. The Kidney BEAM trial aims to evaluate whether an evidence-based physical activity and emotional wellbeing self-management programme (Kidney BEAM) leads to improvements in HRQoL in people with CKD. Methods: This was a prospective, multicentre, randomised waitlist-controlled trial, with health economic analysis and nested qualitative studies. In total, three hundred and four adults with established CKD were recruited from 11 UK kidney units. Participants were randomly assigned to the intervention (Kidney BEAM) or a wait list control group (1:1). The primary outcome was the between-group difference in Kidney Disease Quality of Life (KDQoL) mental component summary score (MCS) at 12 weeks. Secondary outcomes included the KDQoL physical component summary score, kidney-specific scores, fatigue, life participation, depression and anxiety, physical function, clinical chemistry, healthcare utilisation and harms. All outcomes were measured at baseline and 12 weeks, with long-term HRQoL and adherence also collected at six months follow-up. A nested qualitative study explored experience and impact of using Kidney BEAM. Results: 340 participants were randomised to Kidney BEAM (n = 173) and waiting list (n = 167) groups. There were 96 (55%) and 89 (53%) males in the intervention and waiting list groups respectively, and the mean (SD) age was 53 (14) years in both groups. Ethnicity, body mass, CKD stage, and history of diabetes and hypertension were comparable across groups. The mean (SD) of the MCS was similar in both groups, 44.7 (10.8) and 45.9 (10.6) in the intervention and waiting list groups respectively. Conclusion: Results from this trial will establish whether the Kidney BEAM self management programme is a cost-effective method of enhancing mental and physical wellbeing of people with CKD. Trial Registration: NCT04872933. Registered 5th May 2021. [ABSTRACT FROM AUTHOR]

Yoshio Shimizu,1,2 Keiichi Wakabayashi,1 Junichiro Nakata,3 Hiroaki Io,4 Chieko Hamada,5 Yasuhiko Tomino,6 Yusuke Suzuki3 1Department of Nephrology, Juntendo University Shizuoka Hospital, Izunokuni-shi, 410-2211, Japan; 2Shizuoka Medical Research Center for Disaster, Izunokuni-shi, 410-2211, Japan; 3Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, 113-8421, Japan; 4Division of Nephrology, Juntendo University Nerima Hospital, Tokyo, 117-8521, Japan; 5Juntendo University Faculty of Health Sciences and Nursing, Mishima-shi, 411-8787, Japan; 6Asian Pacific Renal Research Promotion Office, Medical Corporation SHOWAKI, Tokyo, 160-0023, JapanCorrespondence: Yoshio Shimizu, Division of Nephrology, Department of Internal Medicine, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni-shi, Shizuoka, 410-2211, Japan, Tel +81-55-948-3111, Fax +81-55-946-0858, Email yosimizu@juntendo.ac.jpBackground: We experienced a sudden breakdown of hemodialysis system during a clinical study of dermal itch and serum BNP concentrations.Patients and Methods: Forty-eight hemodialysis patients were enrolled in the itch-related study. It was intended to improve itch by lowering BNP with supportive communication between the patients and the dialysis staff. We planned to collect data, including visual analogue scale (VAS), dermatology life quality index (DLQI), blood samples and QOL score (KDQOL-SF), four times over a four week interval. The first data was obtained just prior to switching facilities due to a breakdown. The patients underwent hemodialysis in other facilities for two weeks and underwent determination of their clinical data, including QOL scores, three times.Results: While mean blood pressure showed no significant differences, serum albumin, iron and phosphate levels were worsened significantly between pre- and post-relocation. Serum BNP and DLQI showed no significant changes. VAS was significantly worsened. The mean values of the cognitive function in the KDQOL-SF and sleep and the role-physical, role-emotional, social function, dialysis staff’s encouragement in SF-36 analysis were identified as statistically significant items by MANOVA. Both SF-12 physical and mental composites were also statistically significant. Although SF-12 physical composites were significant among the patients under 66 yrs of age (median), eight factors were significant among those over 66 yrs. Independent analyses revealed every item that was detected worsened significantly after the switch of facilities.Conclusion: Unexpected switching of hemodialysis facilities severely impacts the QOL for a long duration as well as the patients’ symptom and laboratory data.Keywords: KDQOL-SF, switch of hemodialysis facilities, dermal itch

Abstract Introduction Monitoring Health Related Quality of Life (HRQoL) in different stages of chronic kidney disease is advised by all nephrology societies. We aimed to study the relation between quality of life and dialysis adequacy. Methods One hundred patients (51% males), on regular hemodialysis 3/week for > 6 months in two hospitals were included. Single pool Kt/V was used to assess dialysis adequacy. Patients were grouped into 3 divisions according to Kt/v: Group A > 1.5 (n = 24), group B 1.2–1.5 (n = 54) and group C

Objective: This study aims to adapt the KDQOL-SF questionnaire into Indonesian and to evaluate the reliability and validity of the questionnaire in healthy subjects in Indonesia. Material & Methods: Previously translated (into Indonesian) KDQOL-SF questionnaire was given to 33 healthy subjects at Cipto Mangunkusumo General Hospital. Respondents were over 18 years old and were able to speak Indonesian orally and in written form. Reliability was measured using Alpha Cronbach’s intraclass correlation coefficient and internal consistency reliability. Validity was evaluated using Pearson’s correlation test. Results: Out of 33 respondents, the majority of subjects were male (81%) with mean age 47.4 ± 13.7 years old. The highest score was in social support aspects with mean score 99.48 ± 2.95, while the lowest score was vitality aspect with mean score 63.28 ± 11.61. Alpha Cronbach’s score was between 0.580-0.999 and Pearson’s correlation coefficient between 0.405-0.976 with P < 0.05. Conclusion: KDQOL-SF questionnaire, which was translated into Indonesian, was valid and reliable to be used in evaluating patients’ quality of before kidney transplantation in Indonesia

Introduction: Monitoring Health Related Quality of Life (HRQoL) in different stages of chronic kidney disease is advised by all nephrology societies. We aimed to study the relation between quality of life and dialysis adequacy.Methods: One hundred patients (51% males), on regular hemodialysis 3/week for > 6 months in two hospitals were included. Single pool Kt/V was used to assess dialysis adequacy. Patients were grouped into 3 divisions according to Kt/v: Group A > 1.5 (n = 24), group B 1.2-1.5 (n = 54) and group C < 1.2 (n = 22). KDQOL-SF™ questionnaire was used to study quality of life in our groups. Group C was reassessed after 3 months of improving Kt/v.Results: Mean values were: Kt/V (1.48 ± 0.41), Cognitive Function (84.27 ± 9.96), Work status (30.00 ± 33.33), Energy (45.70 ± 13.89), Physical Function and Role limitations due to physical function (45.30 ± 12.39 and 31.25 ± 19.26, respectively). Group A had significantly higher scores of KDQOL-SF except Role limitations due to Physical Function. All subscales improved in group C after Kt/v improvement except 3 subscales, namely, work status, patient satisfaction and role limitation due to physical and emotional functions.Conclusion: Inadequate HD badly affects quality of life and improving adequacy refines many components of quality of life. [ABSTRACT FROM AUTHOR]

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The objective of the present study was to translate the Kidney Disease Quality of Life - Short Form (KDQOL-SF™1.3) questionnaire into Portuguese to adapt it culturally and validate it for the Brazilian population. The KDQOL-SF was translated into Portuguese and back-translated twice into English. Patient difficulties in understanding the questionnaire were evaluated by a panel of experts and solved. Measurement properties such as reliability and validity were determined by applying the questionnaire to 94 end-stage renal disease patients on chronic dialysis. The Nottingham Health Profile Questionnaire, the Karnofsky Performance Scale and the Kidney Disease Questionnaire were administered to test validity. Some activities included in the original instrument were considered to be incompatible with the activities usually performed by the Brazilian population and were replaced. The mean scores for the 19 components of the KDQOL-SF questionnaire in Portuguese ranged from 22 to 91. The components "Social support" and "Dialysis staff encouragement" had the highest scores (86.7 and 90.8, respectively). The test-retest reliability and the inter-observer reliability of the instrument were evaluated by the intraclass correlation coefficient. The coefficients for both reliability tests were statistically significant for all scales of the KDQOL-SF (P < 0.001), ranging from 0.492 to 0.936 for test-retest reliability and from 0.337 to 0.994 for inter-observer reliability. The Cronbach's alpha coefficient was higher than 0.80 for most of components. The Portuguese version of the KDQOL-SF questionnaire proved to be valid and reliable for the evaluation of quality of life of Brazilian patients with end-stage renal disease on chronic dialysis.

Background Little is known how health related quality of life (HRQOL) change in the transition from dialysis to renal transplantation (RTX). Longitudinal data addressing the patient-related outcomes are scarce, and particularly data regarding kidney-specific HRQOL are lacking. Thus, the aim of the current study was to assess HRQOL in patients followed from dialysis to RTX. Furthermore, to compare HRQOL in RTX patients and the general population. Methods In a prospective study, HRQOL was measured in a cohort of 110 patients (median age 53.5 (IQR 39-62) years, GFR 54 (45-72) ml/min/1.73 m²) in dialysis and after RTX using the self-administered Kidney Disease and Quality of Life Short Form version 1.3 (KDQOL-SF). Generic HRQOL in the RTX patients was compared to that of the general population (n = 5903) using the SF-36. Clinical important change after RTX was defined as difference in HRQOL of SD/2. Results Follow-up time was 55 (IQR 50-59) months, and time after RTX was 41 (34-51) months. Four of nine domains in kidney-specific HRQOL improved after RTX, i.e. burden of kidney disease, effect of kidney disease, symptoms and work status. In SF-36, general health, vitality, social function and role physical improved after RTX, but none of the domains improved sufficiently to be regarded as clinically relevant change. There were highly significant differences in HRQOL between RTX patients and the general population after adjustment for age and gender for all items of SF-36 except for bodily pain and mental health. Conclusions HRQOL improved in the transition from dialysis to transplantation, but clinical relevant change was only obtained in the kidney specific domains. HRQOL was perceived considerably poorer in RTX patients than in the general population. Our observations point to the need of improving HRQOL even after RTX, and should encourage further longitudinal research and clinical attention during treatment shift. [ABSTRACT FROM AUTHOR]

Objective: To identify modifiable factors associated with health-related quality of life (HRQOL) among chronic hemodialysis patients.Methods: Analysis of baseline data of 9,526 hemodialysis patients from seven countries enrolled in phase I of the Dialysis Outcomes and Practice Patterns Study (DOPPS). Using the Kidney Disease Quality of Life Short Form (KDQOL-SF(TM)), we determined scores for 8 generic scale summaries derived from these scales, i.e., the physical component summary [PCS] and mental component summary [MCS], and 11 kidney disease- targeted scales. Regression models were used to adjust for differences in comorbidities and sociodemographic and treatment factors. The Benjamini-Hochberg procedure was used to correct P-values for multiple comparisons.Results: Unemployment and psychiatric disease were independently and significantly associated with lower scores for all generic and several kidney disease-targeted HRQOL measures. Several other comorbidities, lower educational level, lower income, and hypoalbuminemia were also independently and significantly associated with lower scores of PCS and/or MCS and several generic and kidney disease-targeted scales. Hemodialysis by catheter was associated with significantly lower PCS scores, partially explained by the correlation with covariates.Conclusion: Associations of poorer HRQOL with preventable or controllable factors support a greater focus on psychosocial and medical interventions to improve the well-being of hemodialysis patients. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of this study was to determine the basic psychometric properties, reliability, and validity of the Kidney Disease Quality of Life-Short Form (KDQOL-SF) questionnaire in kidney transplant patients. Methods: The reliability and validity of the instrument were determined in 418 kidney transplant patients followed in a single outpatient transplant centre. Results: Internal consistency of all the Medical Outcome Study Short Form 36 (SF-36) domains was very good, and the Cronbach''s alpha value was above .70 for all but three of the disease-specific subscales. We found significant, moderate to strong negative correlations between most of the KDQOL-SF domains and the Center for Epidemiologic Studies—Depression (CES-D) scores. Finally, substantial differences in KDQOL-SF scores were seen between groups of transplanted patients who were expected to be clinically different, supporting the discriminant validity of the KDQOL-SF instrument. Conclusion: We propose that the KDQOL-SF is a reliable and valid tool and most of its subscales can be used to assess health-related quality of life (HRQOL) in kidney transplant patients and to compare HRQOL between different end stage renal disease (ESRD) patient populations. [Copyright &y& Elsevier]

Background : In evaluations of dialysis therapy, an assessment of health-related quality of life (HRQOL) is often important. The aim of this study was to determine the basic psychometric properties, reliability and validity of the short form of the KDQOL[sup TM] i.e. the KDQOL-SF[sup TM] , a dialysis-targeted instrument, and to assess its ability to detect changes over time. Methods : In a prospective cohort study (Netherlands Cooperative Study on the Adequacy of Dialysis, NECOSAD), all new adult ESRD patients in 32 different Dutch centers were consecutively enrolled. Demographic, clinical and HRQOL data were obtained 3 and 12 months after the start of chronic dialysis therapy. Results : The reliability of the KDQOL-SF[sup TM] was supported by test results that were above the recommended minimal values. Validity of KDQOL-SF[sup TM] was confirmed by the hypothesized positive correlations of the overall health rating and renal function, and by the negative correlations between the number of comorbidities and dialysis dose. Moreover, dialysis-targeted dimensions were more sensitive in detecting relevant differences pertaining to kidney diseases than generic dimensions. The KDQOL-SF[sup TM] was able to detect clinical changes over time. Conclusions : The psychometric properties of the KDQOL-SF[sup TM] were good, and the different dialysis-targeted dimensions were informative with a high reliability and validity. These results support the application of the KDQOL-SF[sup TM] in studies evaluating dialysis therapy. [ABSTRACT FROM AUTHOR]

Health-related quality of life (HRQOL) is a valid marker of outcome for chronic dialysis therapy. A wide range of questionnaires are now available which assess different aspects of an individual's health. Appreciation of those factors that contribute to explaining HRQOL items remains poorly defined. The development of disease-specific questionnaires such as KDQOL-SF[sup Tm] , should allow for such questions to be better answered. A cross-sectional analysis of our chronic dialysis population was made using the KDQOL-SF[sup Tm] questionnaire. By multiple linear regression analysis demographic, clinical and dialysis-related factors were assessed for their contribution to the HRQOL in this population. The HRQOL of these patients was also compared against a general population sample. From a total of 190 chronic dialysis patients, 146 completed the KDQOL-SF[sup Tm] questionnaire. The haemodialysis (HD) and peritoneal dialysis (PD) patients were similar with respect to most demographic, clinical and dialysis variables except for haemoglobin and albumin which were significantly (p < 0.05) greater in the peritoneal and haemodialysis populations respectively. Compared to the general population, the HRQOL of dialysis patients was impaired for all SF-36 subscales. Use of the disease-specific components of KDQOL-SF[sup Tm] discriminated between dialysis modality for our dialysis population. Multiple linear regression analysis demonstrated that 27.5 to 42.7% of the variance in the SF-36 subscales could be explained. Satisfactory sleep, dialysis related symptoms, effect of kidney disease on lifestyle and burden of kidney disease were found to be the most important determinants of HRQOL for this population. [ABSTRACT FROM AUTHOR]

RESUMO INTRODUÇÃO: Qualidade de vida é uma dimensão que tem sido amplamente investigada na saúde da população, independente da faixa etária. Uma condição crônica é um fator que interfere na realização das atividades da vida diária e na percepção de bem-estar individual, como é o caso dos pacientes em tratamento por hemodiálise. OBJETIVO: Descrever as características e analisar as possíveis associações entre a Insuficiência Renal Crônica (IRC) e a qualidade de vida em uma amostra representativa de pacientes com o agravo no município de Caruaru, PE. MÉTODO: A pesquisa foi realizada nos centros de tratamentos dialíticos na cidade de Caruaru, onde toda a população com IRC é atendida (n = 192), sendo 82 pacientes do Centro Regional de Hemodiálise do Agreste (CRHA) e 110 da clínica SOS Rim - Clínica Nefrológica de Caruaru. Para a composição da amostra foi realizado um censo e todos os pacientes cadastrados foram pré-selecionados inicialmente para o estudo. RESULTADOS: Verificou-se que a maioria dos participantes relatou algum grau de incômodo: dores musculares (69,4%), cãibras (89,8%), coceiras (67,3%), fraqueza muscular (73,5%), diminuição de líquido (91,8%), diminuição alimentar (85,7%) e capacidade de trabalhar (75,5%). Já quando questionados se o esforço físico interfere na sua qualidade de vida, este estudo revelou que 70,3% afirmam que sim. Em relação à saúde, 80,6% das pessoas dizem que a doença renal crônica interfere de forma negativa na qualidade de vida. CONCLUSÃO: Os dados indicam que pacientes com IRC apresentam diminuição na qualidade de vida graças a repercussões musculoesqueléticas, tais como cãibras, fraqueza muscular e esforço físico.

We retrospectively evaluated demographic and biochemical parameters associated with depression and health-related quality of life (HRQOL) in maintenance peritoneal dialysis (PD) patients. This study included 105 patients maintaining PD at Seoul National University Hospital. Data were collected from electronic medical record. Korean Beck's Depression Inventory and Korean version of Kidney Disease Quality of Life short form, version 1.3 were used to evaluate depression and HRQOL, respectively. Moderate to severe depression was found in 24.8% of patients. Patients with lower normalized protein equivalent of nitrogen appearance (nPNA) (< 1.2 g/kg/day), lower weekly renal Kt/V(urea) (< 0.2), and lower serum albumin level (≤ 4.0 g/dL) were associated with depression (P < 0.05). Among them, lower weekly renal Kt/V(urea) was the only independent risk factor associated with depression (OR = 3.1, P = 0.007). Depressed patients showed significantly lower scores in every dimension of HRQOL (P < 0.001). Lower weekly renal Kt/V(urea) (β = 0.24, P = 0.005) and lower nPNA (β = 0.15, P = 0.03) were the independent risk factors associated with lower kidney dialysis component summary, whereas lower plasma hemoglobin level was the consistent risk factor for lower physical component summary (β = 0.22, P = 0.03) and mental component summary (β = 0.22, P = 0.01). Depression is a prevalent psychological problem in PD population. Residual renal function is the most important factor associated with depression and impaired HRQOL in PD patients.