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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.

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

Objetivos: Valorar la Calidad de Vida Relacionada con la Salud de los pacientes con Enfermedad Renal Crónica Terminal e identificar las diferencias más significativas según el sexo y tratamiento recibido. Material y métodos: Estudio observacional, analítico y transversal; realizado a pacientes en tratamiento con Hemodiálisis de Alto Flujo o Hemodiafiltración "en línea". Realizamos estadística descriptiva e inferencial y se consideraron significativos aquellos resultados en que el grado de significación resultó igual o inferior al 5% (p=0.05). Resultados: Obtuvimos diferencias estadísticamente significativas en: valores de albúmina sérica según la técnica de diálisis y dosis de tratamiento adecuado (Kt/V) según el sexo. En las dimensiones del test de calidad de vida: síntomas/problemas, situación laboral, función sexual, función física, dolor y vitalidad (según sexo). Y según la técnica en: sueño, actitud del personal de diálisis y función física. En el análisis multivariante, las únicas variables clínicas y sociodemográficas que resultaron ser predictores significativos en algunas de las dimensiones de las escalas KDQOL-SF fueron el sexo, el nivel de estudios y la técnica de diálisis. Conclusiones: Las variables sociodemográficas, analíticas, el sexo y técnicas de diálisis influyen sobre la percepción de la calidad de vida de los pacientes con enfermedad renal crónica terminal.