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Introduction. Mortality rates for patients undergoing maintenance hemodialysis remain high. Published data regarding association between health-related quality of life (HRQOL) and mortality among hemodialysis patients are inconsistent. Very few data are published on the change in HRQOL over time as a predictor of mortality. The aim of this study was to assess whether HRQOL and change of it over time could be considered an independent predictor of mortality in hemodialysis patients. Material and methods. This prospective observational study enrolled 183 patients undergoing maintenance hemodialysis. HRQOL was measured annually 2004–2008 using a generic Short Form 36 questionnaire. Physical component summary (PSC) and mental component summary (MSC) scores were calculated. The change of the patient’s HRQOL over time was calculated as a difference between SF-36 scores of the first and the last HRQOL measurements. Results. The median follow-up was 48 months (range, 1–72 months). Cutoff values for HRQOL predicting mortality for PSC score was ≥35 and for MSC score was ≥45. In the model adjusted for age, sex, dialysis months, creatinine, albumin and hemoglobin levels, mortality risk decreased by 0.96 (95% CI, 0.95–0.99) for 1-point increase in the baseline PSC score and decreased by 0.97 (95% CI, 0.95–0.98) for 1-point increase in the baseline MSC score. A 1-point decline in the PSC score (relative risk, 1.11; 95% CI, 1.008–1.221) and MSC score (relative risk, 1.07; 95% CI, 1.002–1.149) over the period of follow-up were associated with a significant additional increase in mortality. Conclusions. Both baseline HRQOL and decline of HRQOL are independent predictors of mortality in hemodialysis patients.

Infekcija yra svarbi hemodializuojamų ligonių sergamumo ir mirtingumo priežastis. Dėl infekcijos ligoniai dažnai hospitalizuojami. Tyrimo tikslas. Įvertinti hemodializuojamų ligonių hospitalizavimo dažnį ir rizikos veiksnius hospitalizuoti dėl infekcijos, remiantis Kauno apskrities hemodializuojamų ligonių duomenimis. Išanalizuotos ambulatorinės kortelės visų 533 negrįžtamosios stadijos inkstų nepakankamumu sergančių ligonių, kurie buvo hemodializuoti Kauno apskrities hemodializės centruose trejų metų laikotarpiu (2001–2004). Duomenys apie ligonio būklę ir laboratorinius tyrimus rinkti 2001, 2002 ir 2003 metų lapkričio mėnesį. Toliau pacientai prospektyviai stebėti 12 mėnesių ir rinkti duomenys apie jų hospitalizavimą dėl infekcijos. Kiekvienais metais tiriami ligoniai vertinti kaip nauji ir atlikta suminė duomenų analizė. Statistinė duomenų analizė atlikta kompiuteriu naudojant statistinius duomenų paketus „SPSS“ ir „STATISTICA“. Atliekant vienfaktorinę statistinę duo¬menų analizę, lygintos ligonių, hospitalizuotų dėl infekcijos, ir nehospitalizuotų ligonių grupės. Reliatyvi hospitalizavimo dėl infekcijos rizika nustatyta taikant daugiafaktorinę Cox regresinę analizę, įvertintas laikas iki pirmojo hospitalizavimo dėl infekcijos. Hospitalizavimo dėl infekcijos dažnis buvo 0,2 hospitalizavimo ligoniui per metus ir sudarė 18 proc. visų hospitalizavimų. Vieno hospitalizavimo trukmės mediana – 11 dienų. Vienfaktorinėje analizėje hospitalizavimas dėl infekcijos buvo susijęs su... [toliau žr. visą tekstą] Infection is an important cause of morbidity and mortality in hemodialysis patients. These patients are frequently hospitalized for infections. The objective of our study was to evaluate hospitalization rate for infections and to determine risk factors for infection-related hospitalizations of hemodialysis patients in Kaunas region, Lithuania. Ambulatory case records of 533 patients with end-stage renal disease, dialyzed in all hemodialysis centers in Kaunas region during the period of 2001–2004, were analyzed. Data on patient’s condition and routine laboratory tests were collected in November of 2001, 2002, and 2003. These patients then were followed up for the next 12 months in order to evaluate infection-related hospitalization rate. All patients were considered new patients every year, and general analysis of three-year data was performed. Statistical analyses were carried out using SPSS (Statistical Package for Social Sciences) and STATISTICA. Univariate statistical analysis was performed comparing the groups of patients that were hospitalized because of infections and were not hospitalized. Relative risk of infection-related hospitalization was estimated using Cox regression evaluating the time to first infection-related hospitalization. The unadjusted infection-related hospitalization rate was 0.2 per patient a year (18% of all hospitalizations). The median length of hospital stay for infections was 11 days. Univariate statistical analysis showed a statistically... [to full text]

Darbo tikslas – įvertinti mažakraujystės įtaką Kauno krašto hemodializuojamų ligonių hospitalizavimui ir mirštamumui. Išanalizuotos ambulatorinės kortelės visų 148 ligonių, kurie 2001 metų lapkričio mėnesį buvo ambulatoriškai hemodializuoti Kauno apskrities hemodializės centruose. Tyrimas atliktas dviem etapais: per pirmąjį etapą surinkti duomenys apie ligonių amžių, lytį, inkstų nepakankamumą sukėlusią priežastį, hemoglobino kiekį 2001 metų lapkričio mėnesį; per antrąjį etapą šie ligoniai prospektyviai stebėti 12 mėnesių, rinkti duomenys apie jų mirštamumą, hospitalizavimo dažnį ir jo trukmę, hospitalizavimo priežastis. Tyrimo pradžioje vidutinis hemoglobinas (Hb) – 101,2±13,8 g/l. Daugiau kaip pusės (59 proc.) hemodializuojamų ligonių hemoglobinas – 100 g/l ir didesnis. Tolesnis ligonių tyrimas 2002 metais parodė statistiškai reikšmingą Hb skirtumą tarp mirusiųjų ir toliau dializuojamų ligonių: mirusiųjų ligonių vidutinis Hb buvo 92,4±18,6 g/l, o ligonių, ku¬riems pakaitinė inkstų terapija tęsiama – 102,81±12,48 g/l, p=0,02. Hb sumažėjimas 1 g/l didina mirštamumo riziką 5 proc. (p=0,027). Ligonių palyginimas pagal hospitalizavimų skaičių per 2002 m. parodė, kad ligoninėje negulėjusių ligonių Hb buvo 104,2±11,1 g/l, hospitalizuotų ligonių Hb – 99±15,1 g/l, be to, šis skirtumas buvo statistiškai reikšmingas (p=0,02). Hb sumažėjimas 1 g/l didina hospitalizavimo riziką 5 proc. (p=0,027). Palyginus ligonius pagal Hb kiekį (Hb mažesnis ir didesnis nei 100 g/l), nustatytas... [toliau žr. visą tekstą] The objective of our study was to evaluate the influence of anemia on hospitalization and mortality in hemodialysis patients of Kaunas region. We analyzed ambulatory case records of 148 patients dialyzed in all 7 hemodialysis centers of Kaunas region in November 2001. The study consisted of two parts: in the first part data on patient age, gender, primary cause of end-stage renal disease, hemoglobin concentration were collected in November 2001 and in the second part these patients were followed up for 12 months in order to evaluate rate and length of hospitalization, reasons for hospitalization and mortality. At the beginning of the study mean hemoglobin (Hb) value was 101.2±13.8 g/l and more than a half of the patients (59%) had hemoglobin value higher than 100 g/l. Further follow-up of the patients during the year 2002 revealed that hemoglobin level of the patients who died was lower from the patients who followed hemodialysis. Mean hemoglobin of dead and alive patients was 92.4±18.6 g/l and 102.81±12.48 g/l, respectively (p=0.02). Lower hemoglobin concentrations were associated with a 5% higher relative risk of mortality for every 1 g/l decrease in hemoglobin (p=0.027). Analysis showed that mean hemoglobin value was 104.2±11.1 g/l for the patients who were not hospitalized and 99±15.1 g/l for the patients who were hospitalized during the year 2002 (p=0.02). Lower hemoglobin concentrations were associated with a 5% higher relative risk for hospitalization for every... [to full text]

We analysed ambulatory case records of all patients dialysed in 7 hemodialysis centers of Kaunas region during the year 2002 (n=186). Separate analysis of 42 diabetic patients was performed and compared with non-diabetics. Mortality was higher in diabetic patients in comparison with non-diabetics (22.5% and 7.3%, respectivelly; p

The number of patients with end-stage renal disease is increasing, therefore the need of renal replacement therapy is increasing. Rising cost of treating end stage renal disease patients includes not only the cost of dialysis procedure but also the cost of hospitalizations and ambulatory medicamental treatment. There is no analysis done of hospitalizations of end-stage renal disease patients in Lithuania. Our purpose –– to examine hospitalization rate, causes and duration in end-stage renal disease patients dialyzed in Kaunas University of Medicine Hospital. We analyzed ambulatory case records of all end-stage renal disease patients dialyzed in our clinic in November 2001. Retrospective data about diabetes, ischemic heart disease, Karnofsky score, hospitalization rate and causes of hospitalizations were collected. Hospitalizations of the year 2001 analyzed separately. The study included 111 patients. There were 123 hospitalizations in 75 patients, 1967 total hospital redays. Admission rate was 1.34±1.5 per patient year, 19.82±25.96 hospital days per patient year, the mean length of each hospitalization – 16.26±11.57. Most frequent causes of hospitalization –– start of hemodialysis, infections, other causes, rare cause – hemodialysis complications. Karnofsky score correlated negatively with duration of hospitalizations per patient year. No statistically signifficant correlation was found between duration of hospitalizations and the presence of diabetes, ischemic heart disease, the way of starting hemodialysis (urgent or not). In comparison with other countries, in our center there were less hospitalizations but longer hospital days per admission.