Course of symptoms and health-related quality of life during specialized pre-dialysis care.

<h4>Background</h4>Concerns are present on the limited value of renal function alone in defining the optimal moment to start dialysis. Disease-related symptoms and health-related quality of life (HRQOL) may have additional clinical value in defining this moment, but little is known about...

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Autores principales:	Moniek C M de Goeij, Gurbey Ocak, Joris I Rotmans, Jan-Willem Eijgenraam, Friedo W Dekker, Nynke Halbesma
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fd312069ec5b4475a8c4b6f17ebd611c
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spelling	oai:doaj.org-article:fd312069ec5b4475a8c4b6f17ebd611c2021-11-18T08:25:01ZCourse of symptoms and health-related quality of life during specialized pre-dialysis care.1932-620310.1371/journal.pone.0093069https://doaj.org/article/fd312069ec5b4475a8c4b6f17ebd611c2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24699666/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Concerns are present on the limited value of renal function alone in defining the optimal moment to start dialysis. Disease-related symptoms and health-related quality of life (HRQOL) may have additional clinical value in defining this moment, but little is known about how these parameters change during pre-dialysis care. The aims of our study were to describe the course of symptoms and HRQOL during pre-dialysis care and to investigate their association with poor health outcomes.<h4>Methods</h4>In the prospective PREPARE-2 cohort, incident patients starting specialized pre-dialysis care were included when referred to one of the 25 participating Dutch outpatient clinics (2004-2011). In the present analysis, 436 patients with data available on symptoms and HRQOL were included. Clinical data, symptoms (revised illness perception questionnaire), and HRQOL (short form-36 questionnaire; physical and mental summary score) were collected every 6-month interval. A time-dependent Cox proportional hazard model was used to associate symptoms and HRQOL with the combined poor health outcome (i.e. starting dialysis, receiving a kidney transplant, and death).<h4>Results</h4>All symptoms increased, especially fatigue and loss of strength, and both the physical and mental summary score decreased over time, with the most pronounced change during the last 6-12 months of follow-up. Furthermore, each additional symptom (adjusted HR 1.04 (95% CI, 1.00-1.09)) and each 3-point lower physical and mental summary score (adjusted HR 1.04 (1.02-1.06) and 1.04 (1.02-1.06) respectively) were associated with a higher risk of reaching the combined poor health outcome within the subsequent 6 months.<h4>Conclusions</h4>The number of symptoms increased and both the physical and mental HRQOL score decreased during pre-dialysis care and these changes were associated with starting dialysis, receiving a kidney transplant, and death. These results may indicate that symptoms and HRQOL are good markers for the medical condition and disease stage of pre-dialysis patients.Moniek C M de GoeijGurbey OcakJoris I RotmansJan-Willem EijgenraamFriedo W DekkerNynke HalbesmaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e93069 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Moniek C M de Goeij Gurbey Ocak Joris I Rotmans Jan-Willem Eijgenraam Friedo W Dekker Nynke Halbesma Course of symptoms and health-related quality of life during specialized pre-dialysis care.
description	<h4>Background</h4>Concerns are present on the limited value of renal function alone in defining the optimal moment to start dialysis. Disease-related symptoms and health-related quality of life (HRQOL) may have additional clinical value in defining this moment, but little is known about how these parameters change during pre-dialysis care. The aims of our study were to describe the course of symptoms and HRQOL during pre-dialysis care and to investigate their association with poor health outcomes.<h4>Methods</h4>In the prospective PREPARE-2 cohort, incident patients starting specialized pre-dialysis care were included when referred to one of the 25 participating Dutch outpatient clinics (2004-2011). In the present analysis, 436 patients with data available on symptoms and HRQOL were included. Clinical data, symptoms (revised illness perception questionnaire), and HRQOL (short form-36 questionnaire; physical and mental summary score) were collected every 6-month interval. A time-dependent Cox proportional hazard model was used to associate symptoms and HRQOL with the combined poor health outcome (i.e. starting dialysis, receiving a kidney transplant, and death).<h4>Results</h4>All symptoms increased, especially fatigue and loss of strength, and both the physical and mental summary score decreased over time, with the most pronounced change during the last 6-12 months of follow-up. Furthermore, each additional symptom (adjusted HR 1.04 (95% CI, 1.00-1.09)) and each 3-point lower physical and mental summary score (adjusted HR 1.04 (1.02-1.06) and 1.04 (1.02-1.06) respectively) were associated with a higher risk of reaching the combined poor health outcome within the subsequent 6 months.<h4>Conclusions</h4>The number of symptoms increased and both the physical and mental HRQOL score decreased during pre-dialysis care and these changes were associated with starting dialysis, receiving a kidney transplant, and death. These results may indicate that symptoms and HRQOL are good markers for the medical condition and disease stage of pre-dialysis patients.
format	article
author	Moniek C M de Goeij Gurbey Ocak Joris I Rotmans Jan-Willem Eijgenraam Friedo W Dekker Nynke Halbesma
author_facet	Moniek C M de Goeij Gurbey Ocak Joris I Rotmans Jan-Willem Eijgenraam Friedo W Dekker Nynke Halbesma
author_sort	Moniek C M de Goeij
title	Course of symptoms and health-related quality of life during specialized pre-dialysis care.
title_short	Course of symptoms and health-related quality of life during specialized pre-dialysis care.
title_full	Course of symptoms and health-related quality of life during specialized pre-dialysis care.
title_fullStr	Course of symptoms and health-related quality of life during specialized pre-dialysis care.
title_full_unstemmed	Course of symptoms and health-related quality of life during specialized pre-dialysis care.
title_sort	course of symptoms and health-related quality of life during specialized pre-dialysis care.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/fd312069ec5b4475a8c4b6f17ebd611c
work_keys_str_mv	AT moniekcmdegoeij courseofsymptomsandhealthrelatedqualityoflifeduringspecializedpredialysiscare AT gurbeyocak courseofsymptomsandhealthrelatedqualityoflifeduringspecializedpredialysiscare AT jorisirotmans courseofsymptomsandhealthrelatedqualityoflifeduringspecializedpredialysiscare AT janwillemeijgenraam courseofsymptomsandhealthrelatedqualityoflifeduringspecializedpredialysiscare AT friedowdekker courseofsymptomsandhealthrelatedqualityoflifeduringspecializedpredialysiscare AT nynkehalbesma courseofsymptomsandhealthrelatedqualityoflifeduringspecializedpredialysiscare
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Course of symptoms and health-related quality of life during specialized pre-dialysis care.

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