Avaliação da qualidade de vida de idosos em hemodiálise pelo questionário KDQOL / Evaluation of quality of life in elderly patients on hemodialysis using KDQOLquestionnaire

JUSTIFICATIVA: A expectativa média de vida no Brasil aumentou e observa-se um crescimento no número de idosos com doença renal crônica. OBJETIVO: Avaliar a qualidade de vida obtida através do questionário KDQOL (Kidney Disease Qualityof Life) em idosos em hemodiálise, correlacionando os dados desse questionário com idade e condições socioeconômicas.MÉTODOS: Trata-se de um estudo transversal em pacientes com idade maior que 60 anos, portadores de doença renal crônica em hemodiálise em dois centros da cidade de São Paulo(Hospital do Servidor Público Estadual de São Paulo e Hospital Samaritano). Para mensurar os indicadores de qualidade de vida, foi aplicado o questionário KDQOL uma hora antes da realização da sessão de hemodiálise. RESULTADOS: Foram estudados 18 pacientes com média de idade de 71,3±6,8 anos,sendo 61,1% do sexo masculino, 77,7% brancos, com tempo de tratamento hemodialítico de 29,2±27,6 meses, todos realizando3 sessões semanais, com duração de 3,8±0,4h por sessão ea grande maioria (61%) realizando sessões por fistula arterio-venosa.Os escores pior avaliados foram saúde geral, função sexual,funcionamento físico e efeitos da doença renal. Foi encontrada correlação negativa de idade com o estímulo por parte da equipe de diálise e com saúde geral, sendo esses efeitos mais perceptíveis nos pacientes com maior escolaridade. CONCLUSÃO:A importância de mensurar a qualidade de vida em pacientes idosos em hemodiálise justifica-se pela real possibilidade de atuação multidisciplinar e melhoria de muitos escores, como o da função emocional.

IMPORTANCE: The average life expectancy in Brazil has increased and there has been a growth in the number ofelderly patients with chronic kidney disease. OBJECTIVE: Toevaluate quality of life obtained through the KDQOL (KidneyDisease Quality of Life) questionnaire in elderly patients onhemodialysis, correlating the data with age and socioeconomic status. METHODS: This was a cross-sectional study in patientsaged 61 years and older, with chronic kidney disease on hemodialysis in two centers of São Paulo (Hospital do Servidor Público Estadual de São Paulo Hospital Samaritano). Tomeasure the indicators of quality of life, KDQOL questionnaire(Kidney Disease Quality of Life) was applied one hour prior tothe hemodialysis session. RESULTS: We studied 18 patients with a mean age of 71.3±6.8 years, 61.1% male, 77.7% whites, in hemodialysis treatment for 29.2±27.6 months, eachdoing 3 weekly sessions, lasting 3.8±0.4 h per session andthe vast majority (61%) holding sessions for arterio-venousfistula. The worst scores were assessed general health, sexual function, physical functioning and effects of kidney disease.Age showed a negative correlation with stimulation by dialysisstaff and overall health, these being most noticeable effects in patients with higher education levels. CONCLUSION:The importance of measuring the quality of life in elderlypatients on hemodialysis is justified by the real possibility of multidisciplinary work and improvement of many scores, suchas the emotional function.

Early nephrology care provided by the nephrologist alone is not sufficient to mitigate the social and psychological aspects of chronic kidney disease

OBJECTIVE: Patients with chronic kidney disease who receive early nephrology care have a better prognosis with maintenance dialysis. We aimed to determine whether early referral to a nephrologist can also improve the psychological burden of having chronic kidney disease. SUBJECTS AND METHODS: Thirty-nine patients with chronic kidney disease that required hemodialysis were studied: 19 had a $ 6-month history of nephrology care (Group1), and 20 had never received any prior nephrology care (Group2). All patients participated in a semi-structured interview that addressed their perceived knowledge and psychological aspects related to CKD and hemodialysis. Demographic and laboratory data as well as socioeconomic status were evaluated. RESULTS: In both groups, most of the patients were of low socioeconomic status. Group 1 had significantly better laboratory parameters (p<0.05). The patients' answers to the questions showed no differences between the groups: 63 percent of Group 1 and 55 percent of Group 2 reported that they had no prior knowledge about dialysis; 58 percent and 40 percent, respectively, reported that they ''don't completely understand what the doctor says''; and 74 percent and 85 percent, respectively, believed that their ''kidneys would work again''. CONCLUSION: Pre-dialysis nephrology care improves the clinical conditions of the patients with chronic kidney disease but is insufficient for minimizing other aspects of having chronic kidney disease.