الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 101 |  |  |
| | | from | 101 | | |
Abstract
Because of their high incidence and prevalence, CKD and ESRD pose a global threat. According to 2013-2016 statistics, the prevalence of CKD (stages 1-5) in the general adult population in the United States was 14.8 percent, whereas ESRD was 2160 per million.
In CKD and ESRD patients, a variety of complications lead to a worse QOL. Besides the primary cause of ESRD, other factors include: anemia, CV disease, neuromuscular complications, malnutrition, CKD-MBD and fatigue.
Fatigue is a well-known and prevalent complaint among HD patients, and it has been linked to a reduction in HRQOL. The incidence of fatigue in patients on long-term renal replacement therapy ranged from 60% to 97 percent. Despite this, medical professionals are still ignorant of its existence and severity. Among the renal population, post-HD fatigue is a prevalent incapacitating condition. It’s characterized as an exhausting feeling that occurs after each dialysis procedure.
Several approaches for assessing post-HD fatigue have been developed, one of which is the ”time to recover (minutes) from HD.” Lindsay et al. evaluated patients’ replies to a single open-ended question, ”How long does it take you to recover from a dialysis session?”. Post hemodialysis recovery time is a significant determinant of their QOL.
The goal of this study was to determine the factors that influence DRT and the relationship between DRT and HD patient QOL.
The study’s participants were drawn from the dialysis units of Alexandria University Hospitals. Patients with ESRD who have been allocated to long-term HD and have participated in thrice weekly, four-hour HD sessions for more than 90 days and are at least 18 years old, able to read and write, and in complete mental health, were included. We excluded patients who were unable to complete the questionnaires due to reading or hearing difficulties, as well as those with proven medical instability necessitating hospitalization, dementia, active malignancy or liver failure, and who experienced a decline in degree of consciousness during the HD session.
All patients included in the study were subjected to detailed history taking, complete physical examination, dialysis related data was collected including their DRT, subjected to MIS and KDQOL-36 survey, and underwent a group of laboratory investigations.
The results of our study showed that:
• There was a statistically significant positive correlation between DRT and dialysate flow, missed sessions, MIS.
• There was a statistically significant negative correlation between DRT and age, surface area, ultrafiltration, UFR, dialysate Na, post HD MAP, change in MAP, S. phosphate, S. albumin, symptom/ problem list, effects of kidney disease, burden of kidney disease, SF-12 physical composite, SF-12 mental composite.
• There was a statistically positive relation between prolonged DRT and female gender, HF, morning HD schedule.
• There was no statistically significant correlation between DRT and vintage, HD frequency, blood flow rate, HD session duration, Kt/V, anticoagulation dose, dialysate temperature, pre-HD MAP, cases temperature, Hb, serum potassium, serum sodium, serum creatinine, pre and post HD urea, URR, TIBC, serum iron, Transferrin saturation, CRP, serum calcium, BMI.
• There was no statistically significant relation between DRT and smoking status, several co-morbid conditions, vascular access, virology status, HD modality, anticoagulation type and PTH.
• Univariate and multivariate linear regression analysis showed that decrease in dialyzer surface area, dialysate Na and S. albumin were predictors of increase in DRT. Moreover, decrease in all KDQOL subscales were predictors of increase in DRT. Whereas increase in dialysate flow, number of missed sessions and MIS were predictors of increase in DRT.
• Dialysate Na, number of missed sessions, symptom/ problem list, SF-12 physical composite and SF-12 mental composite were independently correlated with DRT.