Avaliação da qualidade de vida e perfil clínico laboratorial dos pacientes em diálise

Abstract

The assessment of quality of life has been used as a major indicator of effectiveness in the treatment of terminal chronic kidney disease. It is noted in the academic community that quality of life is becoming popular in clinical researches of patients with such disease. This dissertation consists of a scientific article that aimed to assess quality of life with the Kidney Disease Quality of Life Short Form and the clinical-laboratory and sociodemographic profiles of both adult and elderly dialysis patients. It is a cross-sectional and observational study performed in two hemodialysis units in the city of Passo Fundo, upstate Rio Grande do Sul, Brazil. The project was approved by the Research Ethics Committee of the University of Passo Fundo, report 1.886135. A total of 179 dialysis patients (hemodialysis and peritoneal dialysis), with therapy duration of over ninety days, were investigated. Quality of life was assessed through a structured interview applied once. Clinical and laboratory data were collected through the active search in medical records of patients and through verbal approach. Data were analyzed with R language. Student t test and ANOVA with Tukey's post-hoc and Least Significant Difference, and Pearson's correlation coefficient were used to analyze data. The normality condition was assessed with Kolmogorov-Smirnov and Shapiro-Wilk tests. The significance level considered was p ≤ 0.05. The results found that clinical, laboratory, and social indicators interfered with the perception of quality of life. The dimension of "work" presented the worst means, followed by the dimensions of "disease load", "physical role", and "physical and mental components". The variables of gender, advanced age, low level of education, low monthly income, residing in urban area far from the dialysis center, dialytic therapy time, diabetes mellitus diagnosis, liver disease, and cataract presented significant correlations. The biochemical indicators of albumin, calcium, and hemoglobin showed significant correlations. Among the limitations of the study is the quantitative and cross-sectional character of the assessment, focused on objective aspects and ignoring individual characteristics that may be related to the perception of quality of life. Prospectiv e studies will be able to assess whether the actions towards the needs referred in the assessment of quality of life were effective. Multicenter studies will be able to identify the most common causes of low perception of quality of life for creating public measures such as the distribution of dialysis centers closer to the homes of patients, viability of the maintenance of labor activities, among others. The results may provide discussions for implementing measures that prevent or delay the loss of renal function and the appearance of comorbidities from the chronic kidney disease already in place. Moreover, they will found the creation of new approaches, strategies, and actions for the interdisciplinary follow-up of patients, consequently improving treatment effectiveness.