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  • 1
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    Online Resource
    Differences in mental health status during the COVID-19 pandemic between patients undergoing in-center hemodialysis and peritoneal dialysis
    Springer Science and Business Media LLC ; 2023
    In:  Journal of Nephrology Vol. 36, No. 7 ( 2023-08-22), p. 2037-2046
    Details
    In: Journal of Nephrology, Springer Science and Business Media LLC, Vol. 36, No. 7 ( 2023-08-22), p. 2037-2046
    Abstract: The mental health of dialysis patients during the COVID-19 pandemic may have been modulated by dialysis modality. Studies comparing mental health of in-center hemodialysis and peritoneal dialysis patients during the first 2 years of the pandemic are lacking. Methods We conducted repeated cross-sectional and multivariable regression analyses to compare the mental health of in-center hemodialysis and peritoneal dialysis patients from March 2019 until August 2021 using data from the Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes. The study period was divided into one pre-pandemic and six 3-month pandemic periods (period 1–period 6). Mental health was assessed with the Mental Component Summary score of the 12-item Short Form health survey and mental symptoms of the Dialysis Symptom Index. Results We included 1274 patients (968 on in-center hemodialysis and 306 on peritoneal dialysis). Mental Component Summary scores did not differ between in-center hemodialysis and peritoneal dialysis patients. In contrast, in-center hemodialysis patients more often reported nervousness during period 3 (27% vs 15%, P  = 0.04), irritability and anxiety during period 3 (31% vs 18%, P  = 0.03, 26% vs. 9%, P  = 0.002, respectively) and period 4 (34% vs 22%, P  = 0.04, 22% vs 11%, P  = 0.03, respectively), and sadness in period 4 (38% vs 26%, P  = 0.04) and period 5 (37% vs 22%, P  = 0.009). Dialysis modality was independently associated with mental symptoms. Conclusions In-center hemodialysis patients more often experienced mental symptoms compared to peritoneal dialysis patients from September 2020 to June 2021, which corresponds to the second lockdown of the COVID-19 pandemic. Mental health-related quality-of-life did not differ between in-center hemodialysis and peritoneal dialysis patients. Trial registration number Netherlands Trial Register NL6519, date of registration: 22 August, 2017. Graphical abstract
    Type of Medium: Online Resource
    ISSN: 1724-6059
    URL: Article
    DOI: 10.1007/s40620-023-01747-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1475007-7
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  • 2
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    Health-related quality of life and symptom burden in patients on haemodialysis
    Oxford University Press (OUP) ; 2023
    In:  Nephrology Dialysis Transplantation ( 2023-08-14)
    Details
    In: Nephrology Dialysis Transplantation, Oxford University Press (OUP), ( 2023-08-14)
    Abstract: Patients on haemodialysis (HD) generally experience poor health-related quality of life (HRQoL) and a broad range of physical and mental symptoms, but it is unknown whether this differs between younger and older patients. We aimed to describe the trajectories of HRQoL and symptom burden of patients & lt;70 and ≥70 years old and to assess the impact of symptom burden on HRQoL. Methods In incident Dutch HD patients, HRQoL and symptoms were measured with the 12-item Short Form Health Survey and Dialysis Symptom Index. We used linear mixed models for examining the trajectories of HRQoL and symptom burden during the first year of dialysis and linear regression for the impact of symptom burden on HRQoL. Results In 774 patients, the trajectories of physical HRQoL, mental HRQoL and symptom burden were stable during the first year of dialysis. Compared with patients & lt;70 years of age, patients ≥70 years reported similar physical HRQoL {mean difference −0.61 [95% confidence interval (CI) −1.86–0.63]}, better mental HRQoL [1.77 (95% CI 0.54–3.01)] and lower symptom burden [−2.38 (95% CI −5.08–0.32)]. With increasing symptom burden, physical HRQoL declined more in older than in younger patients (β = −0.287 versus −0.189, respectively; P-value for interaction = .007). For mental HRQoL, this decrease was similar in both age groups (β = −0.295 versus −0.288, P = .847). Conclusion Older HD patients generally experience a better mental HRQoL and a (non-statistically significant) lower symptom burden compared with younger patients. Their physical HRQoL declines more rapidly with increasing symptom burden.
    Type of Medium: Online Resource
    ISSN: 0931-0509 , 1460-2385
    URL: Article
    DOI: 10.1093/ndt/gfad179
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 1465709-0
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  • 3
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    Differences in hospitalisation between peritoneal dialysis and haemodialysis patients
    Wiley ; 2022
    In:  European Journal of Clinical Investigation Vol. 52, No. 6 ( 2022-06)
    Details
    In: European Journal of Clinical Investigation, Wiley, Vol. 52, No. 6 ( 2022-06)
    Abstract: Dialysis is associated with frequent hospitalisations. Studies comparing hospitalisations between peritoneal dialysis (PD) and haemodialysis (HD) report conflicting results and mostly analyse data of patients that remain on their initial dialysis modality. This cohort study compares hospitalisations between PD and HD patients taking into account transitions between modalities. Methods The Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes collected hospitalisation data of patients who started dialysis between 2012 and 2017. Primary outcome was hospitalisation rate, analysed with a multi‐state model that attributed each hospitalisation to the current dialysis modality. Results In total, 695 patients (252 PD, 443 HD) treated in 31 Dutch hospitals were included. The crude hospitalisation rate for PD was 2.3 ( ± 5.0) and for HD 1.4 ( ± 3.2) hospitalisations per patient‐year. The adjusted hazard ratio for hospitalisation rate was 1.1 (95%CI 1.02–1.3) for PD compared with HD. The risk for first hospitalisation was 1.3 times (95%CI 1.1–1.6) higher for PD compared with HD during the first year after dialysis initiation. The number of hospitalisations and number of hospital days per patient‐year were significantly higher for PD. The most common causes of PD and HD hospitalisations were peritonitis (23%) and vascular access‐related problems (33%). Conclusion PD was associated with higher hospitalisation rate, higher risk for first hospitalisation and higher number of hospitalisations compared with HD. Since the PD hospitalisations were mainly caused by peritonitis, more attention to infection prevention is necessary for reducing the number of hospitalisations in the future.
    Type of Medium: Online Resource
    ISSN: 0014-2972 , 1365-2362
    URL: Issue
    URL: Article
    DOI: 10.1111/eci.v52.6
    DOI: 10.1111/eci.13758
    Language: English
    Publisher: Wiley
    Publication Date: 2022
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  • 4
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    The Impact of COVID-19 on the mental health of dialysis patients
    Springer Science and Business Media LLC ; 2021
    In:  Journal of Nephrology Vol. 34, No. 2 ( 2021-04), p. 337-344
    Details
    In: Journal of Nephrology, Springer Science and Business Media LLC, Vol. 34, No. 2 ( 2021-04), p. 337-344
    Abstract: Studies have shown increased anxiety, depression, and stress levels among different populations during the coronavirus disease 2019 (COVID-19) pandemic. However, the impact of the pandemic on the mental health of dialysis patients remains unknown. The aim of this study was to investigate the mental health of dialysis patients during the COVID-19 pandemic compared to the period preceding the pandemic. Methods Data originate from the ongoing multicentre observational Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes (DOMESTICO). Patients who filled in a health-related quality of life (HRQoL) questionnaire during the pandemic and six to three months prior were included. The mean difference in Mental Component Summary (MCS) score of the Short Form 12 (SF-12) was analysed with multilevel linear regression. A McNemar test was used to compare presence of mental health-related symptoms during and prior to the COVID-19 pandemic. Results A total of 177 patients were included. The mean MCS score prior to COVID-19 was 48.08 ± 10.15, and 49.00 ± 10.04 during the COVID-19 pandemic. The adjusted mean MCS score was 0.93 point (95% CI − 0.57 to 2.42) higher during the COVID-19 pandemic than during the period prior to the pandemic. Furthermore, no difference in the presence of the following mental health-related symptoms was found during the COVID-19 pandemic: feeling anxious, feeling sad, worrying, feeling nervous, trouble falling asleep, and trouble staying asleep. Conclusions The mental health of dialysis patients appears to be unaffected by the COVID-19 pandemic. Dialysis patients may be better able to cope with the pandemic, since they have high resilience and are less impacted by social distancing measures. Trial registration number Netherlands Trial Register NL6519, date of registration: 22 August 2017. Graphic abstract
    Type of Medium: Online Resource
    ISSN: 1121-8428 , 1724-6059
    URL: Article
    DOI: 10.1007/s40620-021-01005-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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  • 5
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    Impact of Polypharmacy on Health-Related Quality of Life in Dialysis Patients
    S. Karger AG ; 2021
    In:  American Journal of Nephrology Vol. 52, No. 9 ( 2021), p. 735-744
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 52, No. 9 ( 2021), p. 735-744
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Dialysis patients are often prescribed a large number of medications to improve metabolic control and manage coexisting comorbidities. However, some studies suggest that a large number of medications could also detrimentally affect patients’ health-related quality of life (HRQoL). Therefore, this study aims to provide insight in the association between the number of types of medications and HRQoL in dialysis patients. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A multicentre cohort study was conducted among dialysis patients from Dutch dialysis centres 3 months after initiation of dialysis as part of the ongoing prospective DOMESTICO study. The number of types of medications, defined as the number of concomitantly prescribed types of drugs, was obtained from electronic patient records. Primary outcome was HRQoL measured with the Physical Component Summary (PCS) score and Mental Component Summary (MCS) score (range 0–100) of the Short Form 12. Secondary outcomes were number of symptoms (range 0–30) measured with the Dialysis Symptoms Index and self-rated health (range 0–100) measured with the EuroQol-5D-5L. Data were analysed using linear regression and adjusted for possible confounders, including comorbidity. Analyses for MCS and number of symptoms were performed after categorizing patients in tertiles according to their number of medications because assumptions of linearity were violated for these outcomes. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A total of 162 patients were included. Mean age of patients was 58 ± 17 years, 35% were female, and 80% underwent haemodialysis. The mean number of medications was 12.2 ± 4.5. Mean PCS and MCS were 36.6 ± 10.2 and 46.8 ± 10.0, respectively. The mean number of symptoms was 12.3 ± 6.9 and the mean self-rated health 60.1 ± 20.6. In adjusted analyses, PCS was 0.6 point lower for each additional medication (95% confidence interval [95% CI]: −0.9 to –0.2; 〈 i 〉 p 〈 /i 〉 = 0.002). MCS was 4.9 point lower (95% CI: −8.8 to –1.0; 〈 i 〉 p 〈 /i 〉 = 0.01) and 1.0 point lower (95% CI: −5.1–3.1; 〈 i 〉 p 〈 /i 〉 = 0.63) for the highest and middle tertiles of medications, respectively, than for the lowest tertile. Patients in the highest tertile of medications reported 4.1 more symptoms than in the lowest tertile (95% CI: 1.5–6.6; 〈 i 〉 p 〈 /i 〉 = 0.002), but no significant difference in the number of symptoms was observed between the middle and lowest tertiles. Self-rated health was 1.5 point lower for each medication (95% CI: −2.2 to –0.7; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). 〈 b 〉 〈 i 〉 Discussion/Conclusion: 〈 /i 〉 〈 /b 〉 After adjustment for comorbidity and other confounders, a higher number of medications were associated with a lower PCS, MCS, and self-rated health in dialysis patients and with more symptoms.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000518454
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
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  • 6
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    Trends in home dialysis use differ among age categories in past two decades: A Dutch registry study
    Wiley ; 2022
    In:  European Journal of Clinical Investigation Vol. 52, No. 1 ( 2022-01)
    Details
    In: European Journal of Clinical Investigation, Wiley, Vol. 52, No. 1 ( 2022-01)
    Abstract: Although the number of patients with end‐stage kidney disease is growing, the number of patients who perform dialysis at home has decreased during the past two decades. The aim of this study was to explore time trends in the use of home dialysis in the Netherlands. Methods Dialysis episodes of patients who started dialysis treatment were studied using Dutch registry data (RENINE). The uptake of home dialysis between 1997 through 2016 was evaluated in time periods of 5 years. Home dialysis was defined as start with peritoneal dialysis or home haemodialysis, or transfer to either within 2 years of dialysis initiation. All analyses were stratified for age categories. Mixed model logistic regression analysis was used to adjust for clustering at patient level. Results A total of 33 340 dialysis episodes in 31 569 patients were evaluated. Mean age at dialysis initiation increased from 62.5 ± 14.0 to 65.5 ± 14.5 years in in‐centre haemodialysis patients, whereas it increased from 51.9 ± 15.1 to 62.5 ± 14.6 years in home dialysis patients. In patients 〈 65 years, the uptake of home dialysis was significantly lower during each 5‐year period compared with the previous period, whereas kidney transplantation occurred more often. In patients ≥65 years, the incidence of home dialysis remained constant, whereas mortality decreased. Conclusions In patients 〈 65 years, the overall use of home dialysis declined consistently over the past 20 years. The age of home dialysis patients increased more rapidly than that of in‐centre dialysis patients. These developments have a significant impact on the organization of home dialysis.
    Type of Medium: Online Resource
    ISSN: 0014-2972 , 1365-2362
    URL: Issue
    URL: Article
    DOI: 10.1111/eci.v52.1
    DOI: 10.1111/eci.13656
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2004971-7
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  • 7
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    Comorbidity is not associated with dialysis modality choice in patients with end‐stage kidney disease
    Wiley ; 2022
    In:  Nephrology Vol. 27, No. 6 ( 2022-06), p. 510-518
    Details
    In: Nephrology, Wiley, Vol. 27, No. 6 ( 2022-06), p. 510-518
    Abstract: This study investigated the association between comorbidity and dialysis modality choice, using the multi‐centre DOMESTICO cohort study that collected comorbidity data of patients who started dialysis in 35 Dutch centres from 2012 to 2016. Comorbidity, assessed by the Charlson comorbidity index, was not significantly associated with home dialysis choice, after adjustment for confounding factors including age and body mass index.
    Type of Medium: Online Resource
    ISSN: 1320-5358 , 1440-1797
    URL: Issue
    URL: Article
    DOI: 10.1111/nep.v27.6
    DOI: 10.1111/nep.14033
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2008235-6
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  • 8
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    Assisted peritoneal dialysis across Europe: Practice variation and factors associated with availability
    SAGE Publications ; 2021
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 41, No. 6 ( 2021-11), p. 533-541
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 41, No. 6 ( 2021-11), p. 533-541
    Abstract: In Europe, the number of elderly end-stage kidney disease patients is increasing. Few of those patients receive peritoneal dialysis (PD), as many cannot perform PD autonomously. Assisted PD programmes are available in most European countries, but the percentage of patients receiving assisted PD varies considerably. Hence, we assessed which factors are associated with the availability of an assisted PD programme at a centre level and whether the availability of this programme is associated with proportion of home dialysis patients. Methods: An online survey was sent to healthcare professionals of European nephrology units. After selecting one respondent per centre, the associations were explored by χ 2 tests and (ordinal) logistic regression. Results: In total, 609 respondents completed the survey. Subsequently, 288 respondents from individual centres were identified; 58% worked in a centre with an assisted PD programme. Factors associated with availability of an assisted PD programme were Western European and Scandinavian countries (OR: 5.73; 95% CI: 3.07–10.68), non-academic centres (OR: 2.01; 95% CI: 1.09–3.72) and centres with a dedicated team for education (OR: 2.87; 95% CI: 1.35–6.11). Most Eastern & Central European respondents reported that the proportion of incident and prevalent home dialysis patients was 〈 10% (72% and 63%), while 27% of Scandinavian respondents reported a proportion of 〉 30% for both incident and prevalent home dialysis patients. Availability of an assisted PD programme was associated with a higher incidence (cumulative OR: 1.91; 95% CI: 1.21–3.01) and prevalence (cumulative OR: 2.81; 95% CI: 1.76–4.47) of patients on home dialysis. Conclusions: Assisted PD was more commonly offered among non-academic centres with a dedicated team for education across Europe, especially among Western European and Scandinavian countries where higher incidence and prevalence of home dialysis patients was reported.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.1177/08968608211049882
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2075957-5
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  • 9
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    Health-related quality of life compared between kidney transplantation and nocturnal hemodialysis
    Public Library of Science (PLoS) ; 2018
    In:  PLOS ONE Vol. 13, No. 9 ( 2018-9-20), p. e0204405-
    Details
    In: PLOS ONE, Public Library of Science (PLoS), Vol. 13, No. 9 ( 2018-9-20), p. e0204405-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1371/journal.pone.0204405
    DOI: 10.1371/journal.pone.0204405.g001
    DOI: 10.1371/journal.pone.0204405.t001
    DOI: 10.1371/journal.pone.0204405.t002
    DOI: 10.1371/journal.pone.0204405.t003
    DOI: 10.1371/journal.pone.0204405.s001
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2018
    detail.hit.zdb_id: 2267670-3
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  • 10
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    Key elements in selection of pre-dialysis patients for home dialysis
    SAGE Publications ; 2021
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 41, No. 5 ( 2021-09), p. 494-501
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 41, No. 5 ( 2021-09), p. 494-501
    Abstract: Most pre-dialysis patients are medically eligible for home dialysis, and home dialysis has several advantages over incentre dialysis. However, accurately selecting patients for home dialysis appears to be difficult, since uptake of home dialysis remains low. The aim of this study was to investigate which medical or psychosocial elements contribute most to the selection of patients eligible for home dialysis. Methods: All patients from a Dutch teaching hospital, who received treatment modality education and subsequently started dialysis treatment, were included. The pre-dialysis programme consisted of questionnaires for the patient, nephrologist and social worker, followed by an assessment of eligibility for home dialysis by a multidisciplinary team. Clinimetric assessment and logistic regression were used to identify domains and questions associated with home dialysis treatment. Results: A total of 135 patients were included, of whom 40 were treated with home dialysis and 95 with incentre haemodialysis. The key elements associated with long-term home dialysis treatment were part of the domains ‘suitability of the housing’, ‘self-care’, ‘social support’ and ‘patient capacity’, with adjusted odds ratios ranging from 0.13 for negative to 18.3 for positive associations. Conclusion: The assessment of contraindications by a nephrologist followed by the assessment of possibilities by a social worker or dialysis nurse who investigates four key elements, ideally during a home visit, and subsequent detailed education offered by specialized nurses is an optimal way to select patients for home dialysis.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.1177/08968608211023263
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2075957-5
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