Browsing by Author "Alija, Pablo"
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- Effect of aging in the perception of health-related quality of life in end-stage renal disease patients under online-hemodiafiltrationPublication . Moura, Alexandra; Madureira, José; Alija, Pablo; Fernandes, João Carlos; Oliveira, José Gerardo; Lopez, Martin; Filgueiras, Madalena; Amado, Leonilde; Sameiro-Faria, Maria; Miranda, Vasco; Santos-Silva, Alice; Costa, ElísioThis work aimed to evaluate how aging could influence patients' perception of health quality of life (HRQOL), as well as, the effect of aging on dialysis adequacy and in hematological, iron status, inflammatory and nutritional markers. In this transversal study were enrolled 305 ESRD patients under online-hemodiafiltration (OL-HDF) (59.67% males; 64.9 ± 14.3 years old). Data about comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patient's records. Moreover, HRQOL score, by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF), was assessed. Analyzing the results according to quartiles of age, significant differences were found for some parameters evaluated by the KDQOL-SF instrument, namely for work status, physical functioning and role-physical, which decreased with increasing age. We also found a higher proportion of diabetic patients, a decrease in creatinine, iron, albumin serum levels, transferrin saturation and nPCR, with increasing age. Moreover, significant negative correlations were found between age and mean cell hemoglobin concentration, iron, transferrin saturation, albumin, nPCR, work status, physical functioning and role-physical. In conclusion, our results showed that aging is associated with a decreased work status, physical functioning and role-physical, with a decreased dialysis adequacy, iron availability and nutritional status, and with an increased proportion of diabetic patients and of patients using central venous catheter, as the vascular access. The knowledge of these changes associated with aging, which have impact in the quality of life of the patients, could be useful in their management.
- Risk factors for mortality in end-stage kidney disease patients under online-hemodiafiltration: three-year follow-up studyPublication . Sousa-Martins, Pedro; Moura, Alexandra; Madureira, José; Alija, Pablo; Oliveira, José Gerardo; Lopez, Martin; Filgueiras, Madalena; Amado, Leonilde; Sameiro-Faria, Maria; Miranda, Vasco; Mesquita, Edgar; Teixeira, Laetitia; Santos-Silva, Alice; Lobato, Luísa; Costa, ElísioEnd-stage kidney disease (ESRD) patients under dialysis have high mortality rate. Infl ammation, poor nutritional status and disturbances in erythropoiesis and iron metabolism have been reported in these patients. Moreover, there is a growing concern about the health related quality of life (HRQOL) in the context of ESRD. The aim of this work was to study the predictive value of these disturbances, dialysis adequacy and of HRQOL for mortality risk, by performing a three-year follow-up study. Clinical, socio-demographical and analytical data (dialysis adequacy, nutritional status, hematological data, lipid profi le, iron metabolism and infl ammatory markers) were obtained from 236 patients (61.02% male; 67.50 [56.00-75.00] years old) under online-hemodiafi ltration. Patient’s reported HRQOL score was assessed by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF). 54 patients died during the 3 years follow-up period. Our data showed that mean cell hemoglobin concentration (MCHC), transferrin and albumin are signifi cant predictors of mortality. The risk of death was higher in patients presenting lower levels of MCHC (Hazard ratio [HR] = 0.70; 95% confi dence interval [CI] = 0.500-0.984), transferrin (HR = 0.99; 95% CI = 0.982 – 0.998), and albumin (HR = 0.96; 95% CI = 0.938- 0.994). Our study showed that poor nutritional status and an infl ammatory-induced iron depleted erythropoiesis are important factors for mortality in these patients. MCHC, transferrin and albumin may provide useful biomarkers of risk in ESRD patients under OL-HDF.