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Abstract
patients, associated, among other factors, with comorbidity, polypharmacy, and restrictions in fluid and dietary intake, potentially affecting the quality of life.
Objectives: To analyze the relationship between constipation and the quality of life of hemodialysis patients, determine the prevalence of objective and subjective constipation, and analyze the most influential variables.
Material and Method: Cross-sectional descriptive observational study in a hospital hemodialysis unit. The Rome IV Diagnostic Criteria (2016) and the Bristol Visual Scale were used to assess constipation. Quality of life was evaluated using the CVE-20 questionnaire.
Results: A total of 38 patients were studied (58% males) with a mean age of 68.69±12.76 years, a hemodialysis duration of 44±37.19 months, and 31.57% were sedentary.
Daily fluid intake was 1004.05±460.13 ml, and diuresis was 658.11±696.47 ml. The Charlson index was 8.15±2.29 points. Subjective constipation was present in 45%, and objective constipation in 42%. Patients with constipation were 56% females, with a mean age of 67.81±14.88 years, and hemodialysis duration of 40.06±32.97 months; 12% were prescribed opioids, 44% phosphorus binders, 56% intravenous iron, and 24% laxatives. Quality of life was lower in constipated patients (53.06 vs. 69.62 points), with significant differences in all dimensions of the questionnaire.
Conclusions: Hemodialysis patients have a significant prevalence of constipation, more prevalent in females. This constipation is associated with a poorer perception of quality of life.
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Copyright (c) 2023 Vanesa Pardo-Vicastillo, Marta Marks-Álvarez, Mª Teresa Andrino-Llorente, Michelle Hernández-Díez, Yolanda García-Fernández, Guillermina Barril-Cuadrado
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References
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- Bulbul E, Cepken T, Caliskan F, Palabiyik B, Sayan C, Kazancioglu R. The quality of life and comfort levels of hemodialysis patients with constipation: a descriptive study and cross-sectional study. Hemodialysis International [Internet]. 2022 [consultado 2 Feb 2023];26:351-60. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35451169/. DOI: https://doi.org/10.1111/hdi.13009
References
NNNconsult. [Internet] 2023 [consultado 10 Feb 2023]. Disponible en: https://www.nnnconsult.com/.
Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ et al. Bowel disorders. Gastroenterology [Internet]. 2016 [consultado 9 Feb 2023];150:1393-407. Disponible en: https://theromefoundation.org/wp-content/uploads/bowel-disorders.pdf. DOI: https://doi.org/10.1053/j.gastro.2016.02.031
Lindberg G, Hamid SS, Malfertheiner P, Thomsen OO, Fernandez LB et al. World Gastroenterology Organisation global guideline: Constipation - a global perspective. J Clin Gastroenterol [Internet]. 2011 [consultado 9 Feb 2023];45(6):483-7. Disponible en: https://journals.lww.com/jcge/Fulltext/2011/07000/World_Gastroenterology_Organisation_Glob. DOI: https://doi.org/10.1097/MCG.0b013e31820fb914
Campillos-Páez MT, Vallés-Ugarte ML, San Laureano-Palomero T, Pérez-Hernánsaiz M. Estreñimiento y consumo de laxantes en ancianos. Atención Primaria [Internet]. 2000 [consultado 14 Feb 2023];26(6):430-2. Disponible en: https://www.elsevier.es/es-revista-atencion-primaria-27-pdf-S0212656700786975. DOI: https://doi.org/10.1016/S0212-6567(00)78697-5
Sumida K, Yamagata K, Kovesdy CP. Constipation in CKD. Kidney Int Rep [Internet]. 2020 [consultado 23 Feb 2023];5(2):121-34. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000799/. DOI: https://doi.org/10.1016/j.ekir.2019.11.002
Ruiz-López MC, Coss-Adame E. Calidad de vida en pacientes con diferentes subtipos de estreñimiento de acuerdo a los criterios de ROMA III. Revista de Gastroenterología de México [Internet]. 2015 [consultado 15 Feb 2023];80(1):13-20. Disponible en: http://www.revistagastroenterologiamexico.org/en-calidad-vida-pacientes-. DOI: https://doi.org/10.1016/j.rgmx.2015.01.003
Zhang J, Huang C, Li Y, Chen J, Shen F et al. Health-related quality of life in dialysis patients with constipation: a cross-sectional study. Patient Prefer Adherence [Internet]. 2013 [consultado 2 Feb 2023];7:589-94. Disponible en: https://pubmed.ncbi.nlm.nih.gov/23814466/. DOI: https://doi.org/10.2147/PPA.S45471
Gil-Gil A, Gumbao-Valero A, Canales-Vitoria AB. Incidencia del estreñimiento en una unidad de hemodiálisis. Rev Soc Esp Enferm Nefrol [Internet]. 2006 [consultado 3 Feb 2023];9(3):172-6. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=. DOI: https://doi.org/10.4321/S1139-13752006000300004
Mearin F, Ciriza C, Mínguez M, Rey E, Mascort JJ, Peña E et al. Guía de práctica clínica: síndrome del intestino irritable con estreñimiento y estreñimiento funcional en adultos: concepto, diagnóstico y continuidad asistencial (parte 1 de 2). Semergen [Internet]. 2017 [consultado 8 Feb 2023];43(1):43-56. Disponible en: https://www.elsevier.es/es-revista-medicina-familia-semergen-40-pdf-S1138359316301071. DOI: https://doi.org/10.1016/j.semerg.2016.06.009
Perona M, Mearin F, Guilera M, Mínguez M, Ortiz V et al. Cuestionario específico de calidad de vida para pacientes con estreñimiento: desarrollo y validación del CVE-20. Med Clin [Internet]. 2008 [consultado 16 Feb 2023];131(10):371-7. Disponible en: https://www.elsevier.es/es-revista-medicina-clinica-2-linkresolver-cuestionario-especifico-calidad-vida-pacientes-13126141. DOI: https://doi.org/10.1016/S0025-7753(08)72285-1
Asociación Médica Mundial [Internet]. Declaración de Helsinki de la AMM - principios éticos para las investigaciones médicas en seres humanos [consultado 2 Feb 2023]. Disponible en: https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/.
Bulbul E, Cepken T, Caliskan F, Palabiyik B, Sayan C, Kazancioglu R. The quality of life and comfort levels of hemodialysis patients with constipation: a descriptive study and cross-sectional study. Hemodialysis International [Internet]. 2022 [consultado 2 Feb 2023];26:351-60. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35451169/. DOI: https://doi.org/10.1111/hdi.13009