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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR  
Year : 2011  |  Volume : 22  |  Issue : 6  |  Page : 1236-1237
Motor disability in end-stage renal failure: An epidemiological study on Italian dialyzed patients


1 Nephrology Unit, S. Eugenio Hospital, Home Care Service of the Rome Association against Leukemias, Lymphomas and Myeloma (Romail), Rome, Italy
2 Hematology Unit, S. Eugenio Hospital, Home Care Service of the Rome Association against Leukemias, Lymphomas and Myeloma (Romail), Rome, Italy

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Date of Web Publication8-Nov-2011
 

How to cite this article:
Vischini G, Tendas A, Ferrannini M, Scaramucci L, Di Segni G, Giovannini M, Niscola P, Palumbo R. Motor disability in end-stage renal failure: An epidemiological study on Italian dialyzed patients. Saudi J Kidney Dis Transpl 2011;22:1236-7

How to cite this URL:
Vischini G, Tendas A, Ferrannini M, Scaramucci L, Di Segni G, Giovannini M, Niscola P, Palumbo R. Motor disability in end-stage renal failure: An epidemiological study on Italian dialyzed patients. Saudi J Kidney Dis Transpl [serial online] 2011 [cited 2019 Nov 14];22:1236-7. Available from: http://www.sjkdt.org/text.asp?2011/22/6/1236/87242
To the Editor,

The results of a cross-sectional study exploring motor disability (MD) by Barthel Index (BI) in a consecutive series of Italian dialyzed patients are reported. End-stage renal disease (ESRD) may progressively cause debilitating deterioration of the patients' personal status, physical reconditioning and several forms of MD, often leading to severe limitations in performing activities of daily living (ADL) and in the loss of individual independence. [1] Although several forms of MD are frequently encountered in ESRD patients, yet information regarding its origin, frequency and management is relatively scarce. A large variety of disabling conditions, which may be related to the primary renal disease, to the treatment being administered or, to associated co-morbidities, may be observed in this setting. [2] Moreover, limitations in performing daily activities affect the well-being and the quality of life (QoL) of the patients, as well as increase the burden on caregivers and the use of health services. In this regard, nephrologists will increasingly be faced with problems arising from functional decline in the setting of hemodialysis. In order to address this issue, we performed a cross-sectional evaluation of MD in a group of consecutive ESRD patients on HD. The MD was assessed using BI, [3] and was used as the basic ADL ability scale; it was classified as mild (BI > 66%), moderate (BI 33-66%) and severe (BI < 33%). There were 82 patients with a median age of 60 years (range 20-76 years). Disability was pre-sent in 33 of the 82 patients (40%); it was mild in 24%, moderate in 15% and severe in 1% of the patients. The frequency reduction of the various BI items is shown in [Figure 1], which shows that complex activities, such as ascending and descending stairs, moving on level surface, dressing and transferring from chair to bed, are the most frequently impaired basic ADL in disabled ESRD patients. In conclusion, although preliminary and related to a limited series of patients, our data provide new insights on a neglected issue in nephrology, such as disability. Indeed, MD is a frequent feature in ESRD patients, but extended data analysis is required to achieve a better understanding about the disablement process and its related risk factors in this setting. A targeted rehabilitative approach to prevent and treat disability, not available in the majority of wards, may lead to positive effects on both patient's QoL and caregiver work-load.
Figure 1: Frequency of activities of daily living impairment expressed as BI items score reduction (item score < maximum score).

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   References Top

1.Tsutsui H, Koike T, Yamazaki C, et al. Identification of hemodialysis patients' common problems using the International Classification of Functioning, Disability and Health. Ther Apher Dial 2009;13(3): 186-92.  Back to cited text no. 1
    
2.Krishnan AV, Pussell BA, Kiernan MC. Neuromuscular disease in the dialysis patient: An update for the nephrologist. Semin Dial 2009;22(3):267-78.  Back to cited text no. 2
    
3.Mahoney Fi, Barthel DW. Functional Evaluation: The Barthel Index. Md State Med J 1965;14:61-5.  Back to cited text no. 3
    

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Correspondence Address:
Pasquale Niscola
Hematology Unit, S. Eugenio Hospital, Home Care Service of the Rome Association against Leukemias, Lymphomas and Myeloma (Romail), Rome
Italy
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PMID: 22089791

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