WELL-BEING AND FUNCTIONAL ABILITY IN UREMIC PATIENTS BEFORE AND AFTERHAVING STARTED DIALYSIS TREATMENT

In this study perceived well-being and Functioning in 28 uraemic patie nts (14 women and 14 men, mean age 54 years) were measured in the pred ialysis stage during conservative renal therapy and 3-9 months after h aving started maintenance dialysis treatment. The patients had partici pated in a patient education programme in the predialysis stage. Disea se-specific symptoms, perceived health (Health Index), functional (SIP ) and emotional (STAI) status were analysed. The results showed that t here were no significant differences in the patients' correction of ur aemia, frequency of symptoms or anxiety prior to and after having star ted dialysis. After having started dialysis treatment, fatigue, lack o f energy and Functional disability in work increased while disability in recreation and pastime decreased. Standard bicarbonate correlated s ignificantly to the symptoms of leg cramps and itching. Serum albumin correlated significantly to eating dysfunction in the SIP. There was a large variation within the group with regard to their self-rated dist urbances. Some patients reported a relatively intact quality of life, some reported a moderate influence, and some a severe decrease in qual ity of life irrespective of whether they were in the predialysis state or on maintenance haemodialysis or CAPD. In conclusion, dialysis trea tment resulted in increased fatigue and lack of energy, while disease- specific symptoms, functional disability and anxiety did not increase during the first months on dialysis. The symptoms of itching and leg c ramps correlated significantly with level of metabolic acidosis, and e ating disability correlated with serum albumin levels, indicating that biochemical variables should be combined with patient assessment of h ealth and well-being in order to optimize treatment and care. Moreover , the wide range of scores in all the research variables indicates tha t assessment of quality of life can be helpful in allocating support t o those patients in need of it.