Associação da qualidade de vida dos nefropatas crônicos com o tipo de acesso vascular para hemodiálise

Abstract

BACKGROUND: The question of quality of life evaluation of patients, in different conditions, is increasingly present in the national and international literature, since its study provides important knowledge for several health decision making. OBJECTIVE: In the present study, we sought to evaluate the quality of life of patients with chronic kidney disease, taking into account the type of vascular access used in hemodialysis. METHOD: In terms of the methodology used, this is a descriptive, cross-sectional study with a quantitative approach of patients diagnosed with end stage renal disease and need for hemodialysis renal replacement therapy, attended at a reference clinic in Manaus. The study population was composed of patients regularly enrolled in this service. For the purposes of data analysis and systematization, the patients were allocated, forming groups according to the vascular access that allows the interface with the dialysis machine. The patients interviewed responded to a quality of life questionnaire, the Kidney Disease and Quality-of-Life Short Form 36 (KDQOL-SF36). A total of 187 individuals were interviewed, of which 68% were in the vascular access group due to simple arteriovenous fistula, 13% of the vascular access group due to complex arteriovenous fistula with basilic vein superficiality, 12% of the group with vascular access through a double lumen catheter, 5 % of the group with vascular access through a long-stay catheter of the permcath type and 2% with arteriovenous fistula with prosthesis. RESULTS: The results obtained had their internal validity tested by Cronbach's Alpha, which revealed a value higher than 0.7, demonstrating the credibility of the information collected. The results obtained through the analysis of KDQOL-SF36, showed that there is a difference in patients' perception of quality of life, depending on the type of vascular access used for hemodialysis. The assessed dimension in which the superiority of one type of access over the other was most evident was the "list of symptoms and problems" in which simple AVF, with 93.75% versus 55.5% of the permcath patient group, judged to have good QV, with a p value of 0.008. CONCLUSIONS: It was concluded that among the possibilities of vascular access existing for hemodialysis, simple AVF was what provided better parameters of quality of life for patients.