Inactivity and Quality of Life in Dialysis Patients
Condition: Chronic Kidney Diseases; End Stage Renal Disease; Hemodialysis Complication; Peritoneal Dialysis
MeSH terms: Kidney Diseases; Renal Insufficiency, Chronic; Kidney Failure, Chronic
Study type: Observational

Summary: 
      The goal of this observational study is to compare hemodialysis and peritoneal dialysis
      patients. The main questions it mains to answer are:

        -  What is the level of physical activity in hemodialysis and peritoneal dialysis patients?

        -  What is the level of quality of life of hemodialysis and peritoneal dialysis patients?

        -  Is there any relation between inactivity and quality of life in hemodialysis and
           peritoneal dialysis patients?

      Participants will answer 2 questionnaires and will do some functional tests.
    

Detailed description: 
      Physical functioning and physical activity are low in patients treated with maintenance
      hemodialysis (HD).

      One of the factors that lead to a further decrease in the activity of hemodialysis patients
      and its complications is the immobility of these patients during hemodialysis. This method of
      treatment forces patients to remain motionless for 4 hours on average 3 times a week. In
      addition, fatigue after dialysis also requires additional rest and immobility for about 2 to
      6 hours.

      Sedentary behaviors are also common in peritoneal dialysis (PD) patients (about 63%), and
      studies have shown that there is no significant difference between the physical activity
      level of PD and HD patients.

      In PD patients, in addition to reducing functional capacity and feeling extreme fatigue, the
      fear of dialysis fluid leakage, hernia and infection also causes a decrease in physical
      activity and an increase in inactivity in these patients.

      The lack of physical mobility and the resulting movement restrictions affect the patient's
      independence and ability to perform daily tasks, including self-care. In addition, the
      emotional and mental health of patients is greatly affected by these restrictions Inactivity
      sets off a vicious cycle in which energy imbalances can increase comorbidities such as
      hypertension, diabetes, coronary artery disease, depressive disorders, hospitalization rates,
      and disability. Each of these conditions aggravates the decrease in the quality of life and
      increases the mortality of patients.

      Quality of life is an important aspect of treatment outcomes and should be considered when
      evaluating the quality and effectiveness of renal care services.

      The quality of life in CKD patients and especially dialysis patients decreases under the
      influence of several factors such as weakness, disability, reduced functional capacity,
      anemia, malnutrition, impaired cognitive function, worsening sleep quality, increased
      depression, and the development of cardiovascular disorders The quality of life of renal
      patients and its social and emotional aspects are considered as the main determinants of
      these clinical outcomes.

      Decreasing the quality of life in hemodialysis patients and peritoneal dialysis patients
      decreases the survival and increases the mortality of these patients. Improving the quality
      of life should not only be considered as a therapeutic goal in itself, but should also be
      considered as an essential factor in reducing the number of hospitalizations and deaths of
      dialysis patients.

      This study aims to evaluate the quality of life of HD patients as well as PD patients. Also
      this study will evaluate the effect of inactivity on quality of life, stratified by both
      dialysis modality and will compere the results in these two dialysis modalities.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Hemodialysis and peritoneal dialysis patients being treated with the same respective
        dialysis modalities for at least 3 months and being ambulatory (with or without assistive
        device) will be included.

        But non-ambulatory patients having significant cognitive dysfunction, progressive
        degenerative,neurologic disease or severe rheumatologic or orthopedic conditions, angina
        upon exertion, or myocardial infarction or cardiac surgery within the last year will be
        excluded.
      
Keywords: Inactivity; Quality of life; Physical activity; Sedentary lifestyle; Peritoneal Dialysis; Hemodialysis; Exercise