Kidney international
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Kidney international · Nov 2009
ReviewHealth related quality of life and the CKD patient: challenges for the nephrology community.
The compromised health-related quality of life (HRQOL) of patients with chronic kidney disease is now well documented. The recent mandate by the Center for Medicare Services in the United States that all dialysis units monitor HRQOL as a condition of coverage has focused attention on the importance of these measures. ⋯ Can HRQOL of these patients be improved? The present review addresses this issue by commenting on strategies that have been used to improve the HRQOL of chronic kidney disease patients. A systematic approach is suggested for nephrology care providers to attempt to evaluate and improve the HRQOL of CKD patients.
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Hemodialysis patients have greater morbidity and mortality when they have a catheter rather than an arteriovenous fistula access. Catheter infection plays a significant role in this effect. Inflammation associated with dialysis catheter use could have an independent adverse effect on patient outcomes. Awareness and further study of the role of inflammation are needed.