title: Patient's response to a simple question on recovery after hemodialysis session strongly associated with scores of comprehensive tools for quality of life and depression symptoms.
abstract: OBJECTIVE
  Many maintenance hemodialysis patients do not feel well after the hemodialysis session and need a time to recover. The main objective of the study was to investigate whether a simple question about the need of some time to recover from hemodialysis was associated with scores of comprehensive tools of depression symptoms and health-related quality of life (HRQOL).
  
  
  METHODS
  Cross-sectional evaluation of 800 Brazilian patients enrolled in the Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO). The KDQOL-SF was used for HRQOL and the 20-item CES-D and BDI for depression symptoms. Linear and logistic models were used for multivariable adjustments.
  
  
  RESULTS
  Patients who reported some time to recover (30%) had significantly (P < 0.001) higher depression symptoms scores (mean difference = 4.75 for CES-D and 4.48 for BDI). HRQOL scores were, in general, lower for patients who referred a time to recover, with mean differences larger than 4.0 (P < 0.05) both for physical and mental components. Strong associations of needing a time to recover and lower scores of several kidney disease-targeted HRQOL components were also observed. Differences in depression symptoms and HRQOL were largely reduced after adjustments for symptoms (muscle pain/cramps, faintness, fatigue, nausea/vomiting).
  
  
  CONCLUSIONS
  The results support the validity of a simple question on post-hemodialysis recovery as a proxy for scores of complex instruments for depression symptoms and HRQOL. The results suggest that the poorer HRQOL and higher depression probability in patients who need a time to recover from hemodialysis could be partially explained by the presence of hemodialysis-related symptoms.
authors.affiliation: Núcleo de Epidemiologia Clínica e Medicina Baseada em Evidências, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, BA, Brazil.
authors.forename: Gildete Barreto
authors.initials: GB
authors.lastname: Lopes
authors.forename: Luciana Ferreira
authors.initials: LF
authors.lastname: Silva
authors.forename: Gustavo Behrens
authors.initials: GB
authors.lastname: Pinto
authors.forename: Luiz Fernando
authors.initials: LF
authors.lastname: Catto
authors.forename: Marcia Tereza Silva
authors.initials: MT
authors.lastname: Martins
authors.forename: Margarida Maria Dantas
authors.initials: MM
authors.lastname: Dutra
authors.forename: Antonio Alberto
authors.initials: AA
authors.lastname: Lopes
mesh_terms: D001938:Brazil; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis / Q000009:adverse effects / Q000523:psychology*; D011795:Surveys and Questionnaires