Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Instrumentation
2.3. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | n (%) | Mean ± SD | Range | |
---|---|---|---|---|
Age | <60 years old | 121 (55.8) | 57 ± 13 | 24–80 |
≥60 years old | 96 (44.2) | |||
Sex | Female | 110 (50.2) | ||
Male | 108 (49.8) | |||
Marital status | Single | 18 (8.3) | ||
Married | 170 (78.3) | |||
Divorced | 3 (1.4) | |||
Widow/widower | 26 (12.0) | |||
Educational level | No formal education | 4 (1.8) | ||
Primary | 37 (17.1) | |||
Secondary | 104 (47.9) | |||
Tertiary | 72 (33.2) | |||
Employment status | Employed | 51 (23.5) | ||
Unemployed | 64 (29.5) | |||
Retired | 102 (47.0) | |||
Monthly Household income (RM) * | B40 (<3860) | 151 (69.6) | ||
M40 (3860–8319) | 46 (21.2) | |||
T20 (≥8320) | 20 (9.2) | |||
Duration of dialysis (months) | 55.4 ± 48.7 | 3–360 | ||
Presence of Comorbidities † | Hypertension | 176 (81.1) | ||
Diabetes mellitus | 121 (55.8) | |||
Total BDI Score | 5.76 ± 5.66 | 0.00–27.00 | ||
Level of Depression | None or minimal | 165 (76.0) | ||
Mild to moderate | 44 (20.3) | |||
Moderate to severe | 8 (3.7) | |||
Level of Social Support ‡ | Family | 190 (87.6) | ||
Friends | 127 (58.5) | |||
Significant others | 175 (80.6) | |||
PSQI score | 6.15 ± 3.54 | |||
Classification of Sleep Quality | Good sleepers | 104 (46.6) | ||
Poor sleepers | 119 (53.4) | |||
Duration of Sleep (hour/day) | <5 hour/day | 74 (34.1) | 5.6 ± 1.8 | |
5–6 hour/day | 45 (20.7) | |||
6–7 hour/day | 46 (21.2) | |||
>7 hour /day | 52 (23.9) | |||
Creatinine (µmol/L) | 950.6 ± 212.5 | 452.7–1021.5 | ||
Serum alkaline phosphatase (units/L) | 385.0 ± 160.0 | 140–1120 | ||
Corrected serum calcium (mmol/L) | Low (<2.10) | 36 (16.6) | 2.23 ± 0.24 | 1.65–2.77 |
Normal (2.10–2.37) | 121 (55.8) | |||
Elevated (>2.37) | 60 (27.6) | |||
Intact parathyroid hormone (pg/mL) | <150 | 126 (58.1) | 248.5 ± 163.2 | 118–452 |
150–300 | 36 (16.6) | |||
>300 | 55 (25.3) | |||
Dialysis Adequacy (Kt/V) | <1.2 | 25 (11.5) | 1.42 ± 0.43 | 1.28–1.51 |
>1.2 | 192 (88.5) | |||
Serum phosphate (mmol/L) | Normal (<1.6) | 49 (22.6) | 1.83 ± 0.50 | 0.78–3.37 |
Elevated (≥1.6) | 168 (77.4) | |||
Missing of phosphate binders | Yes | 155 (71.4) | ||
No | 62 (28.6) | |||
Reasons of missing phosphate binders † | Careless | 138 (63.6) | ||
Forgetful | 112 (51.6) | |||
High tablet burden | 92 (42.4) | |||
Gastrointestinal discomfort/Unpleasant taste | 87 (40.1) | |||
Nutrition knowledge on phosphorus | <60% | 204 (94.0) | ||
≥60% | 13 (6.0) | |||
Factors affecting optimal phosphate control † (patients’ perception) | Dialysis process alone | 183 (84.3) | ||
Low phosphorus diet alone | 158 (72.8) | |||
Phosphate binders alone | 116 (53.5) | |||
All the above | 59 (27.2) |
Variables | Simple Linear Regression | Multiple Linear Regression | ||
---|---|---|---|---|
Standardized Coefficients (β) | p | Standardized Coefficients (β) | p | |
Dialysis adequacy (Kt/V) | −0.455 | 0.007 | −0.413 | 0.011 |
Adherence on Phosphate binders | −0.442 | 0.012 | −0.368 | 0.021 |
Age | −0.334 | 0.015 | −0.305 | 0.026 |
Sleep Duration | −0.378 | 0.032 | −0.288 | 0.037 |
Presence of diabetes mellitus | 0.326 | 0.035 | 0.272 | 0.038 |
Presence of depression | −0.358 | 0.033 | −0.265 | 0.041 |
Social Support | −0.152 | 0.154 | −0.141 | 0.044 |
Employment status | −0.271 | 0.037 | - | - |
Household income | 0.259 | 0.041 | - | - |
Presence of hypertension | 0.189 | 0.056 | - | - |
Duration of dialysis | 0.176 | 0.124 | - | |
PSQI score | 0.130 | 0.274 | - | - |
Nutritional knowledge on Phosphorus | −0.115 | 0.360 | - | - |
Variables | n (%) | Serum Phosphate (mmol/L) Mean ± SD | t or F Value † |
---|---|---|---|
Dialysis adequacy (Kt/V) | |||
<1.2 | 25 (11.5) | 2.18 ± 0.33 | 2.64 * |
>1.2 | 192 (88.5) | 1.78 ± 0.24 | |
Age (years) | |||
<60 | 121 (55.8) | 1.93 ± 0.38 | 2.35 * |
≥60 | 96 (44.2) | 1.70 ± 0.61 | |
Presence of Diabetes | |||
Yes | 121 (55.8) | 1.89 ± 0.51 | 2.01 * |
No | 96 (44.2) | 1.75 ± 0.54 | |
Level of Depression ‡ | |||
None or minimal | 165 (76.0) | 1.90 ± 0.59 a | 5.02 * |
Mild to moderate | 44 (20.3) | 1.59 ± 0.60 b | |
Moderate to severe | 8 (3.7) | 1.62 ± 0.45 b | |
Level of Social Support ‡ | |||
Low or Moderate# | 59 (27.2) | 1.99 ± 0.61 a | 2.12 * |
High | 158 (72.8) | 1.77 ± 0.64 b | |
Duration of Sleep (hour/day) ‡ | |||
<5 | 74 (34.1) | 2.04 ± 0.53 a | 5.68 * |
5–6 | 45 (20.7) | 1.86 ± 0.48 b | |
6–7 | 46 (21.2) | 1.67 ± 0.48 c | |
>7 | 52 (23.9) | 1.65 ± 0.51 c | |
Adhered to phosphate binders | |||
Yes | 62 (28.6) | 1.63 ± 0.46 | 2.48 * |
No | 155 (71.4) | 1.91 ± 0.51 |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Ng, E.S.Y.; Wong, P.Y.; Kamaruddin, A.T.H.; Lim, C.T.S.; Chan, Y.M. Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia. Int. J. Environ. Res. Public Health 2020, 17, 5144. https://doi.org/10.3390/ijerph17145144
Ng ESY, Wong PY, Kamaruddin ATH, Lim CTS, Chan YM. Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia. International Journal of Environmental Research and Public Health. 2020; 17(14):5144. https://doi.org/10.3390/ijerph17145144
Chicago/Turabian StyleNg, Eileen Suk Ying, Poh Yoong Wong, Ahmad Teguh Hakiki Kamaruddin, Christopher Thiam Seong Lim, and Yoke Mun Chan. 2020. "Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia" International Journal of Environmental Research and Public Health 17, no. 14: 5144. https://doi.org/10.3390/ijerph17145144
APA StyleNg, E. S. Y., Wong, P. Y., Kamaruddin, A. T. H., Lim, C. T. S., & Chan, Y. M. (2020). Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia. International Journal of Environmental Research and Public Health, 17(14), 5144. https://doi.org/10.3390/ijerph17145144