Functional Status in Hemodialysis - A Comparative Study with FIM, ADLQ and 7D5L Instruments

Area of Science:

• Nephrology
• Gerontology
• Rehabilitation Medicine

Background:

• Limited data exists on functional status (FS) for hemodialysis (HD) patients in developing nations.
• Chronic kidney disease (CKD) etiology and demographics differ significantly in these regions.
• Assessing FS is crucial for understanding patient well-being and care needs.

Purpose of the Study:

• To evaluate the functional status of patients undergoing hemodialysis (HD) in a developing country.
• To compare the efficacy of three validated generic instruments in assessing FS.
• To identify specific functional domains most affected in this patient population.

Main Methods:

• A cross-sectional study involving 116 adult HD patients with >3 months dialysis vintage.
• Functional status assessed using Functional Independence Measure (FIM), Seven domains and five levels (7D5L), and Activities of Daily Living Questionnaire (ADLQ).
• Data analysis focused on mean scores and proportion of patients demonstrating independence across instruments.

Main Results:

• Patients generally showed good functional independence via FIM and ADLQ, with over 80% independence on ADLQ.
• The 7D5L scale identified more limitations, suggesting sensitivity to mild-moderate functional deficits.
• Locomotion, mobility, and motor task domains were more impaired, particularly in patients under 40 years old.

Conclusions:

• Hemodialysis patients in this setting demonstrate overall functional independence by FIM and ADLQ.
• The 7D5L scale is valuable for detecting subtle functional impairments in daily activities.
• Motor and mobility domains require targeted interventions, and age impacts functional status.
• Existing FS assessment tools may lack a time-dependent component crucial for HD patients.