Andrzej Matyja

Background: Pain is a common and clinically important symptom in hemodialysis, yet its functional impact and determinants remain insufficiently characterized. This study examined factors associated with pain interference using the Pain Effects Scale (PES) in maintenance hemodialysis patients. Methods: In a cross-sectional study, 73 adults receiving thrice-weekly hemodialysis completed the PES, assessing the four-week impact of pain on mood, sleep, mobility, work, recreation, and enjoyment of life. Demographic, clinical, and dialysis-related variables—including vascular access type, dialysis vintage, session duration, ultrafiltration volume, predialysis urea, Kt/V, urea reduction ratio, comorbidities, and transplant history—were extracted from medical records. Associations were evaluated using parametric and non-parametric tests. Results: PES scores indicated substantial pain interference. Older age was positively correlated with higher PES scores (r = 0.32, p = 0.006), and patients with ischemic heart disease had significantly higher PES values than those without (23.1 ± 6.7 vs. 17.3 ± 6.2; p = 0.012). Willingness to pursue transplantation showed a non-significant trend toward lower scores. Conclusions: Pain interference in hemodialysis appears largely independent of routine adequacy metrics and most comorbidities, with ischemic cardiovascular disease emerging as an exception. Findings underscore the need for a biopsychosocial approach integrating pain screening with assessment of mood, sleep, neuropathy, musculoskeletal factors, and ischemic symptoms.

Background and Objectives: Sexual satisfaction is a distinct patient-centered outcome in hemodialysis. Yet its links to routine dialysis parameters remain unclear. To examine sexual satisfaction—assessed with the Sexual Satisfaction Scale (SSS)—in adults receiving maintenance hemodialysis in relation to demographic and dialysis parameters, and to compare SSS scores with healthy controls. Materials and Methods: Cross-sectional study of adults on maintenance hemodialysis (n = 72) and controls (n = 52). Sexual satisfaction was measured with the SSS (higher scores indicate greater dissatisfaction) among respondents with one primary partner. Demographic, clinical, and dialysis variables (shift, session duration, access, vintage, ultrafiltration, predialysis urea, Kt/V, urea reduction ratio), as well as transplant history/intent, were recorded. Group comparisons used t/Welch tests or ANOVA; correlations used Pearson’s r. Results: The SSS did not differ by sex, marital status, education, vascular access, dialysis shift, session duration, or adequacy indices. Prior kidney transplantation was associated with significantly lower SSS scores (mean 9.73 vs. 14.49; p = 0.0047), indicating better sexual satisfaction. Conclusions: Sexual dissatisfaction is common yet largely independent of routine demographic and dialysis metrics. Only previous kidney transplantation showed a significant association with sexual satisfaction in our cohort (p = 0.0047). Findings support a biopsychosocial, patient-centered approach and routine attention to sexual health in hemodialysis care.

Background and Objectives: Chronic kidney disease frequently progresses to end-stage renal disease, requiring dialysis, which imposes significant physical, psychological, and social burdens. Age is a key factor influencing symptom experience and quality of life in dialysis patients, yet findings on its impact remain mixed. This study aimed to examine how age relates to a broad range of health domains—including fatigue, pain, cognition, mental health, sexual satisfaction, bowel control, visual impairment, social support, and quality of life—among hemodialysis patients. Materials and Methods: A cross-sectional study was conducted at a single dialysis center in Poland, involving 79 adult patients undergoing maintenance hemodialysis. Standardized, validated psychometric instruments were used, including the Modified Fatigue Impact Scale (MFIS), Perceived Deficits Questionnaire (PDQ), Pain Effects Scale (PES), Mental Health Inventory (MHI), Modified Social Support Survey (MSSS), Sexual Satisfaction Scale (SSS), Bowel Control Scale (BWCS), Impact of Visual Impairment Scale (IVIS), and WHOQOL-BREF for quality of life. Spearman’s or Pearson’s correlation coefficients were used to evaluate relationships between age and scale scores. Full and abbreviated versions of scales were also compared. Results: Age showed moderate positive correlations with fatigue (ρ = 0.44–0.53), cognitive deficits (ρ = 0.37–0.45), pain (r = 0.41), bowel control issues (ρ = 0.32), and visual impairment (ρ = 0.37), all statistically significant (p < 0.01). No significant associations were observed between age and mental health (MHI), perceived social support (MSSS), or quality of life (WHOQOL-BREF). Abbreviated versions of the scales showed strong correlations with their full versions (ρ > 0.9). Conclusions: While age is linked to increased symptom burden in select domains such as cognition, fatigue, and pain, it does not significantly affect mental health, perceived social support, or overall quality of life in hemodialysis patients. These findings support the use of age-sensitive, multidimensional assessments to inform individualized care strategies.

This study investigates fatigue and quality of life in hemodialysis patients, examining the influence of demographic and clinical factors on these outcomes. A cohort of 115 hemodialysis patients and 112 healthy controls completed the Modified Fatigue Impact Scale (MFIS), the shorter MFIS-5, and the WHOQOL-BREF quality of life assessment. The findings indicate that hemodialysis patients experience significantly higher levels of fatigue, which correspond with lower quality of life, particularly in the physical and psychological domains, compared to healthy controls. Male patients reported significantly higher levels of fatigue and lower quality of life scores, whereas younger patients demonstrated relatively better outcomes. Extended dialysis sessions exceeding four hours were associated with poorer social well-being, and educational attainment was positively linked with physical and environmental quality of life domains. However, marital status did not show a significant effect. The study validates the consistency between MFIS and MFIS-5 scores, recommending MFIS-5 for time-sensitive clinical use without compromising accuracy. These results underscore the need for individualized, multi-dimensional approaches to fatigue management in hemodialysis patients, emphasizing interventions that address physical, psychological, and social well-being to enhance overall quality of life. The findings highlight specific factors that may guide tailored support strategies to improve patient outcomes in this population.

Background: Dialysis patients face multidimensional challenges that affect their quality of life. This study aimed to evaluate the association between dialysis duration and various physical, cognitive, and psychosocial parameters, including fatigue, pain, sexual satisfaction, bowel control, vision, cognitive deficits, mental health, social support, quality of life, and life satisfaction, while incorporating sociodemographic data for greater context. Methods: A cross-sectional study was conducted using validated instruments such as the Modified Fatigue Impact Scale (MFIS), Pain Effect Scale (PES), Sexual Satisfaction Scale (SSS), Bowel Control Scale (BWCS), Impact of Visual Impairment Scale (IVIS), Perceived Deficits Questionnaire (PDQ), Mental Health Inventory (MHI), Modified Social Support Survey (MSSS), WHOQOL-BREF, and Cantril Ladder. Associations between dialysis duration and these parameters were analyzed. Correlations between current and future life satisfaction were also examined. Results: Dialysis duration significantly affected sexual satisfaction, with scores worsening over time (p = 0.029). Cognitive deficits in planning and organization exhibited a near-significant trend (p = 0.072). Patients with low current life satisfaction anticipated significant future declines (p = 0.001). However, no significant associations were observed between dialysis duration and fatigue, pain, bowel control, vision, mental health, social support, overall quality of life, or life satisfaction. Conclusions: Prolonged dialysis negatively influences sexual satisfaction and may impact specific cognitive domains. The relationship between current and expected life satisfaction highlights the importance of addressing psychological health in this population. While other parameters remained unaffected, individualized care strategies focusing on sexual, cognitive, and psychological support could improve outcomes. Future research should focus on exploring these relationships further and developing targeted interventions to address vulnerable areas, such as sexual, cognitive, and psychological health.

Background and Objectives: Hemodialysis patients face significant physical and psychological challenges, including diminished quality of life and reduced social support. This study aimed to assess the levels of social support and quality of life in hemodialysis patients and identify the sociodemographic and dialysis-related factors influencing these outcomes. Materials and Methods: This study included 115 hemodialysis patients and 107 healthy controls. Social support was measured using the Modified Social Support Survey (MSSS) and its abbreviated version (MSSS-5). Quality of life was assessed using the WHOQOL-BREF questionnaire. Demographic variables (age, sex, education, marital status) and dialysis-related factors (session duration, Kt/V, vascular access type, and urea reduction ratio) were analyzed to determine their effects on social support and quality of life. Results: Hemodialysis patients reported significantly lower scores in the Physical Health and Psychological Health domains of the WHOQOL-BREF compared to healthy controls. Males on hemodialysis scored lower than the controls in the Physical Health, Psychological Health, and Environment domains of the WHOQOL-BREF and the Affectionate Support and Positive Social Interaction subscales of MSSS. Conversely, hemodialysis females reported higher scores for Tangible Support, Emotional/Informational Support, and Affectionate Support. Longer dialysis sessions negatively impacted the Social Relationships domain. Married hemodialysis patients had higher Emotional/Informational Support and Affectionate Support scores. Conclusions: Hemodialysis patients experience diminished physical and psychological quality of life, particularly males. Social support, especially emotional and informational support, is crucial for hemodialysis patients, with marital status playing a key role. Addressing these psychosocial factors may improve outcomes for hemodialysis patients.

Background and Objectives: The growing and aging population of hemodialysis patients has become increasingly disabled, with more complex comorbidities, and are older upon initiating dialysis. Visual impairment can adversely affect their quality of life and life satisfaction. Treatment evaluation should not only consider remission of the disease, but also the improvement of quality of life and life satisfaction. This is a single-center cross-sectional study. It was designed to evaluate visual impairment in hemodialyzed patients, its correlation with quality of life and life satisfaction, and its relationship to clinical outcomes in hemodialyzed patients. Materials and Methods: Seventy patients with chronic kidney disease undergoing hemodialysis and aged 18 years or older were recruited from a single Dialysis Unit. The Impact of Visual Impairment Scale (IVIS), WHOQOL-BREF, and Cantril Ladder questionnaires were utilized to assess both sociodemographic and clinical variables. Results: It was found that, among all assessed variables (i.e., sex, marital status, level of education, months on hemodialysis, history of kidney transplantation, Kt/V, URR, and UF), only age and central venous catheter placement were positively correlated with IVIS scores, while arteriovenous fistula and willingness to become a kidney transplant recipient were negatively correlated. Furthermore, a comparison between patients with moderate and severe visual impairment yielded supplemental data indicating that individuals whose dialysis access was through a dialysis catheter and those ineligible or unwilling to undergo transplantation suffered more often from severe visual impairment. This finding may be attributed to age. Conclusions: Older patients were predominantly observed to experience visual impairment. Patients intending to receive a kidney transplant and whose dialysis access was through an arteriovenous fistula were less prone to visual impairment, compared to those who may be ineligible or unwilling to receive transplantation and those with hemodialysis catheters. This phenomenon can be attributed to age-related distinctions in patients’ suitability for specific dialysis access and transplantation. Those reporting visual impairment gave lower ratings in all four domains of their quality of life (comprising physical health, psychological health, social relationships, and environment) and in both present and anticipated five-year life satisfaction. More severe visual impairment was related to an additional reduction in physical health, social relationship, and environment domains, and in life satisfaction.

COVID-19 vaccinations are about to begin in various countries or are already ongoing. This is an unprecedented operation that is also met with a loud response from anti-vaccine communities—currently using all available channels to manipulate public opinion. At the same time, the strategy to educate on vaccinations, explain their mechanism of action, and build trust in science is subdued in different world parts. Such actions should go much beyond campaigns promoting the COVID-19 vaccines solely on the information provided by the health institutions and national authorities. In this paper, actions provided by independent expert groups needed to counteract the anti-vaccine propaganda and provide scientific-based information to the general public are offered. These actions encompass organizing groups continuously communicating science on COVID-19 vaccines to the general public; tracking and tackling emerging and circulating fake news; and equipping celebrities and politicians with scientific information to ensure the quality of messages they communicate, as well as public letters, and statements of support for vaccination by healthcare workers, recognized scientists, VIPs, and scientific societies; and no tolerance to false and manipulated claims on vaccination spread via traditional and social media as well as by health professionals, scientists, and academics. These activities should be promptly implemented worldwide, regardless of the current status and availability of the COVID-19 vaccine in a particular region. If we are about to control the pandemic for the sake of public benefit, it is high time to collectively speak out as academic and medical societies with support from decision-makers. Otherwise, the battle will be lost to those who stand against scientific evidence while offering no feasible solution to the problem.

Most pancreatoduodenectomy resections do not meet the minimum of 12 lymph nodes recommended by the American Joint Committee on Cancer for accurate staging of periampullary malignancies. The purpose of this study was to investigate factors affecting the likelihood of adequate nodal yield in pancreatoduodenectomy specimens subject to routine pathological assessment. Six hundred sixty-two patients subject to pancreatoduodenectomy between 1990 and 2013 for pancreatic, ampullary, and common bile duct cancers were reviewed. Predictors of yielding at least 12 lymph nodes were evaluated with a logistic regression model, and a survival analysis was carried out to verify the prognostic implications of nodal counts. The median number of evaluated nodes was 17 (interquartile range 11 to 25), and less than 12 lymph nodes were reported in surgical specimens of 179 (27 %) patients. Tumor diameter ≥20 mm (odds ratio [OR] 2.547, 95 % confidence interval [CI] 1.225 to 5.329, P = 0.013), lymph node metastases (OR 2.642, 95 % CI 1.378 to 5.061, P = 0.004), and radical lymphadenectomy (OR 5.566, 95 % CI 2.041 to 15.148, P = 0.01) were significant predictors of retrieving 12 or more lymph nodes. Lymph node counts did not influence the overall prognosis of the patients. However, a subgroup analysis carried out for individual cancer sites demonstrated that removing at least 12 lymph nodes is associated with better prognosis for pancreatic cancer. Few variables affect adequate nodal yield in pancreatoduodenectomy specimens subject to routine pathological assessment. Considering the ambiguities related to the only modifiable factor identified, appropriate pathology training should be considered to increase nodal yield rather than more aggressive lymphatic dissection.