TOWARDS PATIENT-CENTERED CKD CARE: QUALITY OF LIFE AND SLEEP BURDEN AMONG PATIENTS IN NORTHERN TANZANIA.

 

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https://storage.unitedwebnetwork.com/files/1099/086e513ddab1afa51c96623aa5e30fb8.pdf
TOWARDS PATIENT-CENTERED CKD CARE: QUALITY OF LIFE AND SLEEP BURDEN AMONG PATIENTS IN NORTHERN TANZANIA.

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Kajiru
Kilonzo
Kajiru Kilonzo kajiru@yahoo.com KCMC University Internal Medicine Moshi Tanzania *
Cuthbert Matay mataycuth@gmail.com KCMC University Internal Medicine Moshi Tanzania -
Brigita Mariwa brigitta.mariwa@gmail.com KCMC University Internal Medicine Moshi Tanzania -
Huda Akrabi drakrabi@gmail.com KCMC University Internal Medicine Moshi Tanzania -
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Chronic kidney disease care is expensive and yet associated with high morbidity and mortality. Despite a modest survival advantage of CKD care, there is a need to improve the quality of care. Measures used in quality improvement have moved from purely traditional outcomes like blood pressure control, estimated GFR decline and other blood values to a more patient centered approach. The patient's well-being as reported by a measure of sleep quality or psychosocial burden is a true reflection of success of care. The aim of this work was to outline the quality of CKD care among outpatients using health related quality of life and sleep quality measurements

Two separate cross sectional studies were conducted between November 2024 to March 2025 among adult outpatients attending both the dialysis unit and nephrology outpatient clinic at Kilimanjaro Christian Medical Center, a tertiary referral hospital in Northern Tanzania. Data were collected using a structured  questionnaire including Kidney Disease Quality of Life tool (KDIQoLTM-36) and Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Clinical and demographic data were obtained from patient records. Associations between clinical variables and HRQoL or sleep quality were analyzed using appropriate statistical tests, with significance set at p<0.05.

A total of 479 patients were assessed. The mean health-related quality of life among participants was 49.10 ± 13.7 (N=138) and the prevalence of poor sleep quality was 36% (N=341). Factors associated with poor sleep quality included Depression, Anxiety and use of amitriptyline. While factors associated with a low HRQoL was a history of hospital admission in the past 6 months and hypocalcemia.


These studies highlight important opportunities to improve the quality of CKD care in Tanzania by integrating patient-reported outcomes into routine clinical assessment. Efforts to look for ways to strengthen screening for depression, Anxiety and sleep disorders should be prioritized, alongside correction of modifiable biochemical abnormalities such as hypocalcemia represent focused areas of interventions to improve the HRQoL among patients at a tertiary hospital in northern Tanzania.


Kewords