Depressive Symptoms, Patient Satisfaction, and Quality of Life Over Time in Automated and Continuous Ambulatory Peritoneal Dialysis Patients

Abstract

Health-related quality of life (HRQOL) is an important clinical outcome for dialysis patients. However, relative superiority in HRQOL between automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) are not clearly known. We compared HRQOL over time between APD and CAPD patients and evaluated factors associated with HRQOL.All 260 incident patients initiating APD or CAPD at multiple centers throughout Korea were prospectively enrolled in this study between October 2010 and February 2013. HRQOL, depressive symptoms, and renal treatment satisfaction were assessed 1 and 12 months after the start of dialysis by the Kidney Disease Quality of Life Short Form 36 (KDQOL-36), the Beck Depression Inventory (BDI), and the Renal Treatment Satisfaction Questionnaire (RTSQ), respectively.Of 196 patients who completed all questionnaires and did not change the peritoneal dialysis (PD) modality during the 1-year follow-up period, 160 were matched. APD patients showed better baseline HRQOL than CAPD patients for the symptoms, patient satisfaction, pain, and social function domains. There were no differences in HRQOL between the 2 groups at 12 months, and CAPD patients had significantly greater improvements in symptoms (P = 0.02), the mental composite summary (P = 0.03), and health status domains (P = 0.03) than APD patients. There were similar improvements in depressive symptoms (P = 0.01) and patient satisfaction with treatment (P = 0.01) in CAPD and APD patients. Interestingly, depressive symptoms, not PD modality, was the most influential and consistent factor for HRQOL. Despite the spontaneous improvement of depressive symptoms, considerable PD patients still had depressive symptoms at the 1-year appointment.APD has no advantage over CAPD for HRQOL. Considering the substantial negative effect of depressive symptoms on HRQOL, it is important to evaluate PD patients for depression and to treat those with depression to improve their HRQOL.

Family caregiver's burden and the social support for older patients undergoing peritoneal dialysis

“…Other strategies, including developing interventions to provide sufficient attention to enable caregivers to be connected with the community, are crucial measures to improve their psychological health. Notably, depression was present in 75% of elderly people on PD in the current study, which was higher than that reported in previous studies among PD populations (Dong et al 2016; Jung et al 2016). As such, implementing standardized tools to screen for depression in elderly people on PD and developing dyadic psychological interventions using multidisciplinary approach including psychologists, nurses, physicians and other healthcare professionals, is of the utmost importance in supporting both elderly people on PD and their family caregivers.…”

Patient-reported advantages and disadvantages of peritoneal dialysis: results from the PDOPPS

“…Additionally, those with lower 24-h urine volumes may try to achieve greater peritoneal ultrafiltration with greater fill volumes, thereby further contributing to a feeling of fullness. We found that patients using APD tended to view PD more positively than those using CAPD, similar to previous findings [29]. Patients using APD accomplish the majority of their therapy at night while sleeping, allowing more flexibility with their time during the day.…”

Health-Related Quality of Life in Patients Treated with Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis in Singapore

“…De Wit et al observed better mental health in APD patients [ 10 ], while Bro et al found no difference in both physical and mental health [ 12 ]. Regarding the kidney disease-specific QOL, one previous study of incident PD patients showed that APD had advantages in KDQOL symptoms at 1 month, but significance disappeared at 12 months [ 22 ]. In our study, the HRQOL of CAPD and APD were almost equivalent, but physical health and KDQOL symptoms were in favor of APD.…”