Clinical and psychosocial factors predicting health‐related quality of life in hemodialysis patients

Abstract

Many patients with end-stage renal disease have significant impairment in health-related quality of life (HRQoL). Most previous studies have focused on clinical factors; however, quality of life can also be affected by psychosocial factors. The aim of this study was to identify the possible predictors of HRQoL among clinical and psychosocial factors in hemodialysis (HD) patients. The study included 101 patients who were undergoing HD. Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also assessed laboratory and clinical factors, including albumin, Kt/V as a marker of dialysis adequacy, normalized protein catabolic rate, and duration of HD. The Euro Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D) was used to evaluate HRQoL. The mean EQ-5D index score was 0.704 ± 0.199. The following variables showed a significant association with the EQ-5D index: age (P < 0.001), depression (P < 0.001), anxiety (P < 0.001), support from friends (P < 0.001), cognitive function (P < 0.001), duration of HD (P = 0.034), triglyceride (P = 0.031), total iron-binding capacity (P = 0.036), and phosphorus (P = 0.037). Multiple regression analysis showed that age (95% confidence interval [CI] -0.008 to -0.002), anxiety (95% CI -0.025 to -0.009), and support from friends (95% CI 0.004 to 0.018) were independent predictors of impaired HRQoL. This study explored determinants of impaired HRQoL in HD patients. We found that impaired HRQoL was independently associated with age, anxiety, and support from friends. We should consider psychosocial as well as clinical factors when evaluating ways to improve HRQoL in HD patients.

Do patient‐reported measures of symptoms and health status predict mortality in hemodialysis? An assessment of POS‐S Renal and EQ‐5D

“…Impaired health‐related quality of life (HRQOL) is associated with mortality in end stage renal disease, yet little is known about the ability of reported symptom or health status to prognosticate in this population. This is despite the reported association between self‐rated health and mortality both in the general population and in chronic kidney disease (CKD) …”

The health‐related quality of life among patients on maintenance haemodialysis: Evaluation using the “EQ‐5D”

“…One study involving Japanese patients on haemodialysis showed the EQ‐5D score was 0.75 ± 0.17 (Katayama et al, ). Another study among Korean patients on haemodialysis reported the HRQOL was 0.704 ± 0.199 (Kang et al, ). Sakthong & Kasemsup () reported that the EQ‐5D score for patients on peritoneal dialysis in Taiwan was 0.65 ± 0.23, whereas the score for this group in our study was 0.86 ± 0.12.…”

“…That study showed that factors such as no spouse, complications and a low education level were associated with lower HRQOL. A South Korean study that evaluated HRQOL among patients on haemodialysis using the EuroQol‐five dimensions (EQ‐5D) indicated that HRQOL deterioration was associated with increased age, increased anxiety and a lack of support from friends (Kang et al, ). The effects of disease on HRQOL are known to vary by differences in social status, cultural heritage, religion and lifestyle (Rui et al, ).…”

Mediating effects of fatigue on the relationships among sociodemographic characteristics, depression, and quality of life in patients receiving hemodialysis

“…Previous studies have reported different results regarding the effect of depression on QoL in patients receiving hemodialysis, with some claiming it to be a significant predictor of QoL (Birmele et al, ; Kring & Crane, ; Lee et al, ), and others pointing to its insignificance (Kang et al, ). In this study, the direct effect of depression on QoL was not found to be significant; however, depression was found to have a significant indirect effect on QoL through fatigue as a mediating variable.…”