Comparisons of quality of life between patients underwent peritoneal dialysis and hemodialysis: a systematic review and meta-analysis

Abstract

Objective: End-stage renal disease (ESRD) leads to renal replacement therapy and certainly has an impact on patients' health-related quality of life (HRQoL). This study aimed to review and compare the HRQoL between peritoneal dialysis (PD) and hemodialysis (HD) patients using the 36-Item Short Form Health Survey (SF-36), EuroQoL-5-dimension (EQ-5D) and the Kidney Disease Quality of Life Instrument (KDQOL). Methodology: Systematic review was conducted by identify relevant studies through MEDLINE and SCOPUS up to April 2017. Studies were eligible with following criteria: studied in ESRD patients, compare any pair of renal replacement modalities, and reported HRQoL. The unstandardized mean differences (USMD) of HRQoL among modalities were calculated and pooled using a random-effect models if heterogeneity was present, otherwise a fixed-effect model was applied. Results: A total of twenty-one studies were included with 29,000 participants. Of them, mean age and percent male were 48.1 years and 45.1, respectively. The pooled USMD (95% CI) of SF-36 between PD and HD (base) were 1.86 (0.47, 3.24) and 0.42 (− 1.99, 2.82) for mental component and physical component summary scores, respectively. For EQ-5D, the pooled USMD of utility and visual analogue scale (VAS) score were 0.02 (− 0.06, 0.10) and 3.56 (1.73, 5.39), respectively. The pooled USMD of KDQOL were 9.67 (5.67, 13.68), 6.71 (− 5.92, 19.32) 6.30 (− 0.41, 12.18), 2.35 (− 4.35, 9.04), 2.10 (0.07, 4.13), and 1.21 (− 2.98, 5.40) for burden of kidney disease, work status, effects of kidney disease, quality of social interaction, symptoms, and cognitive function. Conclusion: Patients with chronic kidney disease (CKD) stage 5 or ESRD treated with PD had better generic HRQoL measured by SF-36 and EQ-5D than HD patients. In addition, PD had higher specific HRQoL by KDQOL than HD patients in subdomain of physical functioning, role limitations due to emotional problems, effects and burden of kidney disease.

Prevalence of Depression and Sleep Disorders in Patients on Dialysis: A Cross-Sectional Study in Qatar

“…In 2008, differences in QOL were compared between 77 in-center HD and 58 CAPD/PD patients, and the study concluded that patients on HD experienced more compromised QOL compared to those on CAPD/PD [12]. e same results were supported later by more recent trials [13][14][15]. However, some other trials concluded that depression is highly more prevalent in patients on PD than in those on HD [16].…”

Associations of Socio-Demographic, Clinical and Biochemical Parameters with Healthcare Cost, Health- and Renal-Related Quality of Life in Hemodialysis Patients: A Clinical Observational Study

“…Patients receiving hospital-based hemodialysis pay higher healthcare and societal costs than peritoneal dialysis patients [ 2 , 7 , 8 , 9 , 10 , 11 ], and general patients [ 10 ]. The cost of hemodialysis treatment has increased over time [ 12 ], even though hemodialysis patients have a poorer health-related quality of life (HRQOL), and kidney disease quality of life (KDQOL) than peritoneal dialysis patients [ 13 ]. Quality of life (QOL) is strongly associated with renal failure progression and death in CKD patients [ 14 ].…”

Farklı diyaliz modalitelerinin hasta yakını yaşam kalitesi üzerindeki etkileri

“…Evde tedavi yöntemlerinden biri olan periton diyalizinin uygulanabilmesi için hasta veya yakınının belirli sosyokültürel seviyede olması, sıvı değişimlerinin uygulanabileceği uygun değişim odasının olması, işlemlerin asepsi kurallarına uygun bir şekilde doktor ve hemşire reçetelerine uygun şekilde yapılabilmesi gerekmektedir. Hastalara esneklik, özgüven, hastane ortamından uzaklaşma, daha esnek kronik böbrek yetmezliği diyeti, daha iyi sağ kalım ve yaşam kalitesi imkanı sağlayan periton diyalizi tedavisi aynı zamanda her gün uygulama gerekliliği, evde hijyenik ortamın sağlanması, tedavi sorumluluğunun üstlenilmesi, sağlık personelinden uzak olunması gibi sebeplerden hasta ve hasta yakınlarına fiziksel, duygusal ve sosyal anlamda yük oluşturabilmektedir (7)(8)(9)(10)(11). Hemodiyaliz tedavisi ise çoğunlukla diyaliz merkezinde sağlık personeli denetiminde yapılması, haftanın belirli günlerinde uygulanması, ev ortamında herhangi bir düzenleme gerektirmemesi (ev hemodiyalizi uygulanan hastalar dışında) gibi göreceli avantajlar sağlamasının yanında haftanın belirli günlerinde bir diyaliz merkezine bağlı olma, fizyolojik olmayan kan temizleme işleminin diyaliz günlerinde hastada yarattığı halsizlik, bulantı ve kusma, kas krampları gibi yan etkilere sebep olabilmesi, kanama ve osteoporoz riskini arttıran kan sulandırıcı ilaç kullanma zorunluluğu, daha sıkı diyet ve daha fazla mortalite ve morbidite riski sebeplerinden hasta ve hasta yakınlarına yük oluşturabilmektedir (12)(13)(14).…”