Self-Assessed Quality of Life in Peritoneal Dialysis Patients

Abstract

Background/Aims: Studies comparing quality of life (QOL) between peritoneal and hemodialysis patients have yielded inconsistent results. Physical (PCS) and mental component summary (MCS) scales of Short Form 36 (SF-36) health survey are highly validated measures of self-assessed QOL. We sought to evaluate these indices in PD patients: (1) as measures of QOL, (2) predictors of QOL, (3) to study change in QOL over time, and (4) to compare QOL in PD vs. hemodialysis patients. Methods: SF-36 questionnaires were administered every 3 months to patients over a 2-year period and PCS and MCS were calculated. Mean follow-up was 15.3 ± 6.6 months for PD and 14.5 ± 5.7 months for HD. Results: Average PCS in PD (31.8 ± 7.8) was lower than HD (36.9 ± 9.8) (p < 0.02), while MCS was similar in the groups (p = NS). The prevalence of depression was 26.1% in PD and 25.4% in HD patients (p = NS). Serum albumin was the only significant predictor of PCS among PD patients and explained much of the decrease in PCS in them. The number of hospitalizations and in-hospital days were significantly lower for PD compared to HD patients (p < 0.05). PCS as well as MCS remained stable in both groups throughout the observation period. Conclusion: Self-assessed physical function is diminished, while mental function is similar in PD compared to HD patients. When corrected for serum albumin, this difference is eliminated. Over time, QOL in patients treated with PD remained stable.

Cross-Sectional Comparison of Quality of Life and Illness Intrusiveness in Patients Who Are Treated with Nocturnal Home Hemodialysis versus Peritoneal Dialysis

“…Determinants of health-related quality of life (QOL) have been examined using longitudinal and cross-sectional studies in patients with ESRD (2)(3)(4). Multiple factors are known to influence health-related QOL in ESRD, including clinical manifestations of disease, nutritional status, inflammation, treatment modality adverse effects, and rapport with care providers (5)(6)(7)(8). Uniformly, in-center conventional hemodialysis (CHD) has a profound negative impact on the QOL of patients with ESRD.…”

Qualidade de Vida: comparação entre diálise peritoneal automatizada e hemodiálise

“…Prolonged periods of treatment may adapt the patient and improve HRQoL perception, at least, in HD patients as compared to APD patients (6,33) . In the same way, low levels of serum albumin, found in the APD patients, are related to poor scores in HRQoL of end-stage renal disease patients, specially in the physical component (13,34) . In this study we used adjusted values for serum albumin for statistical analysis and we have not found this correlation.…”

“…However, not all studies agree with this perception (4,10,(13)(14) and data about the real impact of dialysis modalities on HRQoL is lacking. Nowadays, HRQoL is not only a basic aspect of health but it also has an impact in morbidity and mortality (15)(16)(17)(18) .…”

“…The physical components of HRQoL are commonly reported as diminished in APD when compared with HD, while mental components are usually reported as similar (4,10,(13)(14)33) . The reasons why this physical component is reduced is not clear to us.…”

Pain in Hemodialysis Patients

“…Ağrının, özellikle de kronik yaşanan ağrının, uyku düzeninde bozulma, dikkat ve hafızada zayıflama, depresyon gibi duygu durum bozuklukları, fiziksel ve sosyal aktivitelerde bozulma gibi pek çok olumsuz etkisinin olduğu (5)(6)(7)18) ve ağrı hissinin yaşam kalitesini olumsuz etkileyen önemli faktörlerden birisi olduğu belirtilmektedir (4,6,8). Bu nedenle ağrısı olan bireylerde ağrının doğru tanılanması ve etkin yönetimi önemlidir.…”