The impact of pain on the quality of life of patients with end-stage renal disease undergoing hemodialysis: a multicenter cross-sectional study from Palestine

Abstract

Background Chronic kidney disease is considered as a global health problem. Hemodialysis (HD), following renal transplantation, is the most common form of renal replacement therapy. However, HD may impact the quality of life (QOL). Pain is a frequent complaint among this population that also affects their QOL. The purposes of this study were to assess pain and QOL among end-stage renal disease (ESRD) patients on HD and to examine their association. Methods This was a multicenter, cross-sectional study that occurred in Palestine between August and November 2018. Brief Pain Inventory and European Quality of Life scale 5 dimensions (EQ-5D) scale, including its European Quality of Life visual analogue scale (EQ-VAS) component, were used to assess pain and QOL, respectively. Results A total of 300 participants were included in the final study. The average age of the subjects was 54 ± 16 years. Their median EQ-5D score was 0.68 [0.54–0.88], whereas their median EQ-VAS score was 60 [40–75]. A statistically significant association of pain severity score with EQ-5D score was found (r = − 0.783, p < 0.001). The association between pain interference score and EQ-5D score was also found to be statistically significant (r = − 0.868, p < 0.001). Similarly, pain severity score was significantly assocsiated with EQ-VAS score (r = − 0.590, p < 0.001), the same as was the pain interference score (r = − 0.647, p < 0.001). Moreover, age, gender, BMI, employment, educational level, income level, dialysis vintage, previous kidney transplantation, and chronic medication use were all significantly correlated with QOL. Regression analysis showed that patients aged < 60 years (p < 0.001), those with lower pain severity scores (p = 0.003), and those with lower pain interference scores (p < 0.001) had significantly higher QOL scores. Conclusions Pain has a significant negative impact on QOL in ESRD patients undergoing HD. The subgroups that were at higher risk included elderly patients, females, those with higher BMI, those without a formal education, those unemployed, those living with low monthly income, smokers, those who have multiple comorbidities, and patients with longer dialysis vintage. Our findings provide reliable data for educators and clinicians working with HD patients.

Quality of life assessment in patients on chronic dialysis: Comparison between haemodialysis and peritoneal dialysis at a national hospital in Vietnam

“…First, older age was a significant predictor of poor QoL. Similar results were observed in previous EQ-5D-5L studies, such as those by Hsu et al (Taiwan, 2020) (β = −0.04; p = 0.002) [24] and Samoudi et al (Palestine, 2021) (β = −0.1; p = 0.001) [17]. A possible explanation for this might be that older patients are more likely to have health problems and an increasing decline in organ function.…”

“…In patients undergoing dialysis, QoL has been assessed using the EQ-5D-5L questionnaire in various nations [15][16][17][18][19]. As a tool to measure the improvement and deterioration in QoL, it can be used to evaluate QoL and subsequently test the effectiveness of interventions to improve QoL among patients with ESRD undergoing HD or PD [14].…”

Chronic Pain and Quality of Life in Maintenance Hemodialysis Patients in China: A Multicenter, Cross-Sectional Study

“…Chronic pain is one of the most common symptoms of patients, the prevalence of chronic pain can be as high as 82% in MHD patients, 4 and such pain severely affects quality of life (QOL). 5 …”

“… 6 , 7 The QOL of these patients is associated with socio-demographic factors such as age, sex, level of education, and marital status, 8–10 clinical characteristics such as primary disease, comorbidities, and duration of hemodialysis, 11 , 12 as well as chronic pain factors including the duration of pain, pain severity, pain affect, the location of pain. 5 , 13 , 14 Most importantly, psychosocial factors such as social support, self-efficacy, and depression, can also significantly affect QOL. 15–17 …”

Impact of socio-demographic and clinical characteristics on functional disability and health-related quality of life in patients with rheumatoid arthritis: a cross-sectional study from Palestine

“…United Kingdom tariff for the EQ-5D-5L was used to derive the EQ-5D-5L index values as Palestinian tariff was not available. It was also used in previous publications conducted in Palestine [14,17,21,43,44].…”