The quality of life in end stage renal disease care

Abstract

The improved prognosis and survival statistics of both renal transplantation and dialysis have focused attention on the quality of life offered by these treatments. Using a standardized questionnaire, we assessed the quality of life of 612 patients undergoing renal replacement therapy at our center. Of these patients, 359 had been transplanted and 253 patients were on dialysis. Concerning the sociodemographic data, only the time on specific treatment was longer in dialysis patients than in transplanted patients (49.2 versus 55.6 months, P < 0.05). Most complaints were more common in dialysis patients than in transplanted patients. Only the side effects of medication were seen more in transplanted patients (P < 0.005). Life satisfaction was higher in transplanted patients than in dialysis patients. Dialysis patients were more anxious (P < 0.05) and more depressed (P < 0.001) than transplanted patients. Transplanted patients also felt that they had more social support than did dialysis patients. Overall life quality was almost equal between patients on hemodialysis and patients on peritoneal dialysis, and between patients on the waiting list for transplantation and those not on the waiting list. Despite a significantly better quality of life after renal transplantation, the percentage of patients working remained unchanged. (57.5% versus 57.8%, P = n.s.). We conclude that despite an improved quality of life after renal transplantation, these patients are economically not more productive than patients on dialysis.

Social participation and employment status after kidney transplantation: A systematic review

“…A shortcoming in the majority of studies was the omission of the response rate or the lack of clarity on it. Three studies reported a response rate <60% (item B) [29,33,35]. Likewise, not one study reported on the reliability of questionnaires or interviews used for measurement of indicators of social participation, mostly employment status (item D).…”

“…However, six studies did not describe educational level of the study participants (item E) [30,32,36,[38][39][40]. Furthermore, 11 studies provided insufficient information on clinical variables such as comorbidity (presence of diabetes mellitus) [29,34,35,38,40,41], type of donation (cadaveric or living) [29,35,36,41,42] and dialysis before transplantation (item G) [29,31,36,39,40,42,43]. With respect to data presentation one study omitted reporting information on a relevant indicator of social participation (item I) [31].…”

“…The same applied to homemakers, sometimes marked as unemployed [37], sometimes as employed [31]. This in addition to studies that did not describe how students, homemakers, disabled or retirees were classified at all [29,33,35,38,41,43,44]. In addition to measuring the post-transplant employment status, the prospective studies compared the status with the pre-transplantation situation [32,37,42,43].…”

“…Three studies were only identified by MEDLINE [29][30][31]. Reference checking yielded no additional publications.…”

Lebensqualität nach Organtransplantation

“…Eine Verbesserung der LQ im körperlichen (Anstieg des Karnofsky-Index von 66 auf 88), psychischen und sozialen Bereich zeigte sich in Abhängigkeit von Geschlecht und Alter der Patienten. Männer erreichten im Durchschnitt höhere Werte als Frauen, Patienten über 55 Jahren wiesen im Mittel eine schlechtere LQ auf.In einer neueren deutschen Querschnittstudie verglichen Waiser et al[66] 359 NTX-Patienten mit 235 Hämo-dialysepatienten. Die NTX-Patienten hatten weniger körperliche Beschwerden als die Dialysepatienten, eine bessere Lebenszufriedenheit, ein geringeres Ausmaß an Depressivität und Ängstlich-keit und waren sozial besser integriert.…”