Quality of Life of Patients on Peritoneal Dialysis and Contributing Factors: A Cross-Sectional Study
Main Article Content
Keywords
chronic kidney disease, end-stage renal disease, peritoneal dialysis, quality of life, SF-36 questionnaire
Abstract
In recent years, interest in Health-Related Quality of Life (HRQoL) as a major indicator of clinical efficacy and treatment outcome in patients of End-Stage Renal Disease (ESRD) has grown significantly. This study aimed to determine the contributing factors affecting the quality of life (QoL) of ESRD patients undergoing peritoneal dialysis (PD). A cross-sectional study was conducted on PD patients presented at PD centres of Al-Zahra and Noor hospitals in Isfahan, Iran, from May to August 2019. A total of 173 patients having peritoneal dialysis for more than 3 months filled the validated 36-item short-form health survey questionnaire (SF-36). Baseline demographic details and dialysis-related factors were collected from patients’ medical records. The overall QoL score of patients was 50.28 ± 20.87. Male patients had a higher QoL score than female patients (58.18 in males, compared to 48.18 in females; P = 0.04). A significant association between frequency of dialysis and quality of life was observed, where three sessions of dialysis per day yielded the highest quality of life (QoL score = 59.62; P = 0.047). A significant positive correlation was discovered between QoL score and residual renal function (P = 0.013). In addition, a higher QoL score was observed in self-employed patients (60.95), compared to housewives (46.49) (P = 0.001). QoL assessment should be included as an integral part of patient follow-up to evaluate treatment outcomes and implement possible interventions to improve patient’s quality of life.
References
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32. Sehgal AR. Outcomes of renal replacement therapy among blacks and women. Am J Kidney Dis. 2000 Apr 1;35(4):S148–52. 10.1016/S0272-6386(00)70242-3
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49. Maor Y, King M, Olmer L, Mozes B. A comparison of three measures: The time trade-off technique, global health-related quality of life and the SF-36 in dialysis patients. J Clin Epidemiol. 2001 Jun 1;54(6):565–70. 10.1016/S0895-4356(00)00338-3
2. Okpechi IG, Nthite T, Swanepoel CR. Health-related quality of life in patients on hemodialysis and peritoneal dialysis. Saudi J Kidney Dis Transplant. 2013 May 1;24(3):519. 10.4103/1319-2442.111036
3. Afshar R, Sanavi S, Salimi J. Epidemiology of chronic renal failure in Iran: A four-year single-center experience. Saudi J Kidney Dis Transplant. 2007 Apr 1;18(2):191.
4. Morovatdar N, Tayebi Nasrabad G, Tsarouhas K, Rezaee R. Etiology of renal replacement therapy in Iran. Int J Nephrol. 2019 Nov 26;2019. 10.1155/2019/5010293
5. Beladi MS, Sametzadeh M, Hayati F, Fatemi SM. Evaluation of acquired cystic kidney disease in patients on hemodialysis with ultrasonography. Iran J Kidney Dis. 2010 Jul;4(3):223–6
6. Aghighi M, Mahdavi MM, Zamyadi M, Heydari RA, Rajolani H, Nourouzi S. Changing epidemiology of end-stage renal disease in last 10 years in Iran. Iran J Kidney Dis. 2009 Oct;3(4):192–6
7. Malekmakan L, Haghpanah S, Pakfetrat M, Malekmakan A, Khajehdehi P. Causes of chronic renal failure among Iranian hemodialysis patients. Saudi J Kidney Dis Transplant. 2009 May 1;20(3):501.
8. Mousavi SS, Hayati F, Mousavi M. What is the difference between causes of ESRD in Iran and developing countries?. Shiraz E-Med J. 2012;13(2):e93952.
9. Sayin A, Mutluay RÜ, Sindel S. Quality of life in hemodialysis, peritoneal dialysis, and transplantation patients. Transplant Proc. 2007 Dec 1;39(10):3047–3053. Elsevier. 10.1016/j.transproceed.2007.09.030
10. Subha Palaneeswari M, Rajan PA, Silambanan Santhi J. Blood lead in end-stage renal disease (ESRD) patients who were on maintainence haemodialysis. J Clin Diagn Res (JCDR). 2012 Dec;6(10):1633. 10.7860/JCDR/2012/4865.2627
11. Braunwald F, Kasper H, Longo J. Disturbances of the renal function. In: Harrison’s principles of intenal medicine, vol. 2. 15th ed. McGraw Hill; 2004, pp. 1535–41.
12. Port FK, Wolfe RA, Mauger EA, Berling DP, Jiang K. Comparison of survival probabilities for dialysis patients vs cadaveric renal transplant recipients. JAMA. 1993 Sep 15;270(11):1339–43. 10.1001/jama.270.11.1339
13. Jain D, Haddad DB, Goel N. Choice of dialysis modality prior to kidney transplantation: Does it matter? World J Nephrol. 2019 Jan 21;8(1):1. 10.5527/wjn.v8.i1.0000
14. Noshad H, Sadreddini S, Nezami N, Salekzamani Y, Ardalan MR. Comparison of outcome and quality of life: Haemodialysis versus peritoneal dialysis patients. Singapore Med J. 2009 Feb 1;50(2):185.
15. Mahdavi-Mazdeh M, Zamyadi M, Nafar M. Assessment of management and treatment responses in haemodialysis patients from Tehran province, Iran. Nephrol Dial Transplant. 2008 Jan 1;23(1):288–93. 10.1093/ndt/gfm580
16. Chuasuwan A, Pooripussarakul S, Thakkinstian A, Ingsathit A, Pattanaprateep O. Comparisons of quality of life between patients underwent peritoneal dialysis and hemodialysis: A systematic review and meta-analysis. Health Qual Life Outcomes. 2020 Dec;18(1):1. 10.1186/s12955-020-01449-2
17. Zee J, Zhao J, Subramanian L, Perry E, Bryant N, McCall M, et al. Perceptions about the dialysis modality decision process among peritoneal dialysis and in-center hemodialysis patients. BMC Nephrol. 2018 Dec;19(1). 10.1186/s12882-018-1096-x
18. Morton RL, Snelling P, Webster AC, Rose J, Masterson R, Johnson DW, Howard K. Factors influencing patient choice of dialysis versus conservative care to treat end-stage kidney disease. CMAJ. 2012 Mar 20;184(5):E277–83. 10.1503/cmaj.111355
19. He Z, Hou H, Zhang D, Mo Y, Zhang L, Su G, et al. Effects of dialysis modality choice on the survival of end-stage renal disease patients in southern China: A retrospective cohort study. BMC Nephrol. 2020 Dec;21(1):1–1. 10.1186/s12882-020-02070-7
20. World Health Organization (WHO). Programme on mental health: WHO QOL user manual. World Health Organization; 1998.
21. Ramos EC, Santos ID, Zanini RD, Ramos JM. Quality of life of chronic renal patients in peritoneal dialysis and hemodialysis. Braz J Nephrol. 2015 Sep;37(3):297–305. 10.5935/0101-2800.20150049
22. Haghighi M, Heydari RA, Zamyadi M, Mahdavi MM, Nourouzi S, Rajolani H, et al. Dialysis in Iran. Iran. Red. Crescent. Med. J. [Internet]. 2020 Sep. 30 [cited 2023 Feb. 25];22(9). Available from: https://www.ircmj.com/index.php/IRCMJ/article/view/143
23. Eser E, Fidaner H, Eser SY, Fidaner C, Elbi H. Derivation of response scales for WHO QOL TR: The effect of the level of education on the use of Visual Analog Scales. Eur Psychol. 2000 Dec;5(4):278. 10.1027//1016-9040.5.4.278
24. Bakewell AB, Higgins RM, Edmunds ME. Quality of life in peritoneal dialysis patients: Decline over time and association with clinical outcomes. Kidney Int. 2002 Jan 1;61(1):239–48. 10.1046/j.1523-1755.2002.00096.x
25. Pezeshki M, Rostami Z. Contributing factors in health-related quality of life assessment of ESRD patients: A single center study. Nephro Urol Mon. 2009 Dec 31;1(2):129–36.
26. Zazzeroni L, Pasquinelli G, Nanni E, Cremonini V, Rubbi I. Comparison of quality of life in patients undergoing hemodialysis and peritoneal dialysis: A systematic review and meta-analysis. Kidney Blood Press Res. 2017;42(4):717–27. 10.1159/000484115
27. Jofre R, López-Gómez JM, Valderrábano F. Quality of life for patient groups. Kidney Int. 2000 Jan 1;57:S121–30. 10.1046/j.1523-1755.2000.07420.x
28. Lew SQ, Piraino B. Quality of life and psychological issues in peritoneal dialysis patients. Semin Dial. 2005 Mar 4;18(2):119–23. Blackwell Science Inc., Oxford, UK. 10.1111/j.1525-139X.2005.18215.x
29. Al Wakeel J, Al Harbi A, Bayoumi M, Al-Suwaida K, Al Ghonaim M, Mishkiry A. Quality of life in hemodialysis and peritoneal dialysis patients in Saudi Arabia. Ann Saudi Med. 2012 Nov;32(6):570–4. 10.5144/0256-4947.2012.570
30. Daugirdas JT, Blake PG, Ing TS. Handbook of dialysis. Philadelphia, PA: Lippincott Williams & Wilkins; 2012.
31. Montazeri A, Gashtasbi A, Vahdaninya M. Translate and determine the validity and reliability of such questionnaires Persian SF36. Payesh J. 2005;5(1):49–56.
32. Sehgal AR. Outcomes of renal replacement therapy among blacks and women. Am J Kidney Dis. 2000 Apr 1;35(4):S148–52. 10.1016/S0272-6386(00)70242-3
33. Rocco MV, Gassman JJ, Wang SR, Kaplan RM. Cross-sectional study of quality of life and symptoms in chronic renal disease patients: The modification of diet in renal disease study. Am J Kidney Dis. 1997 Jun 1;29(6):888–96. 10.1016/S0272-6386(97)90463-7
34. Mingardi, G., Cornalba, L., Cortinovis, E., Ruggiata, R., Mosconi, P., Apolone, G.. Health-related quality of life in dialysis patients. A report from an Italian study using the SF-36 Health Survey. DIA-QOL Group. Nephrol Dial Transplant. 1999;14(6):1503–10. (Official Publication of the European Dialysis and Transplant Association-European Renal Association.) 10.1093/ndt/14.6.1503
35. Moreno, F., Gomez, JL., Sanz-Guajardo, D., Jofre, R., Valderrabano, F., Spanish Cooperative Renal Patients Quality of Life Study Group 4. Quality of life in dialysis patients. A Spanish multicentre study. Nephrol Dial Transplant. 1996 Jan 1;11(Supp2):125–9. 10.1093/ndt/11.supp2.125
36. Weisinger JR, Bellorin-Font E. Outcomes associated with hypogonadism in women with chronic kidney disease. Adv Chronic Kidney Dis. 2004 Oct 1;11(4):361–70. 10.1053/j.ackd.2004.07.009
37. Aguiar R, Pei M, Qureshi AR, Lindholm B. Health-related quality of life in peritoneal dialysis patients: A narrative review. Semin Dial. 2019 Sep;32(5):452–62. 10.1111/sdi.12770
38. Ogutmen B, Yildirim A, Sever MS, Bozfakioglu S, Ataman R, Erek E, et al. Health-related quality of life after kidney transplantation in comparison intermittent hemodialysis, peritoneal dialysis, and normal controls. Transplant Proc. 2006 Mar 1;38(2):419–421. Elsevier. 10.1016/j.transproceed.2006.01.016
39. Overbeck I, Bartels M, Decker O, Harms J, Hauss J, Fangmann J. Changes in quality of life after renal transplantation. Transplant Proc. 2005 Apr 1;37(3):1618–21. Elsevier. 10.1016/j.transproceed.2004.09.019
40. Plantinga LC, Fink NE, Harrington-Levey R, Finkelstein FO, Hebah N, Powe NR, et al. Association of social support with outcomes in incident dialysis patients. Clin J Am Soc Nephrol. 2010 Aug 1;5(8):1480–8. 10.2215/CJN.01240210
41. dos Santos Grincenkov FR, Fernandes N, dos Santos Pereira B, Bastos K, Lopes AA, Finkelstein FO, et al. Impact of baseline health-related quality of life scores on survival of incident patients on peritoneal dialysis: A cohort study. Nephron. 2015;129(2):97–103. 10.1159/000369139
42. Rebollo P, Ortega F, Baltar JM, Badía X, Alvarez-Ude F, Díaz-Corte C, et al. Health-related quality of life (HRQOL) of kidney transplanted patients: Variables that influence it. Clin Transplant. 2000 Jun;14(3):199–207. 10.1034/j.1399-0012.2000.140304.x
43. Park HC, Lee H, Lee JP, Kim DK, Oh KH, Joo KW, et al. Lower residual renal function is a risk factor for depression and impaired health-related quality of life in Korean peritoneal dialysis patients. J Korean Med Sci. 2012 Jan;27(1):64. 10.3346/jkms.2012.27.1.64
44. Shafi T, Jaar BG, Plantinga LC, Fink NE, Sadler JH, Parekh RS, et al. Association of residual urine output with mortality, quality of life, and inflammation in incident hemodialysis patients: The Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) Study. Am J Kidney Dis. 2010;56(2):348–58. 10.1053/j.ajkd.2010.03.020
45. Sunder S, Kalra OP, Nashine S, Waghmare V, Ruchi R. Comparative study of adequacy of dialysis and health-related quality of life in patients on CAPD and APD. Perit Dial Int. 2008 Sep;28(5):542–4. 10.1177/089686080802800521
46. Chen YC, Hung KY, Kao TW, Tsai TJ, Chen WY. Relationship between dialysis adequacy and quality of life in long-term peritoneal dialysis patients. Perit Dial Int. 2000 Sep;20(5):534–40. 10.1177/089686080002000508
47. Paniagua R, Amato D, Vonesh E, Guo A, Mujais S. Health-related quality of life predicts outcomes but is not affected by peritoneal clearance: The ADEMEX trial. Kidney Int. 2005 Mar 1;67(3):1093–104. 10.1111/j.1523-1755.2005.00175.x
48. Okaka EI, Davies M, Ahmed M, Naidoo S, Naicker S. Impact of socio-economic factors on quality of life in patients on continuous ambulatory peritoneal dialysis in an African setting. W Afr J Med. 2014 Apr 1;33(2):125–9.
49. Maor Y, King M, Olmer L, Mozes B. A comparison of three measures: The time trade-off technique, global health-related quality of life and the SF-36 in dialysis patients. J Clin Epidemiol. 2001 Jun 1;54(6):565–70. 10.1016/S0895-4356(00)00338-3
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Mar 1, 2023
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Quality of Life of Patients on Peritoneal Dialysis and Contributing Factors: A Cross-Sectional Study. (2023). Journal of Renal and Hepatic Disorders, 7(1), 11-21. https://doi.org/10.15586/jrenhep.v7i1.151
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