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Does Hemodialysis Improve Health-Related Quality of Life in Chronic Kidney Disease? A Tertiary Care Centre Experience
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Introduction: Advances in dialysis procedures have improved treatment and prolonged lives of chronic kidney disease (CKD) patients. However, improving survival via dialysis is not enough. Assessment of health-related quality of life (HRQoL) in CKD patients has evolved with treatment advances so that the expectation of patient outcomes has grown from simple survival to achieving a sense of well-being.
Objective: To evaluate HRQoL scores with either Hemodialysis (HD) or non-dialysis-dependent advanced CKD.
Methods: Adults CKD patients with eGFR less than 30 ml/min/1.73 m2 were randomly selected and divided into two groups; group A and B. Group A consisted of patients on medical management without any renal replacement therapy and group B with patients undergoing thrice-weekly in-center HD for more than three months. All patients were assessed for HRQoL through the SF-36 questionnaire. Patients having psychiatric illness or cognitive dysfunction, transplanted kidney and haemodialysis less than three months were excluded from study.
Results: HRQoL composite summary scores were severely and significantly impaired in group B patients as compared to group A. The mean PCS scores in group A and B were 34.52±5.54 and 31.08±6.83, respectively and the difference being statistically significant. The MCS scores also showed a statistically significant difference among both groups.
Conclusion: In our study low scores were registered in both the composite summary scores of HRQoL in HD group of patients as compare to non-HD group Study points that care is often suboptimal by developed world standards.
Keywords
- NKF: Stages of Chronic Kidney Disease. New York: National Kidney Foundation; 2000. [cited 2000];2000:[Available from: http://www.kidney.org/ professionals/kdoqi/guidelines_ckd/toc.htm.
- ISN, IFKF: World Kidney Day. Brussels: International Society of Nephrology International Federation of Kidney Foundations; 2009. Available from: www.worldkidneyday.org.
- Anand S, Bitton A, Gaziano T. The gap between estimated incidence of end-stage renal disease and use of therapy. PLoS One 2013;8:e72860.
- Yu HD, Petrini MA: The HRQoL of Chinese patients undergoing haemodialysis. J Clin Nurs 2010;19:658– 65.
- Eiser C, Jenney M. Measuring quality of life. Arch Dis Child. 2007 Apr;92(4):348-50.
- Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. J Am Soc Nephrol 2001;12(12):2797-806.
- Ware JE, Kosinski M, Keller SK. SF-36 Physical and Mental Health Sumary Scales: A User’s Manual. Boston: The Health Institute; 1994.
- Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT: The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ 1993;306(6890):1440-4.
- Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130(6):461–70.
- Finkelstein FO, Wuerth D, Finkelstein SH. Health related quality of life and the CKD patient: challenges for the nephrology community. Kidney Int. 2009;76(9):946–52.
- Soni RK, Weisbord SD, Unruh ML. Health-related quality of life outcomes in chronic kidney disease. Curr Opin Nephrol Hypertens. 2010;19(2):153–9.
- Cukor D, Cohen SD, Peterson RA, Kimmel PL. Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. Journal of the American Society of Nephrology 2007;18:3042-55.
- Kurtin PS, Davies AR, Meyers KB, DeGiacomo JM, Kantz ME. Patients-based health status measures in out-patient dialysis: early experiences in developing an outcome assessment program. Med Care 1992;30:MS136-49.
- Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life: a conceptual model of patients outcomes. JAMA1995;273:59-65.
- Khan IH, Garratt AM, Kumar A. Patient’s perception of health on renal replacement therapy: evaluation using a new instrument. Nephrol Dial Transpl 1995;10:684-9.
- Kimmel PL, Peterson RA, Wheis LK. Behavioral compliance in hemodialysis patients. J Am Soc Nephrol 1995;5:1826-34.
- Tong A, Sainsbury P, Chadban S. Patients’ experiences and perspectives of living with CKD. Am J Kidney Dis. 2009;53:689-700.
- Awuah KT, Finkelstein SH, Finkelstein FO. Quality of life of chronic kidney disease patients in developing countries. Kidney International Supplements 2013(3): 227–9.
- Krespi R, Bone M, Ahmad R, Worthington B, Salmon P. Haemodialysis patients’ beliefs about renal failure and its treatment. Patient Educ Couns. 2004;53:18996.
- Unruh ML, Hess R: Assessment of health-related quality of life among pa- tients with chronic kidney disease. Adv Chronic Kidney Dis 2007;14:345–52.
- Reuben DB, Tinetti ME: Goal-oriented patient care – an alternative health outcomes paradigm. N Engl J Med 2012;366:777–9.
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