Assessment of Health‐related Quality of Life in Patients Treated With Hemodialysis in Serbia: Influence of Comorbidity, Age, and Income

Abstract

The importance of measuring health-related quality of life (HRQoL) in patients on maintenance hemodialysis (HD) is being increasingly recognized, but few studies, especially from the Balkan region, have addressed this issue. The aims of this study were (i) to evaluate HRQoL in an outpatient university-affiliated dialysis facility in South Serbia; (ii) to determine the effects of age, presence of comorbidity, primary kidney disease, dose of HD, and family income; and (iii) to make comparisons of the HRQoL in Serbian patients on chronic HD with that reported by others previously. The study enrolled 192 patients on HD for more than 3 months. Comorbidity was assessed using the index of coexistent diseases (ICED), including two subindexes: index of disease severity (IDS) and index of physical impairment (IPI). Patient's self-assessment of HRQoL was measured by the 36-item short form health survey questionnaire (SF-36), encompassing eight summary scales and two summary dimensions. Ten of the baseline variables had significant associations with parameters of HRQoL. Fitting these variables in linear regression models resulted in 41.9% variance for physical dimension of HRQoL (physical component summary score [PCS]), and 32.5% for mental dimension of HRQoL (mental component summary score [MCS]). However, statistically significant effect had only IDS, IPI, and age for PCS, and income of patients for MCS. We found that an increase in IDS score for one unit is associated with a decrease of PCS by 13.2%, and SF-36 score (total quality of life) by 15.2%. The increase of IPI score by one unit decreases PCS by 16.1% and SF-36 score by 17.5%. A 5-year increase in age is associated with a decrease of PCS by 3.1%, and SF-36 score by 3.8%. The monthly income increase of 10 euros per family member increases MCS by 5.2% and SF-36 score by 3.0%. HRQoL in patients on HD was found markedly impaired. Comorbid conditions have negative and statistically significant correlation with parameters of HRQoL, and could explain poor HRQoL to a remarkable extent. Older age and poor income substantially reduce HRQoL in HD patients.

Evaluation of factors affecting healthy life style behaviors and quality of life in patients with heart disease

“…Yine yaş arttıkça yaşam kalitesinin düştü-ğü görülmüştür. Renal replasman tedavisi gören ve hemodiyalize giren kronik hastalarda yaş arttıkça, genel olarak yaşam kalitesinin düştüğü gösterilmiştir (15,16). Yaş ilerledikçe fonksiyonel yetersizliklerin yanı sıra, eşlik eden kronik hastalıklar nedeniyle yaşam doyumu azalmakta ve sonuç olarak yaşam kalitesinin düş-mesine neden olabilir (17).…”

Assessment of Health-Related Quality of Life in Patients Receiving Regular Hemodialysis

“…As such, assessment of HRQOL generally covers physical, social, and psychological domains [4]. Several studies proved that HD patients suffer poor HRQOL, despite continuing advancements in the treatment [3,4,[7][8][9][10][11][12][13][14]. Their HRQL is still much lower than general population [12,15].…”

“…The association of age with HRQOL is quite complex and illustrates the complexity of the QOL concept [4] that age was strongly inversely associated with the physical domain scores. As age increases in the elderly, physical function of the body decreases [2,4,14,[18][19][20][21][22]. A recent Saudi showed that age was a negative predictor of HRQOL score [2].…”

Longitudinal Changes in Health-Related Quality of Life Scores in Brazilian Incident Peritoneal Dialysis Patients (Brazpd): Socio-Economic Status Not a Barrier

“…Socio-economic status has been reported as an important factor negatively associated with HRQOL in HD patients in Brazil (21) and Serbia (22). It is interesting to note that, in a study performed in the Netherlands (23), social factors were used by the doctors as contraindications to the adoption of PD by end-stage renal disease patients.…”