Effect of dialysis modality on frailty phenotype, disability, and health-related quality of life in maintenance dialysis patients

Abstract

BackgroundHealth-related quality of life (HRQoL) surveys are needed to evaluate regional and ethnic specificies. The aim of the present study was to evaluate the differences in HRQoL, frailty, and disability according to dialysis modality in the Korean population.Patients and methodsWe enrolled relatively stable maintenance dialysis patients. A total of 1,616 patients were recruited into our study. The demographic and laboratory data collected at enrollment included age, sex, comorbidities, frailty, disability, and HRQoL scales.ResultsA total of 1,250 and 366 participants underwent hemodialysis (HD) and peritoneal dialysis (PD), respectively. The numbers of participants with pre-frailty and frailty were 578 (46.2%) and 422 (33.8%) in HD patients, and 165 (45.1%) and 137 (37.4%) in PD patients, respectively (P = 0.349). Participants with a disability included 195 (15.6%) HD patients and 109 (29.8%) PD patients (P < 0.001). On multivariate analysis, the mean physical component scale (PCS) and mental component scale (MCS), symptom/problems, and sleep scores were higher in HD patients than in PD patients. Cox regression analyses showed that an increased PCS in both HD and PD patients was positively associated with patient survival and first hospitalization–free survival. An increased MCS in both HD and PD patients was positively associated with first hospitalization–free survival only.ConclusionThere was no significant difference in frailty between patients treated with the two dialysis modalities; however, disability was more common in PD patients than in HD patients. The MCS and PCS were more favorable in HD patients than in PD patients. Symptom/problems, sleep, quality of social interaction, and social support were more favorable in HD patients than in PD patients; however, patient satisfaction and dialysis staff encouragement were more favorable in PD patients than in HD patients.

Health‐related quality of life and health utility of Chinese patients undergoing nocturnal home haemodialysis in comparison with other modes of dialysis

“…In this study, reverse causality where choice of dialysis mode may be dependent on HRQOL cannot be excluded. Second, unlike previous longitudinal studies following ESRD patients under maintenance dialysis over a certain period of time, cross‐sectional data precluded the measurement of HRQOL and utility scores over time and the effect of hospitalization and complication events on the HRQOL outcomes. Third, health utility reported in this study was not elicited from direct utility measurement.…”

Isokinetic Strength in Peritoneal Dialysis Patients: A Reliability Study

“…However, Kang et al [27] observed more favorable mental and physical components in hemodialysis patients compared with PD patients. Although the differences between the two dialysis modalities in terms of physical function and quality of life still remain unclear, patient satisfaction is commonly higher in patients undergoing PD [26,27]. Therefore, physical function is a relevant measure that should be included in comprehensive health assessments in dialysis patients.…”

“…In this regard, the reduced quality of life and physical function may be similar in patients undergoing hemodialysis or PD [26]. However, Kang et al [27] observed more favorable mental and physical components in hemodialysis patients compared with PD patients. Although the differences between the two dialysis modalities in terms of physical function and quality of life still remain unclear, patient satisfaction is commonly higher in patients undergoing PD [26,27].…”

Influences on the Performance based Frailty of Physical Performance, Exercise Self-efficacy, Decisional Balance, and Health related Quality of Life in Adults Undergoing Hemodialysis

“…2014년 우리나라 혈액투석 환자 중 일상생활 활동이 불가능하여 침대에 누워 의존적인 삶을 유지하는 환자 는 17%에 달하며 말기신부전증의 높은 유병율과 함께 혈액투 석 환자 수는 매년 9%씩 증가되고 있다 [1]. 혈액투석 환자의 20%는 적어도 1가지 이상의 일상생활활동에 의존을 보여 도 움이 필요하며 [5], 장애와 사망을 예측하는 지표인 건강 관련 삶의 질 감소 [3], 근육 소모 [7], 신체수행능력 감소 [8,9]를 보여 허약 발생으로 이어지므로 혈액투석 전부터 시작되는 허약 예 방과 지연을 위한 건강관리자의 역할이 강조되고 있다 [5,6,8]. [2,14], 신체기능수행능력 저하는 허약 발생에 영향을 미치므로 [6,8] 신체활동에 대한 자 신감을 증가시키고 신체활동을 긍정적으로 인지하도록 돕는 것이 필요하다 [2,14].…”