Health-related quality of life, depression and mortality in peritoneal dialysis patients in Turkey: seven-year experience of a center

Abstract

Introduction: Impairment of health-related quality of life (HRQoL) and being in a depressive mood were found to be associated with increased mortality in peritoneal dialysis (PD) patients. We aimed to investigate the association between HRQoL, depression, other factors and mortality in PD patients. Materials and methods: Totally 171 PD patients were included and followed for 7 years in this prospective study. Results: Of 171 PD patients, 45 (26.3%) deceased, 18 (10.5%) maintained on PD, 87 (50.9%) shifted to hemodialysis (HD) and 21 (12.3%) underwent transplantation. The most common cause of death was cardiovascular disease (32, 71.1%) followed by infection (6, 13.3%), cerebrovascular accident (5, 11.2%). The etiology of patients who shifted to HD was PD failure (41, 47.1%), peritonitis (33, 37.9%), leakage (6, 6.9%), catheter dysfunction (3, 3.4%), self willingness (4, 4.6%). Non-survivors were older than survivors (56.6 ± 15.0 vs. 43.6 ± 14.6, p ¼ 0.003). There were also statistically significant difference in terms of albumin, residual urine, presence of diabetes and co-morbidity. When the groups were compared regarding HRQoL scores, non-survivors had lower physical functioning (p50.001), role-physical (p ¼ 0.0045), general health (p ¼ 0.004), role-emotional (p ¼ 0.011), physical component scale (PCS) (p ¼ 0.004), mental component scale (MCS) (p ¼ 0.029). Age, presence of residual urine, diabetes, albumin, PCS and MCS were entered in regression analysis. Decrease of 1 g/dL of albumin and being diabetic were found to be the independent predictors of mortality. Conclusions: Diabetes and hypoalbuminemia but not HRQOL scores were associated with higher mortality in PD patients after 7 years of following period.

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

“…Another study investigated the association between the two variables in ESRD patients but did not perform subgroup analysis according to dialysis modality [31]. Other studies evaluated the association between the two variables in PD patients but used only SF-36 items [32,33]. The present study investigated KDQOL–SF including kidney disease–specific items and performed subgroup analyses of each dialysis modality.…”

Depression and Physical Frailty Have Additive Effect on the Nutritional Status and Clinical Outcome of Chinese Peritoneal Dialysis

“…In the non-dialysis elderly general population, depression and frailty are additive risk factors for mortality and other adverse health outcomes [18][19][20]. In previous studies on dialysis patients, physical frailty [6,7] and depression [12,13] have each been shown to be associated with adverse clinical outcomes. Our results show that their effects in PD patients are also additive.…”

“…Cognitive impairment is present in over 20% of dialysis patients [9,10], and is associated with increased risks of mortality and adverse clinical outcome [9,11]. Similarly, depressive symptoms are present in over 50% of PD patients [10] and is associated with excessive morality and represents a risk factor of peritonitis [12,13].…”

The Effect of Motivational Interviewing on Adherence to Treatment and Quality of Life in Chronic Hemodialysis Patients: A Randomized Controlled Trial

“…The score of each domain can range from 0 to 100, where higher scores indicate better HRQL or better health. The Turkish version of SF-36 has been used in different studies about hemodialysis patients and has been reported as valid and reliable (Kalender & Tosun, 2013;Turkmen et al, 2014). In this study, each domain's Cronbach's α ranges from 0.66 to 0.96.…”