Health‐related Quality of Life in Patients on Peritoneal Dialysis in Serbia: Comparison with Hemodialysis

Abstract

Patients' health-related quality of life (HRQoL) is an important indicator of the effectiveness of the medical care they receive. Patients who reach end-stage renal disease are older and have a considerable extent of comorbidity. The objectives of this study were (i) to evaluate HRQoL in patients at the initiation of continuous ambulatory peritoneal dialysis (CAPD) treatment (incident cohort) and in patients on long-term CAPD therapy (prevalent cohort), and (ii) to compare influence of comorbidity on HRQoL in CAPD and hemodialysis (HD) patients. In a cross-sectional study we enrolled 99 CAPD and 192 HD patients. HRQoL was assessed with the 36-item Short Form Health Survey Questionnaire (SF-36). HRQoL summary scales in both incident and prevalent groups of CAPD patients were similar for physical component summary score (PCS) and for mental component summary score (MCS). Generally, higher values were found in mental health domains in comparison to PCS. In the incident group of patients, 1 year of peritoneal dialysis treatment was associated with a slight improvement in both PCS and MCS, but statistical significance (P < 0.05) was found in the role-physical limitation (RP), bodily pain (BP), and vitality (VT) scales only. CAPD patients with the highest disease severity (Index of Disease Severity [IDS]-3) and physical impairment (Index of Physical Impairment [IPI]-2) scored significantly higher parameters of HRQoL than HD patients. Comorbidity had negative influence on HRQoL, but statistically significant correlation has been found in HD patients only. In conclusion, comorbid conditions had negative correlation with parameters of HRQoL in both CAPD and HD patients. One year after starting CAPD, patients reported better scores in some domains, especially in RP, BP, and VT scales. Assessment of HRQoL and comorbidity might be useful in clinical practice in the follow-up of patients treated with both CAPD and HD.

Important determinants of quality of life in a peritoneal dialysis population in Turkey

“…HRQoL can be evaluated at a slightly poor level in PD patients compared with the previous studies. 2,13,19,20,22 Although our scores are in accordance with some studies, [23][24][25][26][27][28][29] they are negated by others. 1,19,30 Previous studies using the SF-36 scale in Turkey have shown that the PCS and MCS scores were higher than ours.…”

“…4,13,19,[22][23][24]29,[31][32][33] MCS and PCS scores in our study were similar to those in studies reported from Serbia, France, and Mexico. 2,28,30 However, MCS in our study was slightly lower than that of the United Kingdom, the United States, and the Netherlands, whereas PCS was higher than that of the United Kingdom and the United States. 13,23,24,34 Finally, the mean summary scores of HRQoL in PD patients in Turkey are almost at the same level as in developed countries.…”

“…1,2 Thus, in recent years, measurement of HRQoL has become increasingly recognized as an important outcome measure in end-stage renal disease (ESRD) patients. 3 Many factors may affect the HRQoL of ESRD patients.…”

Comparison of Health-Related Quality of Life of Patients on Hemodialysis and Continuous Ambulatory Peritoneal Dialysis

“…CAPD pa ti ents had sig ni fi cantly hig her pa rame ters of HRQOL than HD pa ti ents. 24 Ci nar et al sta ted that PD po pu la rity was in cre a sed in the last ye ars be ca u se its is a simp le, com for tab le, and inex pen si ve tre at ment met hod. 5 Similarly Er soy et al sta ted that PD was su i tab le for yo ung, physically ac ti ve pa ti ents who do not want to be de pendent on mac hi nes.…”

“…19 In so me ot her stu di es QOL sco res we re higher in the CAPD pa ti ents. [20][21][22][23][24] The study of Ka lender et al whe re SF-36 was used to eva lu a te QOL of chro nic kid ney di se a se pa ti ents re por ted that the SF-36 sco res we re hig her in the CAPD gro up than HD gro up. 20 Shrest ha et al sta ted that pa ti ents on CAPD ha d bet ter qu a lity of li fe than pa ti ents on HD es pe ci ally in terms of men tal he alth.…”