Longitudinal patterns of health-related quality of life and dialysis modality: a national cohort study

Eneanya, Nwamaka D.; Maddux, Dugan; Reviriego-Mendoza, Marta M.; Larkin, John; Usvyat, Len; Sande, Frank M. van der; Kooman, Jeroen P.; Maddux, Franklin W.

doi:10.1186/s12882-018-1198-5

Cited by 28 publications

(21 citation statements)

References 39 publications

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“…In-centre SDHD is a well-established modality of therapy in the literature, which is associated with improved health related quality of life as compared to conventional haemodialysis [19], but it does require that patients have to attend the dialysis centre more frequently. In this regard, there may be room for home haemodialysis that could offer the benefits reported in the present study with more autonomy and perhaps a better quality of life [20].…”

Section: Discussionmentioning

confidence: 86%

Association between extracellular volume control and survival in patients on short daily haemodialysis

et al. 2020

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Background: Fluid overload (FO) assessed by bioimpedance spectroscopy (BIS) is associated with higher mortality risk in maintenance haemodialysis (HD). The aim was to assess if a better management of FO through short daily haemodialysis (SDHD) could improve survival. Methods: Retrospective analysis of patients who were on HD 3 sessions/week for at least 3 months and shifted to in-centre SDHD (5 or 6 sessions/week, 2 to 3 h/session) between July 2012 and June 2016 at 23 dialysis units in Brazil. The 12-month risk of death was analysed according to the predialysis hydration status measured before and 6 months after initiation of SDHD. Predialysis hydration status was considered adequate when FO ≤15% of extracellular volume. Results: A total of 297 patients on SDHD were included in the analysis. Their median age was 57 (IQR 45-67) years, 62% were males, 44% diabetics, 57% on 6 dialysis sessions/week, with a median session duration of 130 (IQR 120-150) minutes. BIS assessment at initiation of the SDHD regimen was performed in 220 patients and FO > 15% was found in 46.4%. Twelve-month survival rates for those with FO ≤15 and > 15% before initiating SDHD were 87.4 and 88.0%, respectively (P = 0.92). BIS analysis when completing 6 months on SDHD were available for 229 patients, 26.6% with FO > 15%. The survival rates for the next 12 months (from the 6th to the 18th month of follow-up) for those with FO ≤15 and > 15% were 91.0 and 72.0%, respectively (P = 0.0006). In a Cox regression model, after adjustment for demographic, clinical and laboratory variables, FO ≤ 15% persisted associated with a lower mortality risk (hazard ratio 0.34, 95%CI 0.13-0.87). Conclusions: Moving from conventional HD to SDHD was associated with better control of excessive extracellular volume. Patients who reached or maintained predialysis fluid overload ≤15% after initiating SDHD presented a lower risk of death.

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Section: Discussionmentioning

confidence: 86%

Association between extracellular volume control and survival in patients on short daily haemodialysis

et al. 2020

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“…The China Q study by Yu et al (NCT02378350, pending publication) is comparing QOL between 668 patients on either PD or ICHD over 1 year. In addition, a recent large retrospective cohort analysis 34 posed a similar question to the present study, comparing health-related QOL over time between patients (n = 5114) who initiated ICHD or home dialysis (PD or HHD) at multiple time points via the KDQOL scale. Despite the relatively large sample size, the study demonstrated no significant differences in QOL over time between groups after 485 days.…”

Section: Discussionmentioning

confidence: 98%

A Comparison of Patient-Reported Outcome Measures of Quality of Life By Dialysis Modality in the Treatment of Kidney Failure: A Systematic Review

Budhram

Sinclair

Komenda

et al. 2020

Can J Kidney Health Dis

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Background: There is an increasing demand to incorporate patient-reported outcome measures (PROMs) such as quality of life (QOL) in decision-making when selecting a chronic dialysis modality. Objective: To compare the change in QOL over time among similar patients on different dialysis modalities to provide unique and novel insights on the impact of dialysis modality on PROMs. Design: Systematic reviews, randomized controlled trials, and nonrandomized controlled trials were examined via a comprehensive search strategy incorporating multiple bibliographic databases. Setting: Data were extracted from relevant studies from January 1, 2000 to December 31, 2019 without limitations on country of study conduction. Patients: Eligible studies included adults (≥18 years) with end-stage kidney disease of any cause who were prescribed dialysis treatment (either as lifetime treatment or bridge to transplant). Measurements: The 5 comparisons were peritoneal dialysis (PD) vs in-center hemodialysis (ICHD), home hemodialysis (HHD) vs ICHD, HHD modalities compared with one another, HHD vs PD, and self-care ICHD vs traditional nurse-based ICHD. Methods: Included studies compared adults on different dialysis modalities with repeat measures within individuals to determine changes in QOL between dialysis modalities (in-center or home dialysis). Methodological quality was assessed by the Scottish Intercollegiate Guidelines Network (SIGN 50) checklist. A narrative synthesis was conducted, synthesizing the direction and size of any observed effects across studies. Results: Two randomized controlled trials and 9 prospective cohort studies involving a combined total of 3711 participants were included. Comparing PD and ICHD, 5 out of 9 studies found significant differences ( P < .05) favoring PD in the change of multiple QOL domains, including “physical component score,” “role of social component score,” “cognitive status,” “role limitation due to emotional function,” “role limitation due to physical function,” “bodily pain,” “burden of kidney disease,” “effects of kidney disease on daily life,” “symptoms/problems,” “sexual function,” “finance,” and “patient satisfaction.” Conversely, 3 of these studies demonstrated statistically significant differences ( P < .05) favoring ICHD in the domains of “role limitation due to physical function,” “general health,” “support from staff,” “sleep quality,” “social support,” “health status,” “social interaction,” “body image,” and “overall health.” Comparing HHD and ICHD, significant differences ( P < .05) favoring HHD for the QOL domains of “general health,” “burden of kidney disease,” and the visual analogue scale were reported. Limitations: Our study is constrained by the small sample sizes of included studies, as well as heterogeneity among both study populations and validated QOL scales, limiting inter-study comparison. Conclusions: We identified differences in specific QOL domains between dialysis modalities that may aid in patient decision-making based on individual priorities. Trial registration: PROSPERO Registration Number: CRD42016046980. Primary funding source: The original research for this study was derived from the Canadian Agency for Drugs and Technologies in Health (CADTH) 2017 optimal use report, titled “Dialysis Modalities for the Treatment of End-Stage Kidney Disease: A Health Technology Assessment.” The CADTH receives funding from Canada’s federal, provincial, and territorial governments, with the exception of Quebec.

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“…The low physical health scores demonstrate that daily activities were disturbed in hemodialysis patients as they were more dependent on renal replacement treatment for their survival. While the present study did not categorize patients as to the type of dialysis modality used, one study reported that incenter dialysis patients had lower physical functioning compared with home modality patients [70]. Another study explored the impact of exercise programs on the physical fitness of hemodialysis patients, and the results were significantly better after the initiation of intervention [71].…”

Section: Quality Of Life Domainsmentioning

confidence: 99%

A Review of the Quality of Life of Hemodialysis, Breast Cancer, and Type 2 Diabetes Mellitus Patients

Arceo

Dizon

Salunga

et al. 2020

SN Compr. Clin. Med.

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Chronic diseases affect the overall quality of life of patients as it negatively impacts different areas in life. The review assessed and qualitatively compared the quality of life (QoL) of patients suffering from three chronic diseases namely patients undergoing hemodialysis, patients with type 2 diabetes mellitus, and patients with breast cancer. Qualitative assessment of previous studies using the Ferrans and Powers quality of life index was conducted. Nineteen (19) full texts were included and comprehensively analyzed. Statistically significant lower scores were noted on the health/functioning and socioeconomic domains of patients undergoing hemodialysis and no significant difference in other areas on the quality of life. There was also no significant difference in the overall scores among the three chronic diseases under study. But while the overall QoL of patients are within the same range, results suggest that hemodialysis patients experience the greatest negative impact in terms of socioeconomic and health/functioning domains in the QoL. Thus, health interventions, educational programs, and policy formulations should focus on improving these aspects. This would also call for a multidisciplinary approach to address the issues related to the quality of life of hemodialysis patients. Keywords Quality of life. Chronic disease. Type 2 diabetes mellitus. Breast cancer. Hemodialysis patients This article is part of the Topical Collection on Medicine

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Longitudinal patterns of health-related quality of life and dialysis modality: a national cohort study

Cited by 28 publications

References 39 publications

Association between extracellular volume control and survival in patients on short daily haemodialysis

Association between extracellular volume control and survival in patients on short daily haemodialysis

A Comparison of Patient-Reported Outcome Measures of Quality of Life By Dialysis Modality in the Treatment of Kidney Failure: A Systematic Review

A Review of the Quality of Life of Hemodialysis, Breast Cancer, and Type 2 Diabetes Mellitus Patients

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