Mp. Merkus et al., QUALITY-OF-LIFE IN PATIENTS ON CHRONIC DIALYSIS - SELF-ASSESSMENT 3 MONTHS AFTER THE START OF TREATMENT, American journal of kidney diseases, 29(4), 1997, pp. 584-592
The aim of the present multicenter study was to assess quality of life
of Dutch dialysis patients 3 months after the start of chronic dialys
is treatment. The quality of life was compared with the quality of lif
e of a general population sample, and the impact of demographic, clini
cal, renal function, and dialysis characteristics on patients' quality
of life was studied. New end-stage renal disease (ESRD) patients who
were started on chronic hemodialysis or peritoneal dialysis in 13 dial
ysis centers in The Netherlands were consecutively included. Patients'
self-assessment of quality of life was measured by the SF-36, a 36-it
em Short Form Health Survey Questionnaire encompassing eight dimension
s: physical functioning, social functioning, role-functioning physical
, role-functioning emotional, mental health, vitality, bodily pain, an
d general health perceptions. One hundred twenty hemodialysis and 106
peritoneal dialysis patients completed the SF-36. Quality of life of h
emodialysis and peritoneal dialysis patients was substantially impaire
d in comparison to the general population sample, particularly with re
spect to role-functioning physical and general health perceptions. Mea
n role-functioning physical and general health perceptions scores of t
he hemodialysis patients corresponded with the lowest scoring 8% and 1
2%, respectively, of the reference group. Mean role-functioning physic
al and general health perceptions scores of the peritoneal dialysis pa
tients corresponded with the lowest scoring 10% and 12%, respectively,
of the reference group. Hemodialysis patients showed lower levels of
quality of life than peritoneal dialysis patients on physical function
ing, role-functioning emotional, mental health, and pain. However, on
the multivariate level, we could only demonstrate an impact of dialysi
s modality on mental health. A higher number of comorbid conditions, a
lower hemoglobin level, and a lower residual renal function were inde
pendently related to poorer quality of life. The variability of the SF
-36 scores explained by selected demographic, clinical, renal function
, and dialysis characteristics was highest for physical functioning (2
9.7%). Explained variability of the other SF-36 dimensions ranged from
6.9% for general health perceptions to 15.4% for vitality. We conclud
e that quality of life of new ESRD patients is substantially impaired.
Comorbid conditions, hemoglobin, and residual renal function could ex
plain poor quality of life only to a limited extent. Further research
exploring determinants and indices of quality of life in ESRD patients
is warranted. From a clinical perspective, we may conclude that quali
ty of life should be considered in the monitoring of dialysis patients
. (C) 1997 by the National Kidney Foundation, Inc.