CROSS-SECTIONAL STUDY OF QUALITY-OF-LIFE AND SYMPTOMS IN CHRONIC RENAL-DISEASE PATIENTS - THE MODIFICATION OF DIET IN RENAL-DISEASE STUDY

The purposes of this study were to measure health-related quality of l ife in the Modification of Diet in Renal Disease clinical trial; corre late quality of life measures with demographic, medical, and laborator y variables; and compare quality of life in various chronic diseases. The 1,284 patients enrolled in the baseline period of the Modification of Diet in Renal Disease study who completed at least one measurement of quality of life or symptoms served as the subjects of this study. The Quality of Well-Being (QWB) scale, which was a general health-rela ted quality of life index, the Symptom Checklist-SOR (SCL-90R), which provided a global measure of mental health, and the Patient Symptom Fo rm, which assessed the frequency of symptoms specific to this populati on, were used as measurements. The mean +/- SD QWB score was 0.74 +/- 0.09. Using multivariate analysis, there was a significant negative co rrelation between the overall QWB score and age and female gender, and a significant positive correlation between the QWB and level of educa tion, income, and glomerular filtration rate (GFR). For the SCL-90R su bscores, the mean normalized Global Symptom Index was 49.7 +/- 9.6, th e Positive Symptom Total was 47.9 +/- 10.4, and the mean Positive Symp tom Distress Index was 51.3 +/- 12.6. Using multivariate analysis, sig nificant inverse relationships were seen between each of the SCL-SOR s ubscores and income, serum albumin level, and GFR. The most commonly r eported medical symptoms in this cohort included tiring easily, weakne ss, lack of pep or energy, difficulty sleeping, and abdominal bloating or gas. Symptoms in which the severity index score had a negative cor relation with GFR included tiring easily, weakness, lack of pep and en ergy, muscle cramps, easy bruising or bleeding, bad taste in mouth, an d hiccoughs. In conclusion, patients with moderate to advanced renal i nsufficiency have a reduced quality of life and an increased frequency and severity of both symptoms and psychological distress, with the ma gnitude of these changes negatively correlated with GFR. (C) 1997 by t he National Kidney Foundation, Inc.