Self-assessed physical and mental function of haemodialysis patients

Background. Physical (PCS) and mental (MCS) component summary scales of the Short Form 36 (SF-36) health survey are validated measures of quality of l ife (QOL) and functional status. We sought to evaluate the PCS and MCS in h aemodialyis patients as compared to the general population and other chroni c diseases. Methods, A cohort of 134 haemodialysis patients (mean age 60.9 +/- 14.3 yea rs, males 63.4%, Caucasians 66.4%) was followed from January 1996 to Decemb er 1998 (mean follow up 14.5 +/-5.7 months). SF-36 questionnaires were admi nistered every 3 months and PCS and MCS were calculated. Results were compared to the general population and other chronic diseases. Correlators of PCS and MCS, change in QOL over time, and the correlators o f this change were determined. Results. Mean PCS was 36.9 +/-8.8 and mean M CS was 47 +/- 10.7. Compared to the general US population, these represent a decline of 8.7 +/-0.8 for PCS (P<0.0001) and 2.7<plus/minus>0.8 for MCS ( P<0.001). PCS and MCS in end-stage renal disease (ESRD) were lower than in most other chronic diseases studied. Univariate correlators of PCS in haemo dialysis patients included age, male sex, haematocrit, serum albumin, and s everity of comorbid cardiac and pulmonary illnesses. Multivariate analysis demonstrated independent correlators of PCS to be male sex, serum albumin a nd severity of comorbid cardiac and pulmonary diseases. Univariate as well as multivariate correlators of MCS included: serum albumin, KT/V-urea, and status living alone. A trend analysis revealed that both PCS and MCS tended to decline in the initial months of dialysis but stabilized over time. Sta tus living alone was a significant predictor of improvement in MCS by univa riate as well as multivariate analysis. Conclusions. Self assessed physical and mental health of haemodialysis pati ents is markedly diminished compared to the general population and other ch ronic diseases.