Predictors of quality of life among patients on dialysis in southern Brazil
Keywords:
Quality of life, Epidemiologic factors, End-stage renal disease, Dialysis, RiskAbstract
CONTEXT AND OBJECTIVE: Quality of life (QoL) is considered important as an outcome measurement, especially for long-term diseases such as chronic renal failure. The present study searched for predictors of QoL in a sample of patients undergoing dialysis in southern Brazil. DESIGN AND SETTING: This was a cross-sectional study developed in three southern Brazilian dialysis facilities. METHODS: Health-related QoL of patients on hemodialysis or peritoneal dialysis was measured using the generic Short Form-36 (SF-36) health survey questionnaire. The results were correlated with sociodemographic, clinical and laboratory variables. The analysis was adjusted through multiple linear regression. RESULTS: A total of 140 patients were assessed: 94 on hemodialysis and 46 on peritoneal dialysis. The mean age was 54.2 ± 15.4 years, 48% were men and 76% were white. The predictors of higher (better) physical component summary in SF-36 were: younger age (β -0.16; 95% confi dence interval, CI: -0.27 to -0.05), shorter time on dialysis (β -0.06; 95% CI: -0.09 to -0.02) and lower Khan comorbidity-age index (β 5.16; 95% CI: 1.7-8.6). The predictors of higher mental component summary were: being employed (β 8.4; 95% CI: 1.7-15.1), being married or having a marriage-like relationship (β 4.56; 95% CI: 0.9-8.2), being on peritoneal dialysis (β 4.9; 95% CI: 0.9-8.8) and not having high blood pressure (β 3.9; 95% CI: 0.3-7.6). CONCLUSIONS: Age, comorbidity and length of time on dialysis were the main predictors of physical QoL, whereas socioeconomic issues especially determined mental QoL.
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References
Sociedade Brasileira de Nefrologia. Censo 2004/2005. Available from: http://www.sbn.org.br. Accessed in 2008 (Jul 8).
Inriq JK, Sun JL, Yang Q, Briley LP, Szczech LA. Mortality by dialysis modality among patients who have end-stage renal disease and are awaiting renal transplantation. Clin J Am Soc Nephrol. 2006;1(4):774-9.
Jofré R, López-Gómez JM, Moreno F, Sanz-Guajardo D, Valder- rábano F. Changes in quality of life after renal transplantation. Am J Kidney Dis. 1998;32(1):93-100.
Nolan CR. Strategies for improving long-term survival in patients with ESRD. J Am Soc Nephrol. 2005;16 (Suppl 2):S120-7.
Khan IH, Campbell MK, Cantarovich D, et al. Survival on renal replacement therapy in Europe: is there a ‘centre effect’? Nephrol Dial Transplant. 1996;11(2):300-7.
Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF- 36). [Brazilian-Portuguese version of the SF-36. A reliable and valid quality of life outcome measure]. Rev Bras Reumatol. 1999;39(3):143-50.
Diaz-Buxo JA, Lowrie EG, Lew NL, Zhang H, Lazarus JM. Quality-of-life evaluation using Short Form 36: comparison in hemodialysis and peritoneal dialysis patients. Am J Kidney Dis. 2000;35(2):293-300.
Merkus MP, Jager KJ, Dekker FW, De Haan RJ, Boeschoten EW, Krediet RT. Quality of life over time in dialysis: the Netherlands Cooperative Study on the Adequacy of Dialysis. NECOSAD Study Group. Kidney Int. 1999;56(2):720-8.
Kimmel PL, Peterson RA, Weihs KL, et al. Psychologic function- ing, quality of life, and behavioral compliance in patients begin- ning hemodialysis. J Am Soc Nephrol. 1996;7(10):2152-9.
Mittal SK, Ahern L, Flaster E, Maesaka JK, Fishbane S. Self- assessed physical and mental function of haemodialysis patients. Nephrol Dial Transplant. 2001;16(7):1387-94.
Baiardi F, Degli Esposti E, Cocchi R, et al. Effects of clinical and individual variables on quality of life in chronic renal failure patients. J Nephrol. 2002;15(1):61-7.
Harris LE, Luft FC, Rudy DW, Tierney WM. Clinical correlates of functional status in patients with chronic renal insufficiency. Am J Kidney Dis. 1993;21(2):161-6.
Kusek JW, Greene P, Wang SR, et al. Cross-sectional study of health-related quality of life in African Americans with chronic renal insufficiency: the African American Study of Kidney Disease and Hypertension Trial. Am J Kidney Dis. 2002;39(3):513-24.
Chiang CK, Peng YS, Chiang SS, et al. Health-related quality of life of hemodialysis patients in Taiwan: a multicenter study. Blood Purif. 2004;22(6):490-8.
Martínez-Castelao A, Gòrriz JL, Garcia-López F, et al. Per- ceived health-related quality of life and comorbidity in dia- betic patients starting dialysis (CALVIDIA study). J Nephrol. 2004;17(4):544-51.
Lamping DL, Constantinovici N, Roderick P, et al. Clinical outcomes, quality of life, and costs in the North Thames Dialysis Study of elderly people on dialysis: a prospective cohort study. Lancet. 2000;356(9241):1543-50.
Maor Y, King M, Olmer L, Mozes B. A comparison of three measures: the time trade-off technique, global health-related quality of life and the SF-36 in dialysis patients. J Clin Epide- miol. 2001;54(6):565-70.
Blake C, Codd MB, Cassidy A, O’Meara YM. Physical func- tion, employment and quality of life in end-stage renal disease. J Nephrol. 2000;13(2):142-9.
Association between recombinant human erythropoietin and quality of life and exercise capacity of patients receiving haemodialysis. Canadian Erythropoietin Study Group. BMJ. 1990;300(6724):573-8.
Santos PR. Correlação entre marcadores laboratoriais e nível de qualidade de vida em renais crônicos hemodialisados. [Cor- relation between laboratory markers and quality of life level in chronic hemodialysis patients]. J Bras Nefrol. 2005;27(2):70-5. Available from: http://www.jbn.org.br/27-2/05-SANTOS%20P.pdf. Accessed in 2008 (Jul 8).