Health-related quality of life in patients undergoing hemodialysis

Gora  Miljanović; Milan  Marjanović; Sonja Radaković; Miljojko  Janošević; Tatjana  Mraović; Slavica  Rađen

doi:10.2298/VSP160511211M

Gora Miljanović High Health School of Professional Studies in Belgrade
Milan Marjanović Corvus
Sonja Radaković University of Defence, Faculty of Medicine of the Military Medical Academy
Miljojko Janošević Military Academy
Tatjana Mraović University of Defence, Faculty of Medicine of the Military Medical Academy
Slavica Rađen University of Defence, Faculty of Medicine of the Military Medical Academy

DOI: https://doi.org/10.2298/VSP160511211M

Keywords: renal dialysis;, hypertension;, quality of life;, surveys and questionnaires;, health

Abstract

Background/Aim. Chronic renal disease is one of the growing problems all over the world. Health-related quality of life (HRQoL) is an important indicator for those with a chronic disease, such as chronic renal disease, because it may serve as predictor of mortality and hospitalization. The aim of this study was to assess HRQoL in patients on chronic maintenance hemodialysis (HD), and compare it with patients suffering from hypertension (HTA), and normal controls of the same age and gender (C). Methods. The study enrolled 224 males and females older than 18 years: 67 in the HD group, 78 in the HTA group, and 79 in the C group. HRQoL was assessed in all groups using 15-D questionnaire. Results. Significantly higher level of education was recorded in the HD group compared to other two groups. In the HD group there were significantly less employed persons (9%) and significantly more retired (67.2%). All groups were similar regarding an average monthly income and marital status. We found significantly lower total HRQoL score in patients in the HD group, compared to normal controls (0.78 ± 0.16 vs. 0.89 ± 0.10 in the HTA and 0.95 ± 0.06 in the C group) as well as specific scores in almost all investigated domains, except in speech, eating and mental functions. Patients in the HD and HTA groups had similar self-reported quality of life in additional 3 domains: hearing, elimination and distress, while the HD group reported significantly lower scores in remaining 9 domains: mobility, vision, breathing, sleeping, usual activities, discomfort and symptoms, depression, vitality and sexual activity. Patients in the HTA group had significantly lower scores than normal controls in 8 domains (hearing, sleeping, elimination, usual activities, discomfort and symptoms, depression, distress and vitality) as well as in total quality of life, while in remaining 4 domains there was no significant difference (mobility, vision, breathing, sexual activity). Conclusion. Both investigated chronic diseases lead to impairment of HRQoL, which is substantially stronger in hemodialysis than in hypertension. Considering the relationship between depression and HRQoL measures, it may be useful to treat depression of HD patients in order to improve their quality of life.

References

Testa MA, Simonson DC. Assesment of quality-of-life outcomes. N Engl J Med 1996; 334(13): 835−40.

Vasiljevic N, Ralevic S, Marinkovic J, Kocev N, Maksimovic M, Sbu-tega-Milosevic G, et al. The assessment of health-related quality of life in relation to the body mass index value in the urban population of Belgrade. Health Qual Life Outcomes 2008; 6(1): 106−12.

Vlajinac H, Marinkovic J, Tanaskovic S, Kocev N, Radak D, Davi-dovic D, et al. Quality of life after peripheral bypass surgery: A 1 year follow-up. Wien Klin Wochenschr 2015; 127(5−6): 210−7.

Alanne S, Roine RP, Räsänen P, Vainiola T, Sintonen H. Estimat-ing the minimum important change in the 15D scores. Qual Life Res 2015; 24(3): 599−606.

Korhonen PE, Seppälä T, Kautiainen H, Järvenpää S, Aarnio PT, Kivelä SL. Ankle-brachial index and health-related quality of life. Eur J Prev Cardiol 2012; 19(5): 901−7.

Ludt S, Wensing M, Szecsenyi J, van Lieshout J, Rochon J, Freund T, et al. Predictors of health-related quality of life in patients at risk for cardiovascular disease in European primary care. PLoS ONE 2011; 6(12): e29334.

Sprengers RW, Teraa M, Moll FL, de Wit GA, van der Graaf Y, Verhaar MC. JUVENTAS Study Group. SMART Study Group. Quality of life in patients with no-option critical limb ischemia underlines the need for new effective treatment. J Vasc Surg 2010; 52(4): 843−9, 849.e1.

Martinez-Martin P, Jeukens-Visser M, Lyons KE, Rodriguez-Blazquez C, Selai C, Siderowf A, et al. Health-related quality-of-life scales in Parkinson's disease: critique and recommenda-tions. Mov Disord 2011; 26(13): 2371−80.

Mapes DL, Lopes AA, Satayathum S, McCullough KP, Goodkin DA, Locatelli F, et al. Health-related quality of life as a predic-tor of mortality and hospitalization: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney Int 2003; 64(1): 339−49.

White SL, Chadban SJ, Jan S, Chapman JR, Cass A. How can we achieve global equity in provision of renal replacement therapy? Bull World Health Organ 2008; 86(3): 229–37

Schieppati A, Remuzzi G. Chronic renal diseases as a public health problem: epidemiology, social, and economic implica-tions. Kidney Int Suppl 2005; (98): S7−S10.

Petrovic L, Mitic I, Bozic D, Vodopivec S, Djurdjevic-Mirkovic T. Quality of life in patients with chronic renal failure. Med Pregl 2006; 59(9−10): 411−4. (Serbian)

Dedić G, Milojković N, Čukić Z, Bokonjić D. Quality of life of hemodialysis patients waiting for kidney transplantation. Voj-nosanit Pregl 2017; 74(8): doi: 10.2298/VSP150918259D.

Nezu S, Okamoto N, Morikawa M, Saeki K, Obayashi K, Tomioka K, et al. Health-related quality of life (HRQOL) decreases in-dependently of chronic conditions and geriatric syndromes in older adults with diabetes: the Fujiwara-kyo Study. J Epidemiol 2014; 24(4): 259−66.

Murali R, Sathyanarayana D, Muthusethupathy MA. Assessment of quality of life in chronic kidney disease patients using the kidney disease quality of life-short formTM questionnaire in Indian population: A community based study. Asian J Pharm Clin Res 2015; 8(1): 271−4.

Maenpaa J, Puistola U, Riska H, Sintonen H, Saarni O, Juvonen E, et al. Impact of Epoetin-beta on Anemia and Health-related Quality of Life in Cancer Patients: A Prospective Observational Study Using the Generic 15D Instrument. Anticancer Res 2014; 34(5): 2325−9.

Mazur W, Kupiainen H, Pitkäniemi J, Kilpeläinen M, Sintonen H, Lindqvist A, et al. Comparison between the disease-specific Airways Questionnaire 20 and the generic 15D instruments in COPD. Health Qual Life Outcomes 2011; 9: 4.

Sintonen H. The 15D instrument of health-related quality of life: Properties and applications. Ann Med 2001; 33(5): 328−36.

Landreneau K, Lee K, Landreneau MD. Quality of life in patients undergoing hemodialysis and renal transplantation-a meta-analytic review. Nephrol Nurs J 2010; 37(1): 37−44.

Thaweethamecharoen T, Srimongokol W, Noparatayaporn P, Jariyay-othin P. Patient-Reported Outcomes (PRO) of Quality of Life (QOL) studies validity and reliability of KDQOK-36 in Thai Kidney Disease Patients. Value Health Reg Issues 2013; 2: 98−102.

Bugarski V, Sakac V, Vodopivec S, Slankamenac P. Relation be-tween personality dimensions and depressive symptoms in pa-tients on hemodialysis. Med Pregl 2010; 63(5−6): 305−12. (Serbian)

Park JI, Kim M, Kim H, An JN, Lee J, Yang SH, et al. Not early referral but planned dialysis improves quality of life and de-pression in newly diagnosed end stage renal disease patients: a prospective cohort study in Korea. PLoS One 2015; 10(2): e0117582.

Jaar BG, Chang A, Plantinga L. Can we improve quality of life of patients on dialysis? Clin J Am Soc Nephrol 2013; 8(1): 1−4.

Stojanovic M, Stojanovic D, Stefanovic V. The impact of malnutri-tion on mortality in patients on maintenance hemodialysis in Serbia. Artif Organs 2008; 32(5): 398−405.

Theofilou P. Quality of life in patients undergoing hemodialysis or peritoneal dialysis treatment. J Cliln Med Res 2011; 3(3): 132−8.

Germin-Petrovic D, Mesaros-Devcic I, Lesac A, Mandic M, Soldatic M, Vezmar D, et al. Health-related quality of life in the patients on maintenance hemodialysis: The analysis of demographic and clinical factors. Coll Antropol 2011; 35(3): 687−93.

Sayin A, Mutluay R, Sindel S. Quality of life in hemodialysis, peritoneal dialysis, and transplantation patients. Transplant Proc 2008; 39(10): 3047−53.

Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, et al. Systematic review: Kidney transplantation compared with di-alysis in clinically relevant outcomes. Am J Transplant 2011; 11(10): 2093−109.

Mazairac AH, Grooteman MP, Blankestijn PJ, Penne EL, van der Weerd NC, den Hoedt CH, et al. Differences in quality of life of hemodialysis patients between dialysis centers. Qual Life Res 2012; 21(2): 299−307.

Stojanovic M, Stefanovic V. Assessment of Health-related quality of life in patients treated with hemodialysis in Serbia: Influence of comorbidity, age, and income. Artif Organs 2007; 31(1): 53−60.

Vukadinovic N. The quality of life of chronically ill patients. Opšta medicina 2011; 17(1−2): 56−61. (Serbian)