Quality of life and utilities of end stage renal disease patients undergoing dialysis
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Abstract
Introduction: Numbers of patient with end stage renal disease (ESRD) have been continually increased. Renal replacement therapy increases life time of patients with ESRD. Few studies reported utility of ESRD patients undergoing renal replacement therapy. This study aimed to assess health profiles and utility of patients undergoing hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). Methods: This cross-sectional study design was conducted between February and June 2017 at chronic kidney disease (CKD) clinics in two tertiary hospitals. Patients undergoing HD or CAPD and having stable disease during previous six months were recruited. Patients with comorbidities including lupus erythematosus, nephrotic syndrome, and cancer were excluded. Clinical data were obtained from medical chart reviews. Quality of life was measured using the European Quality of Life Measure-5 Domain-5-Level (EQ-5D-5L) and visual analog scale (VAS). Health profile scores were converted into utility scores using population-based algorithm. Descriptive statistics were used to describe patients’ characteristics, health profiles, and utility scores. Logistic regression was used to analyze the relationship of health profile in each dimension, a binary response variable, with patient groups (adjusted odds ratio). Results: A total of 42 HD patients and 46 CAPD patients were participated in this study. The mean age of HD patients was 62 (SD 13) and those of CAPD patients was 56 (SD 10). Nearly all CAPD patients (96%) were the Universal Coverage Scheme members. Approximately 60% of HD patients were under Civil Servant Medical Benefit Scheme. Median duration of CKD among HD patients (7 years, interquartile range 4 to 10) was longer than those with CAPD (4 years, interquartile range 3 to 6). The most common comorbidities of HD and CAPD patients were hypertension, followed by diabetes and dyslipidemia. On average, the utility and VAS scores of HD patients were 0.81 (SD 0.17) and 70.2 (SD 19.2). Mean utility and VAS scores of CAPD patients were 0.83 (SD 0.23) and 69.9 (SD 19.9). Mobility (60%) and pain/discomfort (60%) were the two domains that HD patients were more likely to have any problems as compared with other domains. For CAPD patients, anxiety/depression (53%) and pain/discomfort (52%) were the domains that patients were likely to report having any problems. There were no significant differences in health profiles between CAPD and HD patients in all domains. Conclusion: EQ-5D–derived health utility score of HD and CAPD patients were similar. Pain/discomfort was the major problems that affected quality of life of both HD and CAPD patients. The results are expected to be used for future study focusing on economic evaluation of interventions for patients with CKD.
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References
Afiatin, Khoe LC, Kristin E, et al. Economic evaluation of policy options for dialysis in end-stage renal disease patients under the universal health coverage in Indonesia. PLoS One 2017;12(5):12(5):e0177436.
Aiyasanon N. Comparative study of quality of life in patients on chronic hemodialysis and chronic peritoneal dialysis. Thesis (Silpakorn university) 2009.
Boateng EA, East L. The impact of dialysis modality on quality of life: a systematic review. J Ren Care 2011;37(4):190-200.
Bunyatnopparat K, Anutrakulchai S. Factors associated with life quality of hemodialysis patients. Srinagarind Med J 2017;32(1):2-9.
Chewchanwattana A, Limwattananon C, MPhil CG, et al. The validity of a new practical quality of life measure in patients on renal replacement therapy. J Med Assoc Thai 2006;89(2):207-217.
Chuasuwan A., Praditpornsilpa K. editor. Thailand renal replacement therapy year 2014.
Drennan J, Cleary J. Quality of life of patients on haemodialysis for end-stage renal disease. Journal of Advanced Nursing 2005;51(6):577-586.
Feroze U, Noori N, Kovesdy CP, Molnar MZ, Martin DJ, Reina-Patton A, et al. Quality-of-life and mortality in hemodialysis patients: roles of race and nutritional status. Clin J Am SocNephrol 2011;6(5):1100-1111.
Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. Association among sf36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. J Am Soc Nephrol 2001;12(2):2797-806.
Laolam N, Kriyasin P, Palakul W, Chimpalee A, Halue G, Chandeying V. Quality of life assessment among patients on hemodialysis and peritoneal dialysis at Phayao Hospital. Naresuan Phayao Journal 2014;7(2):172-177.
Liebman S, Li N, Lacson E. Change in quality of life and one-year mortality risk in maintenance dialysis patients. Qual Life Res 2016;25(9):2295-2306.
Liem YS, Bosch JL, Hunink MG. Preference-based quality of life of patients on renal replacement therapy: a systematic review and meta-analysis. Value Health 2008;11(4):733-741.
Liem YS, Bosch JL, Arends LR, et al. Quality of life assessed with the medical outcomes study short form 36-item health survey of patients on renal replacement therapy: a systematic review and meta-analysis. Value Health 2007;10(5):390-397.
Loos C, Briançon S, Frimat L, Hanesse B, Kessler M. Effect of end-stage renal disease on the quality of life of older patients. J Am Geriatr Soc 2003;51(2):229-233.
Lynette L, Sam-ang S, Adrian S. Thai SF-36 health survey: tests of data quality, scaling assumptions, reliability and validity in healthy men and women. Health Qual Life Outcomes 2008;6:52-60.
National Statistical Office. Executive Summary from Health and Welfare Survey 2011 [1/8/2017]. Available from: http://service.nso.go.th/nso/nsopublish/themes/files/healthy/healthyExec54.pdf.
Pattanaphesaj J, Thavorncharoensap M, Tongsiri s, Teerawattananon y, Cairns j. Health-related quality of life measure (EQ-5D-5L): the development, psychometric testing, and its preference-based score in Thai population. Health Intervention and Technology Assessment Program; 2012.
Sakthong P, Kasemsup V. Health utility measured with EQ-5D in Thai patients undergoing peritoneal dialysis. Value Health 2012;15(1 Suppl):S79-84.
Sarakwan J, Sittisongkram S, Khrabiad S, Boonkerd M, Meepaen M. Quality of Life in Patients with End Stage of Renal Disease. Journal of Phrapokklao Nursing College 2017;8(2):152-164.
Teerawattananon Y, Mugford M, Tangcharoensathien V. Economic evaluation of palliative management versus peritoneal dialysis and hemodialysis for end-stage renal disease: evidence for coverage decisions in Thailand. Value Health 2007;10(1):61-72.
Tiansaard J, Chaiviboontham S, Phinitkhajorndech N. Perception of symptom burden, financial burden, and quality of life in patients with end stage renal disease undergoing hemodialysis. Rama Nurs J 2017;23(1):61-77.
Tongsiri S, Cairns J. Estimating population-based values for EQ-5D health states in Thailand. Value Health 2011;14(8):1142-1145.
Vathesatogkit P, Sritara P, Kimman M, et al. Associations of lifestyle factors, disease histiry and awaress with health-related quality of life in a Thai population. PLOS ONE 2012;7(11): 1-9.
Wyld M, Morton RL, Hayen A, Howard K, Webster AC. A systematic review and meta-analysis of utility based quality of life in chronic kidney disease treatments. PLoS Med 2012;9(9):e1001307.
Yang F, Lau T, Luo N. Cost-effectiveness of haemodialysis and peritoneal dialysis for patients with end-stage renaldisease in Singapore. Nephrology (Carlton) 2016;21(8):669-677.
Zazzeroni L, Pasquinelli G, Nanni E, Cremonini V, Rubbi I. Comparison of quality of life in patients undergoing hemodialysis and peritoneal dialysis: a systematic review and meta analysis. Kidney Blood Press Res 2017;42(4):717-727.