Abstract
ObjectiveEnd-stage renal disease (ESRD) leads to renal replacement therapy and certainly has an impact on patients’ health-related quality of life (HRQoL). This study aimed to review and compare the HRQoL between peritoneal dialysis (PD) and hemodialysis (HD) patients using the 36-Item Short Form Health Survey (SF-36), EuroQoL-5-dimension (EQ-5D) and the Kidney Disease Quality of Life Instrument (KDQOL).MethodologySystematic review was conducted by identify relevant studies through MEDLINE and SCOPUS up to April 2017. Studies were eligible with following criteria: studied in ESRD patients, compare any pair of renal replacement modalities, and reported HRQoL. The unstandardized mean differences (USMD) of HRQoL among modalities were calculated and pooled using a random-effect models if heterogeneity was present, otherwise a fixed-effect model was applied.ResultsA total of twenty-one studies were included with 29,000 participants. Of them, mean age and percent male were 48.1 years and 45.1, respectively. The pooled USMD (95% CI) of SF-36 between PD and HD (base) were 1.86 (0.47, 3.24) and 0.42 (− 1.99, 2.82) for mental component and physical component summary scores, respectively. For EQ-5D, the pooled USMD of utility and visual analogue scale (VAS) score were 0.02 (− 0.06, 0.10) and 3.56 (1.73, 5.39), respectively. The pooled USMD of KDQOL were 9.67 (5.67, 13.68), 6.71 (− 5.92, 19.32) 6.30 (− 0.41, 12.18), 2.35 (− 4.35, 9.04), 2.10 (0.07, 4.13), and 1.21 (− 2.98, 5.40) for burden of kidney disease, work status, effects of kidney disease, quality of social interaction, symptoms, and cognitive function.ConclusionPatients with chronic kidney disease (CKD) stage 5 or ESRD treated with PD had better generic HRQoL measured by SF-36 and EQ-5D than HD patients. In addition, PD had higher specific HRQoL by KDQOL than HD patients in subdomain of physical functioning, role limitations due to emotional problems, effects and burden of kidney disease.
Highlights
End-stage renal disease (ESRD) can be treated by renal replacement therapy (RRT), which certainly impact on health-related quality of life (HRQoL) of the patients [1– 3]
Patients with chronic kidney disease (CKD) stage 5 or ESRD treated with peritoneal dialysis (PD) had better generic HRQoL measured by short form (SF)-36 and EQ-5D than HD patients
The generic instruments (e.g., 36-Item Short Form Health Survey (SF-36), European Quality of Life-5 Dimensions (EQ5D), the World Health Organization Quality of LifeBREF (WHOQOL-BREF), 15-dimensional Health-related quality of life (15D-HRQoL), 12-item General Health Questionnaire (GHQ-12)) measure overall health and functions whereas the disease-specific instrument is used to focus on individual symptoms of a specific disease (e.g., Kidney Disease Quality of Life (KDQOL), Quality of Life Index-Dialysis, and Transplantation)
Summary
End-stage renal disease (ESRD) can be treated by renal replacement therapy (RRT), which certainly impact on health-related quality of life (HRQoL) of the patients [1– 3]. Both ESRD treated by RRT or conservative management will have limitation in HRQoL, and have increase in morbidity and mortality [4–7]. The generic instruments (e.g., 36-Item Short Form Health Survey (SF-36), European Quality of Life-5 Dimensions (EQ5D), the World Health Organization Quality of LifeBREF (WHOQOL-BREF), 15-dimensional Health-related quality of life (15D-HRQoL), 12-item General Health Questionnaire (GHQ-12)) measure overall health and functions whereas the disease-specific instrument is used to focus on individual symptoms of a specific disease (e.g., Kidney Disease Quality of Life (KDQOL), Quality of Life Index-Dialysis, and Transplantation). There is no consensus about standard instrument to measure HRQoL [2]
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