Abstract
The number of patients on peritoneal dialysis (PD) in Brazil is significant, with a higher prevalence of diabetic and elderly individuals on PD than on hemodialysis. These data point to a selection bias in that population. To assess the quality of life (QOL) of patients starting PD in Brazil. The study assessed 6,198 patients participating in a multicenter prospective cohort study, using data from BRAZPD. The QOL was assessed by use of the Karnofsky index (QOL assessment by health professionals) and the SF-36 (patient's self-assessment) in 1,624 incident patients. Of the patients analyzed, 40% were diabetic and 47% were elderly (over the age of 60 years). Patients had low QOL scores in all the SF-36 domains, the "physical role" domain being the most affected and the "social functioning" domain having the best score. On the other hand, according to the Karnofsky index, most patients had high QOL scores. Elderly and diabetic patients had lower QOL as compared with non-elderly and non-diabetic by using both the SF-36 and Karnofsky index. The overall evaluation by use of the SF-36 showed a reduction in the QOL. The Karnofsky index showed a better QOL as compared with the SF-36 assessment, but similar results were found in the subgroups evaluated: the ederly and the diabetic patients had the worst QOL in both assessments.
Highlights
The number of patients on peritoneal dialysis (PD) in Brazil is significant, with a higher prevalence of diabetic and elderly individuals on PD than on hemodialysis
Patients with chronic kidney disease (CKD) usually tend to show a reduction in their quality of life (QoL) because of the several restrictions resulting from CKD treatment
Some studies have reported no difference in the QoL of patients undergoing hemodialysis (HD) as compared with that of patients undergoing peritoneal dialysis (PD), since both groups have a reduction in scores.[1]
Summary
The number of patients on peritoneal dialysis (PD) in Brazil is significant, with a higher prevalence of diabetic and elderly individuals on PD than on hemodialysis. These data point to a selection bias in that population. The Karnofsky index showed a better QoL as compared with the SF-36 assessment, but similar results were found in the subgroups evaluated: the ederly and the diabetic patients had the worst QoL in both assessments. As compared with non-diabetic patients, diabetic patients use more medications, score lower in the physical domains of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF36), and have greater blood pressure levels, more cardiovascular complications, a worse self-perception of QoL, lower physical functioning, and higher mortality.[3] The presence of comorbidities can, relate to the reduction in QoL
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