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Abstract
Objective: Very less is known about health-related quality of life (HRQOL) among patients with kidney diseases in Nepal. This study examined HRQOL among haemodialysis and kidney transplant recipients in Nepal. Design and method: The Nepali version of World Health Organization Quality of Life Instruments -(WHOQOL-BREF) questionnaire was administered using face to face interviews among end stage renal disease (ESRD) patients, from two large national referral centers in Nepal. The differences in socio-demographic characteristics among ESRD patients were examined using the Chi-square test. The group differences in quality of life (QOL) were examined using the Mann-Whitney U test and Kruskal-Wallis tests. Results: Of the 161 participants, 92 (57.1%) were renal transplant recipients and 62 (42.9%) patients were on maintenance haemodialysis. Hypertension (70.9%) was the most common co-morbidity among ESRD patients. Haemodialysis patients scored significantly lower than the transplant recipients in all four domains as well as in overall perception of quality of life and general health. Ethnicity (p = 0.020), socio-economic status (p < 0.001), educational status (p < 0.001) and employment status (p = 0.009) were significantly associated with the overall QOL in ESRD patients. Across patient groups, educational status (p = 0.012) was positively associated with QOL in dialysis patients, while urban residence (p = 0.023), higher socio-economic status (p < 0.001), higher educational status (p = 0.004) and diabetes status (p = 0.010) were significantly associated with better QOL in transplant recipients. Conclusions: The overall QOL of the renal transplant recipients was higher than that of the patients on maintenance haemodialysis; this was true in all four domains of the WHOQOL-BREF. ESRD patients with low HRQOL could benefit from targeted risk modification intervention.
Highlights
Very less is known about health-related quality of life (HRQOL) among patients with kidney diseases in Nepal
Infrequent and inadequate haemodialysis along with malnutrition and frequent use of blood transfusion are some of the major problems prevailing in Nepalese haemodialysis patients [11,12,13]; at the same time, expenses of the post-transplant medicines and distance to travel for regular follow up apparently affect the kidney transplant recipients [9]
This study provides a comparative situation of QOL faced by haemodialysis and transplant recipients and the evidence could be useful for policy makers, program managers and other stakeholders for developing an effective response towards improving the health conditions of people with end-stage renal disease (ESRD)
Summary
Very less is known about health-related quality of life (HRQOL) among patients with kidney diseases in Nepal. This study examined HRQOL among haemodialysis and kidney transplant recipients in Nepal. The incidence and prevalence of end-stage renal disease (ESRD) has been rising globally, yet the burden in South Asia is not known precisely due to improper registration systems [1]. ESRD treatment is costly and unaffordable for most Nepalese people, the Government of Nepal provides payment to the hospital to cover some cost for haemodialysis and transplant recipients [3, 9, 10]. The quality of life (QOL) of ESRD patients on maintenance haemodialysis and kidney transplant recipients is compromised impacting various health outcomes [14, 15]
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