P1530QUALITY OF LIFE AND MORTALITY IN PATIENTS UNDERGOING HEMODIALYSIS

Abstract

Abstract Background and Aims The mortality of patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) is higher than the general population. And it is well known that quality of life (QOL) falls immediately after receiving HD. However, studies on the relationship between reduced QOL and mortality in HD patients were very rare. This study aims to observe the correlation between impaired QOL and mortality in HD patients and to identify risk factors that affect mortality. Method The study included 160 patients with ESRD undergoing HD during over 3 months. The QOL was evaluated using WHO Quality of Life-BREF (WHOQOL-BREF). The WHOQOL-BREF instrument comprises 26 items, which measure the following four domains: physical health (domain 1), psychological health (domain 2), social relationships (domain 3), and environment (domain 4). Univariate analysis was used to determine the relationship between comorbidities, sex, age, laboratory findings, and QOL and mortality in HD patients. Multivariate analysis was performed by cox proportional hazard regression. Expected survival at 5 and 10 years was determined by two-sample t-tests. Results The mean age was 58.1 years old. 95 patients (59.7%) received HD due to diabetes mellitus. 42 patients (26.4%) had been diagnosed with coronary heart disease. In univariate analysis, age, coronary heart disease, malignancy, comorbidities, and blood calcium level were positively correlated with mortality. In particular, the domain 1 and 2 of WHOQOL-BREF were negatively associated with mortality. The mean scores of domain 1 and 2 was 18.2±5.2 and 15.9±4.5 for survivors and 15.5±5.7 and 13.7±4.9 for deaths. Multivariate analysis identified the age, comorbidity, serum calcium, and domain 1 of WHOQOL-BREF were independent risk factors for mortality (Table 1). Additionally, predicting 5- and 10- year survival, mortality was correlation with older age, higher Charlson Comorbidity Index, lower serum calcium, and lower domain 1 of WHOQOL-BREF (Table 2). Conclusion The impaired QOL of patients with ESRD undergoing HD was closely related to mortality. In particular, low QOL in physical health domain significantly increased mortality. Therefore, in order to improve the survival of HD patients, we should be considered about QOL as well as medical problems