Abstract
BackgroundHaemodialysis (HD) is a life-saving but burdensome therapy for patients with end-stage renal disease (ESRD) which can have a detrimental impact on patients’ quality of life and outcomes. There is currently little data on the health related quality of life (HRQOL) of Chinese ESRD patients undergoing HD and this study sought to examine the patterns of HRQOL and its associated factors within this population, as well as in comparison with the general local population.MethodsA cross-sectional study of 244 ESRD patients receiving HD in the hospital and in the community in Hong Kong was conducted using the Short Form-12 Health Survey version 2 (SF-12v2). All study subjects were one-to-one matched with subjects in a Hong Kong general population database by sex and exact age. Independent t-tests were performed to compare the mean SF-12v2 scores between HD patients and the general population, followed by one-way analysis of variance with post hoc Tukey’s HSD tests to compare community-based haemodialysis, hospital-based haemodialysis and the general population. Multiple linear regressions were used to identify the factors (socio-demographic, clinical characteristics and comorbidities) associated with the HRQOL scores of ESRD patients receiving HD.ResultsThe SF-12v2 Physical Functioning, Role Physical, Bodily Pain, General Health and Physical Component Summary scores of HD patients were significantly lower than the age-sex adjusted general population. However, the SF-12v2 Mental Health and Mental Component Summary scores of HD patients were significantly higher than the corresponding general population. Poorer HRQOL was associated with being female, smoking, unemployment and hospital-based haemodialysis.ConclusionsHD patients had substantially poorer physical HRQOL but better mental HRQOL than the age-sex adjusted general population. Patients receiving HD in the community setting had better HRQOL. Reasons for these observations will need to be further investigated. Those patients who are female, smokers and unemployed may warrant more attention as their poorer HRQOL may be associated with poorer outcomes.
Highlights
Haemodialysis (HD) is a life-saving but burdensome therapy for patients with end-stage renal disease (ESRD) which can have a detrimental impact on patients’ quality of life and outcomes
In order to compare the health related quality of life (HRQOL) of our study subjects against the Hong Kong general population, we identified a matching subject from the Hong Kong population study dataset for each subject in our study
There was no significant difference between the two groups in dialysis adequacy (Kt/V) or hemoglobin level, two conventional clinical outcome measures
Summary
Haemodialysis (HD) is a life-saving but burdensome therapy for patients with end-stage renal disease (ESRD) which can have a detrimental impact on patients’ quality of life and outcomes. CKD is a significant problem in Asia [2] with a prevalence of 11.9 % in Taiwan [3] and 10.8 % in Mainland China [4] This is due to the increasing prevalence of key causes of CKD, hypertension and diabetes mellitus, which in turn increase the health burden attributable to CKD in the future [5]. Due to the progressive nature of CKD, many patients with CKD are likely to deteriorate to end-stage renal disease (ESRD) and eventually require some form of renal replacement therapy such as renal transplant, haemodialysis (HD) or peritoneal dialysis (PD). In Asia, over 90 % of dialysis patients were on HD in China and Taiwan in 2005-2006 [6, 7] which contrasts sharply with the situation in Hong Kong where PD is designated as first-line therapy according to government policy. Of the HD patients, over 60 % were treated in government-funded hospital-based renal units [10]
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