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Al wakeel J, Bayoumi M, Al Ghonaim M, Al Harbi A, Al Swaida A, Mashraqy A.
End stage renal disease (ESRD) is a
progressive irreversible deterioration
in renal function in which the body’s
ability to maintain metabolic and fluid
electrolyte balance fails, resulting in
uremia.
The condition may be caused by systemic
diseases such as diabetes mellitus (leading cause),
hypertension, chronic glomerulonephritis,
pyelonephritis, obstruction of the urinary tract,
heredity lesions as in polycystic kidney disease,
vascular disorders, infections, medication, or toxic
agents.
Hemodialysis (HD) and peritoneal
dialysis (PD) are important renal
replacement therapy in end stage renal
disease (ESRD). It is worth noting that
ESRD is a disease with serious effects on
the patients' QoL, negatively affecting
their social, financial and psychological
well-being.
Regarding relevant research, renal
patients undergoing HD or CAPD/PD
treatment were found to experience
QoL deficits.
Patients' quality of life is determined
by their subjective interpretation of
their losses and gains in the process
of being ill.
Health related quality of life is a
multidimensional concept that includes
physical functioning, social and role
functioning, mental health, and general
health perceptions.
WHO has defined "QOL" as "individual’s perceptions of their position in life in the context of the culture and value systems where they live and in relation to their goals, expectations, standards and concerns”.
QoL decline over time, with the
perception of the quality of physical
health deteriorating more than mental
health, however many patients
continue to feel hopeless, anxious,
and worry about finances, loss of
sexual function, family burden, and
loss of independence.
Introduction
The reported annual incidence of end-stage renal disease in Saudi Arabia is 100 to 120 patients per million population (Shaheen & Souqiyyeh; 2004).
The recent statistics for The saudi organ transplant center the total number for patients with ESRD more than 9500 on HD and 900 on PD.
Assessment of quality of life is still a developing area of clinical research, with researchers continuing to refine the concept.
Recently, it has been recognized that patients’ quality of life and patient satisfaction with care are important domains that need to be understood better and addressed more fully.
Aim of the study
Compare The Quality Of Life Between Hemodialysis
And Peritoneal Dialysis Patients.
AIM of the STUDY
Subjects and Methods
RESEARCH DESIGNA cross-sectional descriptive design.
SETTINGking Khalid university hospital in dialysis unit, King Saud university, and security forces hospital in dialysis unit
SUBJECT :
All patient on hemodialysis and
peritoneal dialysis in the
aforementioned setting.
Their total number was 100 patients on
HD and 100 on PD.
Age above 18 years old, both sex.
Patients were excluded from the study
if they had neurological illness.
INSTRUMENT
An interview form was prepared and included two sections. The first was concerned with patient’s basic demographic data, as well as the main caregiver, and dialysis duration.The second section consisted of the Kidney Disease Quality of Life scale short form - KDQOL-SFTM-1.3 (Hays et al, 1994).
The KDQOL includes 36 items are categorized into six domains, namely: General health, Physical, Emotional, Social status, Illness impact, and Medical & Financial satisfaction. The scoring of the tool responses was done according to the guidelines of the KDQOL-SFTM (Hays et al,
1997). The scoring direction was done so that higher scores indicate better QoL.
<4040-
60+
Mal
e
Fem
ale
Singl
e
Mar
ried
no fo
rmal
edu
catio
n
basic/in
term
edia
tehi
gh
28
48
24
53
47
40
60
38
45
17 19
53
28
43
57
29
71
34
47
19
60 +40< -40Age
HDPD
Socio-demographic characteristics
JOB STATUS
HDPD
37
21
63
79
Working Unemployed
Caregiver
Parent Spouse Sibling Children Self Housekeeper
12
37
3
29
910
3
22
4
41
24
6
HD PD
12
42
46
15
70
15
PD HD
Duration of dialysis (months) in HD & PD patients
60 +12< -12
Quality of life % of HD & PD patients
Gen
eral
Hea
lth
phys
ical
Emot
iona
l
Social
Illne
ss Im
pact
Satis
fact
ion
Tota
l QoL
39,3
47.947
58.1
43.249.3
45.65
60
43.4
61.3
70.3
62.6565.3
62.6
PD HD
Quality of life of HD and PD patients in Median
Gen
eral
Hea
lth
physical
Emot
ional
Socia
l
Illnes
s Im
pact
Satisfa
ctio
n
Tota
l QoL
39.3
47.947
58.1
43.249.3
45.65
60
43.4
61.3
70.3
62.6565.3
62.6PD HD
UnstandardizedCoefficients Standardized
Coefficients
B Std. Error
Constant 56.668 4.474
Age -0.454 0.058 -0.435
Sex (reference: male) 4.341 1.586 0.152
Dialysis duration -0.041 0.014 -0.174
Dialysis type (reference: hemodialysis)
11.208 1.708 0.392R-square=0.40Model ANOVA: F=34.25, p<0.001Variables excluded by model: education, marital status, job status
Best fitting linear regression model for the scores of quality of life of hemodialysis and peritoneal dialysis patients
Conclusion Hemodialysis is a negative predictor of QoL score compared to peritoneal dialysis.A negative predictors effect of QoL score are age, sex, dialysis duration.Also male sex is a negative predictor, compared to female sex.Peritoneal dialysis patients more satisfied financial and with medical care compared to hemodialysis patients.
RECOMMENDATIONS
Patient QoL should be the main objective for doctors and nurses during care of dialysis patients.
Develop Educational program for dialysis patient to improve all aspects of quality of life.
A family member or significant other should attend the educational program sessions to help dialysis patients to cope.
A simple manual of guidelines of care for patients undergoing hemodialysis and peritoneal dialysis should be made available in all units and provided to newly admitted patients.
Design exercise program for both hemodialyis and peritoneal therapy to improve physical QoL.
Further research is suggested to assess the effect on the QoL of children and adolescents.
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