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Health-related quality of life among haemodialysis patients--relationship with clinical indicators, morbidity and mortality.
J Clin Nurs. 2006 Apr; 15(4):498-504.JC

Abstract

AIM

To verify the association between quality of life and morbidity, mortality and clinical indicators in haemodialysis patients.

BACKGROUND

While a number of therapies have been reported to increase quality of life in end-stage renal disease, patients report that they remain substantially burdened by limited physical functioning and by dialysis-related symptoms. Indeed, quality of life may be the most critical outcome for those undergoing haemodialysis. Furthermore, quality of life has been associated with clinical indicators, morbidity and survival in haemodialysis patients.

DESIGN

Descriptive cohort study of patients undergoing haemodialysis at the Nephrology Hemodialysis Unit of the Hospital de Clínicas in Porto Alegre, Brazil.

METHODS

Forty haemodialysis patients were followed for 12 months and evaluated for demographics, time on dialysis, diabetes mellitus, clinical indicators (dose of dialysis--Kt/V, haematocrit and serum albumin) and comorbidities. The comorbidities were evaluated with the end-stage renal disease severity index and health-related quality of life with The Medical Outcomes Study 36 (SF-36).

RESULTS

Men present higher health-related quality of life scores in the energy and fatigue component (P = 0.04). Patients treated for over one year at the beginning of follow up and patients with less schooling had better results in General Health Perception (P < 0.05). The health-related quality of life evaluation of patients who later died showed that they already had a worse perception of physical functioning as compared to the survivors (P = 0.05). Patients with diagnosed diabetes perceived their physical functioning more negatively compared with those with other etiologies of end-stage renal disease (P = 0.045). We found a correlation between physical functioning and serum albumin (r = 0.341, P < 0.05) and between physical functioning and haematocrit (r = 0.317, P < 0.05). The end-stage renal disease severity index was more strongly related to physical functioning (r = -0.538, P < 0.001). Comparing the patients' results to the indicators above and below the established targets, we observed a trend to worse health-related quality of life in patients with Kt/V above target. However, in the case of albumin, patients with results above target tended to have better results.

CONCLUSION

A close relationship was observed between quality of life and morbidity and mortality. Among the clinical indicators, albumin and haematocrit have the greatest influence on quality of life.

RELEVANCE TO CLINICAL PRACTICE

Haemodialysis patients experience various problems that may adversely influence their quality of life. Special care must be given to those who have diabetes mellitus, high morbidity scores, low serum albumin and low haematocrits.

Authors+Show Affiliations

Morsch CM
Hemodialysis Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. cmfm2@terra.com.br
Gonçalves LF
No affiliation info available
Barros E
No affiliation info available

MeSH

BrazilComorbidityCross-Sectional StudiesFemaleHealth StatusHumansKidney Failure, ChronicMaleMiddle AgedQuality of LifeRenal DialysisSeverity of Illness IndexSocioeconomic Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16553764

Citation

Morsch, Cássia Maria, et al. "Health-related Quality of Life Among Haemodialysis Patients--relationship With Clinical Indicators, Morbidity and Mortality." Journal of Clinical Nursing, vol. 15, no. 4, 2006, pp. 498-504.
Morsch CM, Gonçalves LF, Barros E. Health-related quality of life among haemodialysis patients--relationship with clinical indicators, morbidity and mortality. J Clin Nurs. 2006;15(4):498-504.
Morsch, C. M., Gonçalves, L. F., & Barros, E. (2006). Health-related quality of life among haemodialysis patients--relationship with clinical indicators, morbidity and mortality. Journal of Clinical Nursing, 15(4), 498-504.
Morsch CM, Gonçalves LF, Barros E. Health-related Quality of Life Among Haemodialysis Patients--relationship With Clinical Indicators, Morbidity and Mortality. J Clin Nurs. 2006;15(4):498-504. PubMed PMID: 16553764.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health-related quality of life among haemodialysis patients--relationship with clinical indicators, morbidity and mortality. AU - Morsch,Cássia Maria, AU - Gonçalves,Luiz Felipe, AU - Barros,Elvino, PY - 2006/3/24/pubmed PY - 2006/5/12/medline PY - 2006/3/24/entrez SP - 498 EP - 504 JF - Journal of clinical nursing JO - J Clin Nurs VL - 15 IS - 4 N2 - AIM: To verify the association between quality of life and morbidity, mortality and clinical indicators in haemodialysis patients. BACKGROUND: While a number of therapies have been reported to increase quality of life in end-stage renal disease, patients report that they remain substantially burdened by limited physical functioning and by dialysis-related symptoms. Indeed, quality of life may be the most critical outcome for those undergoing haemodialysis. Furthermore, quality of life has been associated with clinical indicators, morbidity and survival in haemodialysis patients. DESIGN: Descriptive cohort study of patients undergoing haemodialysis at the Nephrology Hemodialysis Unit of the Hospital de Clínicas in Porto Alegre, Brazil. METHODS: Forty haemodialysis patients were followed for 12 months and evaluated for demographics, time on dialysis, diabetes mellitus, clinical indicators (dose of dialysis--Kt/V, haematocrit and serum albumin) and comorbidities. The comorbidities were evaluated with the end-stage renal disease severity index and health-related quality of life with The Medical Outcomes Study 36 (SF-36). RESULTS: Men present higher health-related quality of life scores in the energy and fatigue component (P = 0.04). Patients treated for over one year at the beginning of follow up and patients with less schooling had better results in General Health Perception (P < 0.05). The health-related quality of life evaluation of patients who later died showed that they already had a worse perception of physical functioning as compared to the survivors (P = 0.05). Patients with diagnosed diabetes perceived their physical functioning more negatively compared with those with other etiologies of end-stage renal disease (P = 0.045). We found a correlation between physical functioning and serum albumin (r = 0.341, P < 0.05) and between physical functioning and haematocrit (r = 0.317, P < 0.05). The end-stage renal disease severity index was more strongly related to physical functioning (r = -0.538, P < 0.001). Comparing the patients' results to the indicators above and below the established targets, we observed a trend to worse health-related quality of life in patients with Kt/V above target. However, in the case of albumin, patients with results above target tended to have better results. CONCLUSION: A close relationship was observed between quality of life and morbidity and mortality. Among the clinical indicators, albumin and haematocrit have the greatest influence on quality of life. RELEVANCE TO CLINICAL PRACTICE: Haemodialysis patients experience various problems that may adversely influence their quality of life. Special care must be given to those who have diabetes mellitus, high morbidity scores, low serum albumin and low haematocrits. SN - 0962-1067 UR - https://www.unboundmedicine.com/medline/citation/16553764/Health_related_quality_of_life_among_haemodialysis_patients__relationship_with_clinical_indicators_morbidity_and_mortality_ DB - PRIME DP - Unbound Medicine ER -