Nephrol Dial Transplant (2003) 18: 2622-2628
© 2003 European Renal Association-European Dialysis and Transplant Association
Original Article
A simple risk score predicts poor quality of life and non-survival at 1 year follow-up in dialysis patients
1Department of Psychiatry, University of Groningen, 2Department of Psychiatry and 3Department of Nephrology, VU Medical Center, Amsterdam, The Netherlands
Correspondence and offprint requests to: P. de Jonge, PhD, Department of Social Psychiatry, Disciplinegroep Psychiatrie, RijksUniversiteit Groningen, Hanzeplein 1 Gebouw 32, Postbus 30001, 9700 RB Groningen, The Netherlands. Email: p.de.jonge{at}med.rug.nl
Background. Quality of life (QoL) in end-stage renal disease patients has become an important focus of attention in evaluating dialysis. We studied risk factors of poor QoL at 1 year follow-up.
Methods. Of a baseline sample of 80 dialysis patients, we contacted 60 patients who were alive at 1 year follow-up. QoL data were obtained for 46 (76.7%) of these patients. QoL measured with the SF-36 [physical health component score (PCS) and mental health component score (MCS)] at 1 year-follow-up was predicted by means of multivariate regression analysis by data collected at baseline using INTERMED—an observer-rated method to assess biopsychosocial care needs—and several indicators for disease severity and comorbidity.
Results. The regression models explained 32% of the variance in PCS and 40% in MCS. INTERMED score (P < 0.01) was the only independent risk factor for low MCS, while for low PCS, diabetic comorbidity (P = 0.02) and age (P = 0.03) were independent risk factors. A simple risk score consisting of INTERMED 
21, diabetic comorbidity and age 65 was significantly correlated with non-survival (P = 0.02) and with PCS (P < 0.01) and MCS (P < 0.01) in surviving patients, although not with hospital admissions during follow-up.
Conclusions. A simple risk score based on INTERMED, age (65) and comorbid diabetes (yes/no) can be used to detect patients at risk of poor QoL and non-survival at an early stage of treatment.
Keywords: dialysis; end-stage renal disease; INTERMED; quality of life; SF-36
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