Nephrology Dialysis Transplantation, Vol 14, Issue 5 1163-1170, Copyright © 1999 by Oxford University Press
M Merkus, K Jager, F Dekker, R de Haan, E Boeschoten and R Krediet
Background. So far, little attention has been paid to
the value of dialysis adequacy for patients' quality of life (QL).
Therefore we studied the impact of demographic, Clinical, and dialysis
characteristics on physical symptoms and perceived QL. Methods.
The study population consisted of 120 incident chronic
haemodialysis (HD) and 106 peritoneal dialysis (PD) patients, starting
dialysis treatment in 13 Dutch centres. Data were collected 3 months after
the start of dialysis. Nine physical symptoms were assessed with a
self-administered questionnaire. Patient's self-assessment of QL was
measured with the 36-item MOS Short Form (SF-36™).
Results. The most common symptoms in HD and PD were
fatigue (respectively 82 and 87%) and itching (73 and 68%). In HD only a
medium to high comorbidity - age risk index was associated with greater
symptom burden. In PD also a lower percentage lean body mass, a lower rGFR,
and past episodes of underhydration were associated with greater symptom
burden. The explained variance by these variables was only 12% in HD and
21% in PD. However, greater symptom burden explained a substantial
additional amount of impaired physical and mental QL on top of demographics
and clinical status. Dialysis variables were associated neither with
symptoms nor with QL. Conclusion. Symptom burden can
be explained to a limited extent by demographic and clinical variables and
not by dialysis characteristics. Addition of symptom burden to the other
variables makes it possible to explain one-third of perceived QL. This
underlines the importance of symptom reduction in order to improve
patient's QL. Keywords: dialysis adequacy; end-stage
renal disease; haemodialysis; peritoneal dialysis; quality of life;
symptoms
ORIGINAL ARTICLES
Physical symptoms and quality of life in patients on chronic dialysis: results of The Netherlands cooperative study on adequacy of dialysis (NECOSAD)
Departments of Clinical Epidemiology and Biostatistics, and Nephrology, Academic Medical Center, PO Box 22700, 1100 DE Amsterdam, The Netherlands; Corresponding author
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