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Health-related quality of life of Asian patients with end-stage renal disease (ESRD) in Singapore

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Abstract

Background

This study aimed to identify factors associated with the health-related quality of life (HRQOL) of multiethnic Asian end-stage renal disease (ESRD) patients treated with dialysis. The role of dialysis modality was also explored.

Methods

Data used in this study were from two cross-sectional surveys of Singaporean ESRD patients on haemodialysis (HD) or peritoneal dialysis (PD). In both surveys, participants were assessed using the kidney disease quality of life (KDQOL) instrument and questions assessing socio-demographic characteristics. Clinical data including co-morbidity (measured by Charlson comorbidity index [CCI]), albumin level, haemoglobin level, and dialysis-related variables (e.g. dialysis vintage and dialysis adequacy) were retrieved from medical records. The 36-item KDQOL (KDQOL-36) was used to generate three summary scores (physical component summary [PCS], mental component summary [MCS] and kidney disease component summary [KDCS]) and two health utility scores (Short Form 6-dimension [SF-6D] and EuroQol 5-dimension [EQ-5D]). Linear regression analysis was performed to examine the association of factors with each of the HRQOL scale scores.

Results

Five hundred and two patients were included in the study (mean age 57.1 years; male 52.4 %; HD 236, PD 266). Mean [standard deviation (SD)] PCS, MCS and KDCS scores were 37.9 (9.7), 46.4 (10.8) and 57.6 (18.1), respectively. Mean (SD) health utility score was 0.66 (0.12) for SF-6D and 0.60 (0.21) for EQ-5D. In multivariate regression analysis, factors found to be significantly associated with better HRQOL included: young (<45 years) or old age (>60 years), low CCI (<5), high albumin (≥37 g/l) and high haemoglobin (≥11 g/dl) with PCS; long dialysis vintage (≥3.5 years) with MCS; old age, Malay ethnicity and PD modality with KDCS; low CCI, high albumin and high haemoglobin with EQ-5D and high albumin with SF-6D.

Conclusions

Clinical characteristics are better predictors of HRQOL in ESRD patients than socio-demographics in Singapore. Dialysis modality has no impact on the health utility of those patients.

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Abbreviations

HRQOL:

Health-related quality of life

ESRD:

End-stage renal disease

HD:

Haemodialysis

PD:

Peritoneal dialysis

SF-36:

36-Item short form health survey

SF-12:

12-Item short form health survey

EQ-5D:

EuroQol 5-dimension

QALY:

Quality-adjusted life year

KDQOL-SF:

Kidney disease quality of life short form questionnaire

KDQOL-36:

Kidney disease quality of life 36-item questionnaire

SF-6D:

Short Form 6-dimension

CCI:

Charlson comorbidity index

PCS:

Physical component summary

MCS:

Mental component summary

KDCS:

Kidney disease component summary

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Acknowledgements

This study was funded by the National University Health System (NUHS) Cross Department Collaborative Grant, NKF Research Fund [NKFRC2008/07/24] and Ministry of Education-NUS Academic Research Fund [FY2007-FRC5-006]. All are gratefully acknowledged. The authors wish to thank School of Health and Related Research, University of Sheffield, United Kingdom, for providing the scoring algorithm for the SF-6D, and Dr Tonia Griva, Ms Zhenli Yu, the renal health care teams and all study participants for their contributions.

Conflict of interest

None declared

Author information

Authors and Affiliations

  1. Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, Singapore, 117549, Singapore

    F. Yang, K. S. Chia & N. Luo

  2. Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore

    K. Griva & H. J. Ng

  3. Health Services Research, City University London, Northampton Square, London, EC1V0HB, UK

    K. Griva & S. P. Newman

  4. Division of Nephrology, University Medicine Cluster, National University Health System, Singapore, Singapore

    T. Lau, A. Vathsala & E. Lee

  5. National Kidney Foundation, Singapore, Singapore

    N. Mooppil

  6. Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore

    M. Foo

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  1. F. Yang
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  2. K. Griva
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  3. T. Lau
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  4. A. Vathsala
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  5. E. Lee
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  6. H. J. Ng
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  7. N. Mooppil
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  8. M. Foo
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  9. S. P. Newman
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  10. K. S. Chia
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  11. N. Luo
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Correspondence to N. Luo.

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Yang, F., Griva, K., Lau, T. et al. Health-related quality of life of Asian patients with end-stage renal disease (ESRD) in Singapore. Qual Life Res 24, 2163–2171 (2015). https://doi.org/10.1007/s11136-015-0964-0

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