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Health-related quality of life associated with risk of death in Brazilian dialysis patients: an eight-year cohort

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Abstract

Purpose

Despite the advancements in renal replacement therapy, patients with end-stage renal disease face several limitations, with significant impacts on health-related quality of life (HRQoL) and mortality. This study aims to examine associations between quality of life and risk of death in Brazilian patients who underwent dialysis therapy between 2007 and 2015.

Methods

Observational, prospective, non-concurrent cohort study of patients who underwent dialysis therapy at the Brazilian Public Health System (SUS) and were followed up for 8 years. Semi-structured questionnaires interrogating socioeconomic and demographic characteristics, as well as HRQoL measures (36 Item Short-Form Health Survey, SF-36), were employed. The Cox proportional risk model was used to investigate associations between HRQoL and risk of death.

Results

Our sample comprised 1162 patients; of these, 884 were on hemodialysis (HD) and 278 on peritoneal dialysis (PD). Among the HD patients, death was associated with the physical (HR: 0.993; 95% CI: 0.989–0.997) and physical summary component (HR: 0.994; 95% CI: 0.989–0.999) domains of HRQoL. Regarding the PD patients, death was associated with the bodily pain (HR: 0.994; 95% CI: 0.990–0.998), mental health (HR: 0.094; 95% CI: 0.990–0.998), emotional problems (HR: 0.993; 95% CI: 0.987–0.998), social functioning (HR: 1.012; 95% CI: 1.002–1.023), physical problems (HR: 0.992; 95% CI: 0.986–0.998) and mental summary component (HR: 0.989; 95% CI: 0.981–0.997) domains of HRQoL.

Conclusions

Our data suggest that early and timely intervention measures aiming to enhance the HRQoL of dialysis patients are an essential component of professional practice and may contribute to improving the management of factors associated with dialysis patients' mortality.

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Acknowledgements

MLC was funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council of Technological and Scientific Development), Brazil, and Fundação de Amparo à Pesquisa do Estado de Minas Gerais (The Minas Gerais State Research Foundation), Brazil.

Funding

This study was funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq [National Council of Technological and Scientific Development], Brazil (http://www.cnpq. br/web/guest/geral), Grant Number: 306030/2018-7, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (Capes)-Finance code 001 and Fundação de Amparo à Pesquisa do Estado de Minas Gerais-FAPEMIG (The Minas Gerais State Research Foundation), Brazil (http://www.fapemig.br/); grant number: (CDS-CDS–PPM-00369–17).

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Authors and Affiliations

  1. Group in Economics and Health, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil

    Mariana Araújo Pena Bastos, Ilka Afonso Reis & Mariângela Leal Cherchiglia

  2. Department of Preventive and Social Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil

    Mariângela Leal Cherchiglia

  3. Department of Statistics, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil

    Ilka Afonso Reis

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  1. Mariana Araújo Pena Bastos
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  3. Mariângela Leal Cherchiglia
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Contributions

Study conception and design: MAPB, MLC, IAR; data analysis and interpretation: MAPB, IAR, MLC; statistical analysis: MAPB, IAR, MLC; supervision or mentoring: IAR, MLC. All authors contributed significant intellectual content during the preparation and revision of this manuscript and take full responsibility for the overall work, ensuring proper investigation and clarification of issues regarding the accuracy or integrity of any part of this work.

Corresponding authors

Correspondence to Mariana Araújo Pena Bastos or Mariângela Leal Cherchiglia.

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Conflict of interest

MAPB declares that she has no conflict of interest; IAR declares that she has no conflict of interest; MLC declares that she has no conflict of interest. All authors have no other relevant financial or non-financial interests to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board (IRB) at the Federal University of Minas Gerais (UFMG) approved the study (decision 397/2004, CAAE 44121315.2.0000.5149), and informed consent was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.

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Bastos, M.A.P., Reis, I.A. & Cherchiglia, M.L. Health-related quality of life associated with risk of death in Brazilian dialysis patients: an eight-year cohort. Qual Life Res 30, 1595–1604 (2021). https://doi.org/10.1007/s11136-020-02734-9

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