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Differences in Health-Related Quality of Life and Treatment Preferences Among Black and White Patients with End-Stage Renal Disease

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Abstract

Background: Relatively little is known about racial differences in health-related quality of life (HRQL) among patients receiving dialysis for end-stage renal disease (ESRD) or how such differences may relate to preferences for renal transplantation. Methods: We surveyed 1392 patients, ages 18–54 approximately 10 months after they initiated dialysis in 4 regions of the United States. The HRQL measures analyzed were overall health, emotional health, physical activity, energy level, social activity, and effect of ESRD on daily life. We also examined whether the measures of HRQL were associated with patients' preferences for renal transplantation by race. Results: After adjustment for socioeconomic and clinical characteristics, Black women and men reported better overall health than White women and men, respectively. Black women reported higher energy levels than white women, and black men reported less negative effects of ESRD on daily life compared to white men. Black men with high levels of physical activity were less likely to be certain about preferring a transplant than white men with similar levels of physical activity. Conclusions: Black patients receiving dialysis reported better HRQL than white patients, even after controlling for potential confounders. Racial differences in preferences for renal transplantation among men may be associated with their levels of physical activity.

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References

  1. Young CJ, Gaston RS. African Americans and renal transplantation: Disproportionate need, limited access, and impaired outcomes. Am J Med Sci 2002; 323: 94-99.

    Google Scholar 

  2. Ayanian JZ, Cleary PD, Weissman JS, Epstein AM. The effect of patients' preferences on racial differences in access to renal transplantation. N Engl J Med 1999; 341: 1661-1669.

    Google Scholar 

  3. Epstein AM, Ayanian JZ, Keogh JH, et al. Racial disparities in access to renal transplantation-clinically appropriate or due to underuse or overuse? N Engl J Med 2000; 343: 1537-1544.

    Google Scholar 

  4. Ferraro KF. Are Black older adults health-pessimistic? J Health Cog Behav 1993; 34: 201-214.

    Google Scholar 

  5. Evans RW, Manninen DL, Garrison LP, et al. The quality of life of patients with end-stage renal disease. N Engl J Med 1985; 312: 553-559.

    Google Scholar 

  6. Fisher R, Gould D, Wainwright, S, Fallon M. Quality of life after renal transplantation. J Clin Nursing 1998; 7: 553-563.

    Google Scholar 

  7. U.S. Renal Data System. USRDS 1998 Annual Data Report. Bethesda, Maryland: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1998.

    Google Scholar 

  8. Bloembergen WE, Port FK, Mauger EA, Wolfe RA. Causes of death in dialysis patients: Racial and gender differences. J Am Soc Nephrol 1994; 5: 1231-1242.

    Google Scholar 

  9. Price DA, Owen WF. African-Americans on maintenance dialysis: A review of racial differences in incidence, treatment, and survival. Adv Renal Replace Ther 1997; 4: 3-12.

    Google Scholar 

  10. Mesler DE, McCarthy EP, Byrne-Logan S, et al. Does the survival advantage of non-White dialysis patients persist after case mix adjustment? Am J Med 1999; 106: 300-306.

    Google Scholar 

  11. Ren XA, Amick BC. Race and self assessed health status: The role of socioeconomic factors in the USA. J Epidemiol Comm Health 1996; 50: 269-273.

    Google Scholar 

  12. Straus WL, Eisen GM, Sandler RS, et al. Crohn's disease: Does race matter? The Mid-Atlantic Crohn's Disease Study Group. Am J Gastroenterol 2000; 95: 479-483.

    Google Scholar 

  13. Apter AJ, Reisine ST, Affleck G, et al. The influence of demographic and socioeconomic factors on health-related quality of life in asthma. J Allergy Clin Immunol 1999; 103: 72-78.

    Google Scholar 

  14. Breitbart W, McDonald MV, Rosenfeld B, et al. Pain in ambulatory AIDS patients. I: Pain characteristics and medical correlates. Pain 1996; 68: 315-321.

    Google Scholar 

  15. Weissman JS, Cleary PD, Seage GR, et al. The influence of health-related quality of life and social characteristics on hospital use by patients with AIDS in the Boston Health Study. Med Care 1996; 34: 1037-1056.

    Google Scholar 

  16. Kutner NG, Devins GM. A comparison of the quality of life reported by elderly Whites and elderly Blacks on dialysis. Geriatr Nephrol Urol 1998; 8: 77-83.

    Google Scholar 

  17. Kutner NG, Brogan D, Fielding B, Hall WD. Black/white differences in symptoms and health satisfaction reported by older hemodialysis patients. Ethn Dis 2000; 10: 328-333.

    Google Scholar 

  18. Hays RD, Kallich JD, Mapes DL, et al. Development of the Kidney Disease Quality of Life instrument. Qual Life Res 1994; 3: 329-338.

    Google Scholar 

  19. Moreno F, Sanz-Guajardo D, Lopez-Gomez JM, et al. Increasing the hematocrit has a beneficial effect on quality of life and is safe in selected dialysis patients. Spanish Cooperative Renal Patients Quality of Life Study Group of the Spanish Society of Nephrology. J Am Soc Nephrol 2000; 11: 335-342.

    Google Scholar 

  20. Hemmingway H, Nicholson A, Stafford M, et al. The impact of socioeconomic status on health functioning as assessed by the SF-36 questionnaire: The Whitehall II study. Am J Public Health 1997; 87: 1484-1490.

    Google Scholar 

  21. Ferrans CE, Powers MJ, Kasch CR. Satisfaction with health care of hemodialysis patients. Res Nurs Health 1987; 10: 367-374.

    Google Scholar 

  22. Harris DC, Chapman JR, Stewart JH, et al. Low dose erythropoietin in maintenance haemodialysis: Improvement in quality of life and reduction in true cost of haemodialysis. Aust NZ J Med 1991; 21: 693-700.

    Google Scholar 

  23. Parkerson GR, Gutman RA. Predictors of functional health status of end stage renal disease patients. Health Care Financ Rev 1997; 18: 37-49.

    Google Scholar 

  24. Bass EB, Jenckes MW, Fink NE, et al. Use of focus groups to identify concerns about dialysis. Choice Study. Med Dec Making 1999; 19: 287-295.

    Google Scholar 

  25. Ren XS, Amick BC. Racial and ethnic disparities in self-assessed health status: Evidence from the National Survey of Families and Households. Ethn Health 1996; 1: 293-303.

    Google Scholar 

  26. Bremer BA, McCauley CR, Wrona RM, Johnson JP. Quality of life in end-stage renal disease: A reexamination. Am J Kidney Dis 1989; 13: 200-209.

    Google Scholar 

  27. Christensen AJ, Holman Jr JM, Turner CW, et al. A prospective study of quality of life in end-stage renal disease: Effects of cadaveric renal transplantation. Clin Transplant 1992; 5: 40-47.

    Google Scholar 

  28. Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 1999; 341: 1725-1730.

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Division of General Internal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA

    LeRoi S. Hicks, Arnold M. Epstein & John Z. Ayanian

  2. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

    LeRoi S. Hicks, Paul D. Cleary & John Z. Ayanian

  3. Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA

    Arnold M. Epstein

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  1. LeRoi S. Hicks
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  2. Paul D. Cleary
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  3. Arnold M. Epstein
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  4. John Z. Ayanian
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Hicks, L.S., Cleary, P.D., Epstein, A.M. et al. Differences in Health-Related Quality of Life and Treatment Preferences Among Black and White Patients with End-Stage Renal Disease. Qual Life Res 13, 1129–1138 (2004). https://doi.org/10.1023/B:QURE.0000031350.56924.cc

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  • DOI: https://doi.org/10.1023/B:QURE.0000031350.56924.cc

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