Abstract
Background
Quality of Life (QoL) reflects the quality and outcome of healthcare along with key indicators of performance such as mortality and morbidity.
Objective
The aim of the study was to measure the QoL among patients with End Stage Renal Disease (ESRD) on maintenance hemodialysis and to understand various correlates of QoL.
Methods
A total of 95 ESRD patients from three dialysis centres in Southern districts of Kerala were interviewed. QoL was measured using vernacular version of World Health Organization Quality Of Life – Brief Version (WHOQOL-BREF) questionnaire.
Results
The mean age of the patients was 56.2 ± 13 years and 73.7% were males. Mean converted scores for overall QoL was 42.37 ± 21.3 and Health-related QoL (HRQoL) was 43.3 ± 18.3, indicating poor QoL. Males had significantly higher physical domain scores (p < 0.03). Occupation, income and Socio-economic Status (SES) influenced overall HRQoL while better income and higher SES predicted better scores in psychological and environmental domains.
Conclusion
Patients with better control over inter-dialysis weight gain (≤1600 g) had significantly higher scores. This study highlights the importance of using QoL tools in assessing the QoL of patients and the factors contributing to it.
Article PDF
Avoid common mistakes on your manuscript.
References
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39;S1–S266.
Srinath Reddy K, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet 2005;366;1744–9.
Lysaght MJ. Maintenance dialysis population dynamics: current trends and long-term implications. J Am Soc Nephrol 2002;13;S37–S40.
El Nahas M. The global challenge of chronic kidney disease. Kidney Int 2005;68;2918–29.
Barsoum RS. Chronic kidney disease in the developing world. N Engl J Med 2006;354;997–9.
Hemmelgarn BR, Manns BJ, Lloyd A, James MT, Klarenbach S, Quinn RR, et al. Relation between kidney function, proteinuria, and adverse outcomes. JAMA 2010;303;423–9.
Tonelli M, Wiebe N, Culleton B, House A, Rabbat C, Fok M, et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol 2006;17;2034–47.
Ritz E, Rychlík I, Locatelli F, Halimi S. End-stage renal failure in type 2 diabetes: a medical catastrophe of worldwide dimensions. Am J Kidney Dis 1999;34;795–808.
Huang ES, Basu A, O’Grady M, Capretta JC. Projecting the future diabetes population size and related costs for the U.S. Diabetes Care 2009;32;2225–9.
Thomas R, Kanso A, Sedor JR. Chronic kidney disease and its complications. Prim Care: Clinics in Office Practice 2008;35;329–44.
Ritz E, Bakris G. World Kidney Day: hypertension and chronic kidney disease. Lancet 2009;373;1157–8.
Zimmet P, Alberti KGMM, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414;782–7.
Atkins RC, Zimmet P. World Kidney Day 2010: diabetic kidney disease—act now or pay later. Am J Kidney Dis 2010;55;205–8.
Garg CC, Karan AK. Reducing out-of-pocket expenditures to reduce poverty: a disaggregated analysis at rural-urban and state level in India. Health Policy Plan 2009;24;116–28.
Government of India. Key Indicators of Social Consumption in India Health. NSS 71st Round Survey. January - June 2014. Ministry of Statistics and Programme Implementation. National Sample Survey Office; 2015.
Levey AS, Atkins R, Coresh J, Cohen EP, Collins AJ, Eckardt KU, et al. Chronic kidney disease as a global public health problem: approaches and initiatives-a position statement from Kidney Disease Improving Global Outcomes. Kidney Int 2007;72;247–59.
Joshi VD. Quality of life in end stage renal disease patients. World J Nephrol 2014;3;308–16.
Gururaj M. Kuppuswamy’s socio-economic status scale – a revision of income parameter for 2014. Int J Recent Trends Sci Technol 2014;11;1–2.
WHOQOL Group. Measuring quality of life: the development of the World Health Organization quality of life instrument (WHOQOL). Geneva: World Health Organization; 1993.
The WHOQOL Group. The development of the World Health Organisation quality of life assessment instrument (the WHOQOL) In: Orley J, Kukyen W, editors. Quality of life assessment: international perspectives. Berlin, Heidelberg: Springer-Verlag; 1994.
Menon B, Cherkil S, Aswathy S, Unnikrishnan AG, Rajani G. The process and challenges in the translation of World Health Organization Quality of Life (WHOQOL-BREF) to a regional language; Malayalam. Indian J Psychol Med 2012;34;149–52.
Cabrera C, Brunelli SM, Rosenbaum D, Anum E, Ramakrishnan K, Jensen DE, et al. A retrospective, longitudinal study estimating the association between interdialytic weight gain and cardiovascular events and death in hemodialysis patients. BMC Nephrol 2015;16;113.
Flythe JE, Curhan GC, Brunelli SM. Disentangling the ultrafiltration rate-mortality association: the respective roles of session length and weight gain. Clin J Am Soc Nephrol 2013;8;1151–61.
Lauritsen JM, Bruus M. EpiData (version 3.1). A comprehensive tool for validated entry and documentation of data. Odense, Denmark: The EpiData Association; 2004. Available from: https://www.epidata.dk
R Core Team. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2016. Available from: https://www.R-project.org/
Luyckx VA, Tonelli M, Stanifer JW. The global burden of kidney disease and the sustainable development goals. Bull World Health Organ 2018;96;414–422D.
Varma PP. Prevalence of chronic kidney disease in India-Where are we heading? Indian J Nephrol 2015;25;133–5.
Alani H, Tamimi A, Tamimi N. Cardiovascular co-morbidity in chronic kidney disease: current knowledge and future research needs. World J Nephrol 2014;3;156–68.
Eknoyan G, Lameire N, Barsoum R, Eckardt KU, Levin A, Levin N, et al. The burden of kidney disease: improving global outcomes. Kidney Int 2004;66;1310–14.
International Diabetes Federation. IDF diabetes atlas, 5th ed. Brussels, Belgium: International Diabetes Federation; 2011.
Agarwal SK, Dash SC, Irshad M, Raju S, Singh R, Pandey RM. Prevalence of chronic renal failure in adults in Delhi, India. Nephrol Dial Transplant 2006;20;1638–42.
Ledebo I, Ronco C. The best dialysis therapy? Results from an international survey among nephrology professionals. NDT Plus 2008;1;403–8.
Abra G, Kurella Tamura M. Timing of initiation of dialysis: time for a new direction? Curr Opin Nephrol Hypertens 2012;21;329–33.
Prasad N, Jha V. Hemodialysis in Asia. Kidney Dis (Basel) 2015;1;165–77.
Beerappa H, Chandrababu R. Adherence to dietary and fluid restrictions among patients undergoing hemodialysis: an observational study. Clin Epidemiol Glob Health 2019;7;127–30.
Joshi VD. Quality of life in end stage renal disease patients. World J Nephrol 2014;3;308–16.
Wan EYF, Chen JY, Choi EPH, Wong CKH, Chan AKC, Chan KHY, et al. Patterns of health-related quality of life and associated factors in Chinese patients undergoing hemodialysis. Health Qual Life Outcomes 2015;13;108.
Khanna U. The economics of dialysis in India. Indian J Nephrol 2009;19;1–4.
Li PK, Chow KM. The cost barrier to peritoneal dialysis in the developing world—an Asian perspective. Perit Dial Int 2001;21;S307–S13.
Suja A, Anju R, Anju V, Neethu J, Peeyush P, Saraswathy R. Economic evaluation of end stage renal disease patients undergoing hemodialysis. J Pharm Bioallied Sci 2012;4;107–11.
Kaur G, Prinja S, Ramachandran R, Malhotra P, Gupta KL, Jha V. Cost of hemodialysis in a public sector tertiary hospital of India. Clin Kidney J 2018;11;726–33.
Kaufman SE. The increasing importance of quality of life research. Clin Res 2001;1;18–22.
Edgell ET, Coons SJ, Carter WB, Kallich JD, Mapes D, Damush TM, et al. A review of Health-Related quality-of-life measures used in end stage renal disease. Clin Ther 1996;18;887–938.
Fox E, Peace K, Neale TJ, Morrison RB, Hatfield PJ, Mellsop G. “Quality of Life” for patients with end-stage renal failure. Ren Fail 1991;13;31–5.
Lin CC, Lee BO, Hicks FD. The phenomenology of deciding about hemodialysis among Taiwanese. West J Nurs Res 2005;27;915–29; discussion 930–4.
Blake C, Codd MB, Cassidy A, O’Meara YM. Physical function, employment and quality of life in end-stage renal disease. J Nephrol 2000;13;142–9.
Drüeke TB, Eckardt KU. Role of secondary hyperparathyroidism in erythropoietin resistance of chronic renal failure patients. Nephrol Dial Transplant 2002;17;28–31.
London GM, Pannier B, Guerin AP, Blacher J, Marchais SJ, Darne B, et al. Alterations of left ventricular hypertrophy in and survival of patients receiving hemodialysis: follow-up of an interventional study. J Am Soc Nephrol 2001;12;2759–67.
Lok P. Stressors, coping mechanisms and quality of life among dialysis patients in Australia. J Adv Nurs 1996;23;873–81.
Mok E, Tam B. Stressors and coping methods among chronic haemodialysis patients in Hong Kong. J Clin Nurs 2001;10;503–11.
Welch JL, Austin JK. Stressors, coping and depression in haemodialysis patients. J Adv Nurs 2001;33;200–7.
Kimmel PL, Emont SL, Newmann JM, Danko H, Moss AH. ESRD patient quality of life: symptoms, spiritual beliefs, psychosocial factors, and ethnicity. Am J Kidney Dis 2003;42;713–21.
Valderrábano F, Jofre R, López-Gómez JM. Quality of life in end-stage renal disease patients. Am J Kidney Dis 2001;38;443–64.
Merkus M P, Jager KJ, Dekker FW, de Haan RJ, Boeschoten EW, Krediet RT. Physical symptoms and quality of life in patients on chronic dialysis: results of the Netherlands cooperative study on adequacy of dialysis (NECOSAD). Nephrol Dial Transplant 1999;14;1163–70.
Author information
Authors and Affiliations
Corresponding author
Additional information
Data availability statement: The authors confirm that the data supporting the findings of this study are available within the article.
Rights and permissions
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
About this article
Cite this article
Visweswaran, K., Shaffi, M., Mathew, P. et al. Quality of Life of End Stage Renal Disease Patients Undergoing Dialysis in Southern Part of Kerala, India: Financial Stability and Inter-dialysis Weight Gain as Key Determinants. J Epidemiol Glob Health 10, 344–350 (2020). https://doi.org/10.2991/jegh.k.200716.001
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.2991/jegh.k.200716.001