Modality transition on renal replacement therapy and quality of life of patients: a 10-year follow-up cohort study
Despite advance in renal replacement therapy (RRT), patients with chronic end-stage renal disease (ESRD) face various limitations, and renal transplantation (Tx) is the treatment that impacts most on quality of life (QoL). This study aimed to assess changes in QoL in a cohort of ESRD dialysis patients.
Sociodemographic, clinical, nutritional, lifestyle, and QoL data were collected from 712 patients at baseline (time 1) and after 10 years of follow-up (time 2) for patients surviving. The QoL was assessed through the 36-Item Short Form Health Survey (SF-36) and the multiple linear regression model was used to analyze the factors associated with change in QoL.
A total of 205 survivors were assessed and distributed into three groups according to current RRT (Dialysis–Dialysis, Dialysis–Tx, and Dialysis–Tx–Dialysis). At time 1, only age was significantly different among groups; at time 2, transplant patients sustained greater social participation, job retention, and improvement in SF-36 scores. The factors associated with change in QoL were more time on dialysis interfering negatively on physical functioning (p = 0.002), role-physical limitations (p = 0.002), general health (p = 0.007), social functioning (p = 0.02), role-emotional (p = 0.003), and physical components ( p = 0.002); non-participation in social groups at times 1 and 2 reducing vitality (p = 0.02) scores; and having work at time 2, increasing vitality (p = 0.02) and mental health (p = 0.02) scores.
QoL was shown to be dynamic throughout the years of RRT, transplantation being the treatment with more benefits to the ESRD. More time on dialysis and limited social and occupational routine were associated with a reduction in QoL.
KeywordsQuality of life End-stage renal disease Chronic kidney disease Renal replacement therapy
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.
Study conception and design: DCSB, MLC, ELM, IAR; data collection: DCSB, ELM, DPM, THMN, MLC; data analysis and interpretation: DCSB, ELM, DPM, THMN, MLC; statistical analysis: DCSB, ELM, IAR, DPM, MLC; supervision or mentoring: ELM, 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.
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: 307054/2014-4, 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-PPM-00716-15).
Compliance with ethical standards
Conflict of interest
DCSB, ELM, IAR, DPM, THMN, MLC declares that she has no conflict of interest. All authors have no other relevant financial interests to declare.
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 397/2006 and 59817316.7.0000.5149/2016) 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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