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Quality of life and emotional distress between patients on peritoneal dialysis versus community-based hemodialysis

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Abstract

Purpose

Patient-reported outcomes are important endpoints to evaluate new models of renal delivery. This is the first study to compare Quality of Life (QOL) and emotional adjustment outcomes between patients on community-based hemodialysis (HD) and those on peritoneal dialysis (PD).

Methods

Data were collected between 2009 and 2011 from a cross-sectional sample of 232 HD patients and 201 PD patients recruited through community dialysis centers and outpatient PD clinics in Singapore. Participants completed the Hospital Anxiety and Depression Scale, World Health Organization Quality of Life Brief and the Short form for the Kidney Disease Quality of Life. Measures of ESRD severity, comorbidity and biochemistry were also collected.

Results

Physical and emotional QOL impairments were noted for both dialysis groups. Case-mix-adjusted comparisons indicated higher symptoms of depression (p = 0.027), and poorer physical health yet higher satisfaction with care (p = 0.001) in PD relative to community-based HD.

Conclusions

Peritoneal dialysis regimes offer flexibility and autonomy under the support of PD teams. Although outcomes for most QOL domains measured were equivalent, PD patients are more satisfied with care but are at risk for emotional distress and provide poor ratings of physical health. Further research is needed to explore the expansion of standards of care to address psychosocial needs in PD populations.

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Abbreviations

APD:

Automated peritoneal dialysis

CAPD:

Continuous ambulatory peritoneal dialysis

HD:

Hemodialysis

ESRD:

End stage renal disease

NKF:

National kidney foundation

PD:

Peritoneal dialysis

QOL:

Quality of life

RCT:

Randomized clinical trial

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Acknowledgments

This research was supported by Grants from NKF Research Fund [NKFRC2008/07/24] and Ministry of Education—NUS Academic Research Fund (start up) [FY2007-FRC5-006] to KG, both of which are gratefully acknowledged. The authors also thank Dr Tonia Griva, the Renal Health Care Professionals and patients for their support in this study.

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Authors and Affiliations

  1. Department of Psychology, National University of Singapore, 9 Arts Link AS402/28, Singapore, 117570, Singapore

    K. Griva, A. W. Kang & Z. L. Yu

  2. National Kidney Foundation, Kim Keat Road, Singapore, Singapore

    N. K. Mooppil

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

    M Foo & Choong Meng Chan

  4. Health Services Research Group, City University, College Building Room A224 St John Street, London, UK

    K. Griva & S. P. Newman

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  1. K. Griva
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  2. A. W. Kang
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  3. Z. L. Yu
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  4. N. K. Mooppil
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  5. M Foo
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  6. Choong Meng Chan
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  7. S. P. Newman
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Correspondence to K. Griva.

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Griva, K., Kang, A.W., Yu, Z.L. et al. Quality of life and emotional distress between patients on peritoneal dialysis versus community-based hemodialysis. Qual Life Res 23, 57–66 (2014). https://doi.org/10.1007/s11136-013-0431-8

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