Elsevier

Value in Health

Volume 11, Issue 4, July–August 2008, Pages 733-741
Value in Health

Preference-Based Quality of Life of Patients on Renal Replacement Therapy: A Systematic Review and Meta-Analysis

https://doi.org/10.1111/j.1524-4733.2007.00308.xGet rights and content
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Abstract

Objectives

Various utility measures have been used to assess preference-based quality of life of patients with end-stage renal disease (ESRD). The purposes of this study were to summarize the literature on utilities of hemodialysis (HD), peritoneal dialysis (PD), and renal transplantation (RTx) patients, to compare utilities between these patient groups, and to obtain estimates for quality-of-life adjustment in economic analyses.

Methods

We searched the English literature for studies that reported visual analog scale (VAS), time trade-off (TTO), standard gamble (SG), EuroQol-5D (EQ-5D), and health utilities index (HUI) values of ESRD patients. We extracted patient characteristics and utilities and calculated mean utilities and 95% confidence intervals (CIs) for categories defined by utility measure and treatment modality using random-effects models.

Results

We identified 27 articles that met the inclusion criteria. VAS articles were too heterogeneous to summarize quantitatively and we found only one study reporting HUI values. Thus, we summarized utilities from TTO, SG, and EQ-5D studies. Mean TTO and EQ-5D-index values were lower for dialysis compared to RTx patients, though not statistically significant for TTO values (TTO values: HD 0.61, 95% CI 0.54–0.68; PD 0.73, 95% CI 0.61–0.85; RTx 0.78, 95% CI 0.63–0.93; EQ-5D-index values: HD 0.56, 95% CI 0.49–0.62; PD 0.58, 95% CI 0.50–0.67; RTx 0.81, 95% CI 0.72–0.90). Mean HD versus PD associated TTO, EQ-5D-index and EQ-VAS values were not statistically significantly different.

Conclusion

RTx patients tended to have a higher utility than dialysis patients. Among HD and PD patients, there were no statistically significant differences in utility.

Keywords

hemodialysis
meta-analysis
peritoneal dialysis
quality of life
renal transplantation

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