Journal
HEMODIALYSIS INTERNATIONAL
Volume 21, Issue 3, Pages 409-421Publisher
WILEY
DOI: 10.1111/hdi.12505
Keywords
Quality of life; residual renal function; glomerular filtration rate; Kidney Disease Quality of Life Short Form; hemodialysis
Categories
Funding
- Danish Council for Independent Research/Medical Sciences
- Aase og Ejnar Danielsens Fond
- Beckett-Fonden
- Civilingenior Frode Nygaard og Hustrus Fond
- Danish Society of Hypertension
- Danish Society of Nephrology
- Direktor Kurt Bonnelycke & Hustru Grethe Bonnelyckes Fond
- Fabrikant Karl G. Andersens Fond
- Fausbolls Helsefond
- Fonden til udvikling og uddannelse ved Nyremedicinsk Afdeling ved Aarhus Universitetshospital
- Fresenius Medical Care Denmark
- Frimodt-Heineke Fonden
- Helen & Ejnar Bjornows Fond
- Institute of Clinical Medicine at Aarhus University
- Kirsten Anthonius' Fond
- Nyreforeningens Forskningsfond
- Overlage Poul M Christiansen Hustrus Fond
- Region Midtjyllands Sundhedsvidenskabelige Forskningsfond
- Snedkermester Sophus Jacobsen & Hustru Astrid Jacobsens Fond
- Sanofi Denmark
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Introduction: Health related quality of life (HRQOL) is markedly reduced in hemodialysis patients compared to the general population. We investigated the course of self-reported HRQOL over time and the association with selected factors, focusing on changes in glomerular filtration rate (GFR). Methods: Eighty-two newly started hemodialysis patients from the SAFIR cohort filled out the Kidney Disease Quality of Life Short Form Version 1.3 (KDQOL-SFTM) questionnaire at baseline, 6 and 12 months. The SAFIR study was a randomized, placebo-controlled, double-blind intervention study, examining the effects of the angiotensin II receptor blocker irbesartan. HRQOL was a secondary outcome measure. Main inclusion criteria: Dialysis vintage <1 year, left ventricular ejection fraction >30% and urinary output >300 mL/day. GFR was measured with mean creatinine and urea clearance from 24-hour urine collections at baseline, 6 and 12 months. Findings: Irbesartan treatment did not affect HRQOL. Patients were pooled into one group for further analyses. Decline in GFR correlated significantly with decreasing HRQOL over time. HRQOL was stable over time, with a slight nonsignificant tendency toward improved HRQOL. The largest HRQOL-differences (positive values equal improved HRQOL) observed during the 12 month study period were (mean[95% confidence interval]): Burden of kidney disease:6.4[-2.2;15.0], Role limitations-physical:12.7[-2.1;27.5], and Role limitations-emotional:9.7[-5.2;24.6]. Comorbidity, especially diabetes, hospital admissions, female gender, and age were strongly associated with lower HRQOL in cross sectional analysis. Discussion: Preservation of residual renal function seems to be important for HRQOL. In newly started HD patients, HRQOL showed little change after 12 months. HRQOL was negatively affected by comorbidity, especially diabetes, hospital admissions, female gender, and age.
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