Health-related quality of life associated with risk of death in Brazilian dialysis patients: an eight-year cohort

• Published in: Quality of life research 2021-06, Vol.30 (6), p.1595-1604
• Main Authors: Bastos, Mariana Araújo Pena, Reis, Ilka Afonso, Cherchiglia, Mariângela Leal
• Format: Article
• Language: English
• Subjects: Hemodialysis; Medicine; Medicine & Public Health; Mortality; Peritoneal dialysis; Public Health; Quality of life; Quality of Life Research; Sociology
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-020-02734-9

Purpose Despite the advancements in renal replacement therapy, patients with end-stage renal disease face several limitations, with significant impacts on health-related quality of life (HRQoL) and mortality. This study aims to examine associations between quality of life and risk of death in Brazilian patients who underwent dialysis therapy between 2007 and 2015. Methods Observational, prospective, non-concurrent cohort study of patients who underwent dialysis therapy at the Brazilian Public Health System (SUS) and were followed up for 8 years. Semi-structured questionnaires interrogating socioeconomic and demographic characteristics, as well as HRQoL measures (36 Item Short-Form Health Survey, SF-36), were employed. The Cox proportional risk model was used to investigate associations between HRQoL and risk of death. Results Our sample comprised 1162 patients; of these, 884 were on hemodialysis (HD) and 278 on peritoneal dialysis (PD). Among the HD patients, death was associated with the physical (HR: 0.993; 95% CI: 0.989–0.997) and physical summary component (HR: 0.994; 95% CI: 0.989–0.999) domains of HRQoL. Regarding the PD patients, death was associated with the bodily pain (HR: 0.994; 95% CI: 0.990–0.998), mental health (HR: 0.094; 95% CI: 0.990–0.998), emotional problems (HR: 0.993; 95% CI: 0.987–0.998), social functioning (HR: 1.012; 95% CI: 1.002–1.023), physical problems (HR: 0.992; 95% CI: 0.986–0.998) and mental summary component (HR: 0.989; 95% CI: 0.981–0.997) domains of HRQoL. Conclusions Our data suggest that early and timely intervention measures aiming to enhance the HRQoL of dialysis patients are an essential component of professional practice and may contribute to improving the management of factors associated with dialysis patients' mortality.