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Medicine (Baltimore). 2016 May;95(21):e3795. doi: 10.1097/MD.0000000000003795.

Depressive Symptoms, Patient Satisfaction, and Quality of Life Over Time in Automated and Continuous Ambulatory Peritoneal Dialysis Patients: A Prospective Multicenter Propensity-Matched Study.

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From the Department of Internal Medicine, Kyungpook National University School of Medicine (H-YJ, J-YC, J-HC, S-HP, C-DK, Y-LK), Department of Statistics (HMJ), BK21 Plus KNU Biomedical Convergence Program, Department of Biomedical Science, Kyungpook National University (Y-LK), Department of Internal Medicine, Daegu Fatima Hospital, Daegu (S-HK), Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan (YWK), Department of Internal Medicine, College of Medicine, The Sungkyunkwan University of Korea, Samsung Changwon Hospital, Changwon (SC), Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju (H-YK), Department of Internal Medicine, Eulji University Hospital, Daejeon (KB), Department of Internal Medicine, Jeju National University, School of Medicine, Jeju National University Hospital, Jeju (HWK), Department of Internal Medicine, Eulji Medical Centerl (SYL), Department of Internal Medicine, Korea University Anam Hospital, Seoul (SKJ), and Department of Internal Medicine, St. Carollo Hospital, Suncheon (JL), Korea.


Health-related quality of life (HRQOL) is an important clinical outcome for dialysis patients. However, relative superiority in HRQOL between automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) are not clearly known. We compared HRQOL over time between APD and CAPD patients and evaluated factors associated with HRQOL.All 260 incident patients initiating APD or CAPD at multiple centers throughout Korea were prospectively enrolled in this study between October 2010 and February 2013. HRQOL, depressive symptoms, and renal treatment satisfaction were assessed 1 and 12 months after the start of dialysis by the Kidney Disease Quality of Life Short Form 36 (KDQOL-36), the Beck Depression Inventory (BDI), and the Renal Treatment Satisfaction Questionnaire (RTSQ), respectively.Of 196 patients who completed all questionnaires and did not change the peritoneal dialysis (PD) modality during the 1-year follow-up period, 160 were matched. APD patients showed better baseline HRQOL than CAPD patients for the symptoms, patient satisfaction, pain, and social function domains. There were no differences in HRQOL between the 2 groups at 12 months, and CAPD patients had significantly greater improvements in symptoms (P = 0.02), the mental composite summary (P = 0.03), and health status domains (P = 0.03) than APD patients. There were similar improvements in depressive symptoms (P = 0.01) and patient satisfaction with treatment (P = 0.01) in CAPD and APD patients. Interestingly, depressive symptoms, not PD modality, was the most influential and consistent factor for HRQOL. Despite the spontaneous improvement of depressive symptoms, considerable PD patients still had depressive symptoms at the 1-year appointment.APD has no advantage over CAPD for HRQOL. Considering the substantial negative effect of depressive symptoms on HRQOL, it is important to evaluate PD patients for depression and to treat those with depression to improve their HRQOL.

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