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BMC Nephrol. 2017 Jul 6;18(1):217. doi: 10.1186/s12882-017-0621-7.

Quality of life as indicator of poor outcome in hemodialysis: relation with mortality in different age groups.

Author information

1
Dianet Dialysis Center, Brennerbaan 130, 3524, BN, Utrecht, The Netherlands. i.vanloon@dianet.nl.
2
Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands. i.vanloon@dianet.nl.
3
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands. i.vanloon@dianet.nl.
4
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
5
Dianet Dialysis Center, Brennerbaan 130, 3524, BN, Utrecht, The Netherlands.
6
Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
7
Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands.
8
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.
9
Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands.
10
Department of Geriatrics, Diakonessenhuis Utrecht, Utrecht, The Netherlands.

Abstract

BACKGROUND:

Physical, cognitive and psychosocial functioning are frequently impaired in dialysis patients and impairment in these domains relates to poor outcome. The aim of this analysis was to compare the prevalence of impairment as measured by the Kidney Disease Quality of Life- Short Form (KDQOL-SF) subscales between the different age categories and to assess whether the association of these subscales with mortality differs between younger and older dialysis patients.

METHODS:

This study included data from 714 prevalent hemodialysis patients, from 26 centres, who were enrolled in the CONvective TRAnsport STudy (CONTRAST NCT00205556, 09-12-2005). Baseline HRQOL domains were evaluated for patients <65 years, 65-74 years and over 75 years. Multivariable Cox proportional hazards analyses were performed to assess the relation between the separate domains and 2-year mortality.

RESULTS:

Emotional health was higher in patients over the age of 75 compared to younger patients (mean level 71, 73 and 77 for increasing age categories respectively, p = 0.02), whilst physical functioning was significantly lower in older patients (mean level 60, 48 and 40, p < 0.01). A low level of physical functioning (Hazard Ratio (HR) 1.72 [95%Confidence Interval (CI) 1.02-2.73]), emotional health (HR 1.85 [95% 1.30-2.63]), and social functioning (HR 1.59 [95% CI 1.12-2.26]), was individually associated with an increased 2-year mortality within the whole population. The absence of effect modification suggests no evidence for different relations within the older age groups.

CONCLUSIONS:

In dialysis patients, older age is associated with lower levels of physical functioning, whilst the level of emotional health is not associated with age. KDQOL-SF domains physical functioning, emotional health and social functioning are independently associated with mortality in prevalent younger and older hemodialysis patients.

KEYWORDS:

Dialysis; End-stage renal disease; Frailty; Geriatric nephrology; Quality of life

PMID:
28679361
PMCID:
PMC5498985
DOI:
10.1186/s12882-017-0621-7
[Indexed for MEDLINE]
Free PMC Article

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