Document Type : Research Paper
Authors
1 GP Medicine, Islamic Azad University, Medical Branch, Tehran.
2 PhD in Clinical Psychology/Psychopathology, University of Strasbourg, France (Corresponding Author)
Abstract
Abstract
The growing incidence of chronic kidney disease (CKD) suggests a surge in the number of patients undergoing dialysis and experiencing the problems associated with this treatment, one of which is the low quality of life (QoL). The present study was conducted to compare QoL among patients undergoing peritoneal dialysis (PD) and hemodialysis (HD).
Methods: This descriptive cross-sectional study was conducted among 77 HD patients and 46 PD patients who were admitted to Imam Reza and Ghaem hospitals, Tehran, Iran, in 2018. QoL was assessed using the Short Form (36) Health Survey (SF-36). The resulting data were analyzed using descriptive statistics, independent t-test, and ANOVA.
Results: Urinary tract infection and income level had a significant impact on QoL. In addition, QoL differed significantly between HD and PD patients, such that PD patients enjoyed a greater QoL score. Similarly, there was a significant difference between HD and PD patients in terms of general health, social functioning, energy and vitality, emotional health, as well as objective and mental aspects of quality of life. In fact, PD patients showed higher scores in all these domains. In addition, bodily pain was higher in HD patients than PD patients.
Conclusion: Based on the findings, the overall QoL in PD patients was higher than that of HD patients. Thus, considering the advantages of PD, patients should be encouraged to choose this treatment method
Keywords
Maglakelidze N, Pantsulaia T, Tchokhonelidze I, Managadze L,
Chkhotua A, editors. Assessment of health-related quality of life in
renal transplant recipients and dialysis patients. Transplantation
proceedings; 2011: Elsevier.
.2 Jansz TT, Bonenkamp AA ,Boereboom FT, Van Reekum FE, Verhaar
MC, Van Jaarsveld BC. Health-related quality of life compared between
kidney transplantation and nocturnal hemodialysis. PloS one.
2018;13(9):e0204405.
.3 Li Y-N, Shapiro B, Kim JC, Zhang M, Porszasz J, Bross R, et al .
Association between quality of life and anxiety, depression, physical
109 Investigating the Efficacy of Implicit Stimulation in Visual
….
activity and physical performance in maintenance hemodialysis
patients. Chronic diseases and translational medicine. 2016;2(2):110-9.
.4 Brunner LS. Brunner & Suddarth's textbook of medical-surgical
nursing: Lippincott Williams & Wilkins; 2010.
.5 Yildiz N, Erguven M, Yildiz M, Ozdogan T, Turhan Pn. Acute
peritoneal dialysis in neonates with acute kidney injury and
hypernatremic dehydration. Peritoneal Dialysis International.
2013;33.6-292:)3(
.6 Rahimimoghadam Z, Rahemi Z, Sadat Z, Ajorpaz NM. Pilates exercises
and quality of life of patients with chronic kidney disease.
Complementary therapies in clinical practice. 2019;34:35-40.
.7 Ring A, Jacoby A, Baker GA, Marson A, Whitehead MM .Does the
concept of resilience contribute to understanding good quality of life in
the context of epilepsy? Epilepsy & Behavior. 2016;56:153-64.
.8 Gilbertson EL, Krishnasamy R, Foote C, Kennard AL, Jardine MJ,
Gray NA. Burden of care and quality of life among caregivers for adults
receiving maintenance dialysis: a systematic review. American Journal
of Kidney Diseases. 2019;73(3):332-43.
.9 Mittal SK, Ahern L, Flaster E, Maesaka JK, Fishbane S. Self‐assessed
physical and mental function of haemodialysis patients. Nephrology
Dialysis Transplantation. 2001;16(7):1387-94.
.12 Tamura Y, Urawa A, Watanabe S, Hasegawa T, Ogura T, Nishikawa K,
et al., editors. Mood status and quality of life in kidney recipients after
transplantation. Transplantation proceedings; 2018: Elsevier.
.11 De Pasquale C, Veroux M, Pistorio M, Papotto A, Basile G, Patanè M,
et al., editors. Return to work and quality of life: a psychosocial survey
after kidney transplant. Transplantation proceedings; 2019: Elsevier.
.12 Lee M-C, Wu S-FV, Hsieh N-C, Tsai J-M. Self-management programs
on eGFR, depression, and quality of life among patients with chronic
kidney disease: a meta-analysis. Asian Nursing Research.
2016;10(4):255-62.
.13 Moreiras-Plaza M, Blanco-García R, Cossio-Aranibar CR ,RodriguezGoyanes G. Assessment of health-related quality of life: the cinderella
of peritoneal dialysis? International journal of nephrology. 2011;2011.
.14 Zyga S, Alikari V, Sachlas A, Stathoulis J, Aroni A, Theofilou P, et al.
Management of pain and quality of life in patients with chronic kidney
disease undergoing hemodialysis. Pain Management Nursing.
2015;16(5):712-20.
.15 Paniagua R, Amato D, Vonesh E, Guo A, Mujais S. Health-related
quality of life predicts outcomes but is not affected by peritoneal
clearance: The ADEMEX trial. Kidney international. 2005;67(3):1093-
104.
Quarterly of Clinical Psychology Studies, Vol. 11, No. 41, Winter 2021 110
.16 Ellis RJ, Small DM, Ng KL, Vesey DA, Vitetta L, Francis RS, et al.
Indoxyl sulfate induces apoptosis and hypertrophy in human kidney
proximal tubular cells. Toxicologic Pathology. 2018;46(4):449-59.
.17 Diaz-Buxo JA, Lowrie EG, Lew NL, Zhang H, Lazarus JM. Quality-oflife evaluation using Short Form 36: comparison in hemodialysis and
peritoneal dialysis patients. American Journal of Kidney Diseases.
2000;35(2):293-300.
.18 Chan R, Brooks R, Steel Z, Heung T, Erlich J, Chow J, et al. The
psychosocial correlates of quality of life in the dialysis population: a
systematic review and meta-regression analysis. Quality of Life
Research. 2012;21(4):563-80.
.19 Theofilou P. Quality of life in patients undergoing hemodialysis or
peritoneal dialysis treatment. Journal of clinical medicine research.
2011;3(3):132.
.22 de Abreu MM, Walker DR, Sesso RC, Ferraz MB. Health-related
quality of life of patients recieving hemodialysis and peritoneal dialysis
in São Paulo, Brazil: a longitudinal study. Value in health.
2011;14(5):S119-S21.
.21 Zeraati AA, Naghibi M, Ahmad Zadeh S, Hasan Zamani B.
Comparison of quality of life between hemodialysis and peritoneal
dialysis patients in Imam Reza and Ghaem hospital dialysis centers in
Mashhad. medical journal of mashhad university of medical sciences.
2010;53(3):169-76.
.22 Abbaszadeh A, Javanbakhtian R, Salehee S, Motvaseliyan M.
Comparative assessment of quality of life in hemodialysis and kidney
transplant patients. SSU_Journals. 2010;18(5):461-8.
.23 Zeraati AA, Naghibi M, Ojahedi MJ, Ahmad Zadeh S, Hasan Zamani
B. Comparison of quality of life between hemodialysis and peritoneal
dialysis patients in Imam Reza and Ghaem hospital dialysis centers in
Mashhad. medical journal of mashhad university of medical sciences.
2010;53(3):169-76.
.24 Liem YS, Bosch JL, Arends LR, Heijenbrok-Kal MH, Hunink MM.
Quality of life assessed with the Medical Outcomes Study Short Form
36-Item Health Survey of patients on renal replacement therapy: a
systematic review and meta-analysis. Value in Health. 2007;10(5):390-
7.
.25 Sayin A, Mutluay R, Sindel S, editors. Quality of life in hemodialysis,
peritoneal dialysis, and transplantation patients. Transplantation
proceedings; 2007: Elsevier.
.26 Zhang A-H, Cheng L-T, Zhu N, Sun L-H, Wang T. Comparison of
quality of life and causes of hospitalization between hemodialysis and
111 Investigating the Efficacy of Implicit Stimulation in Visual
….
peritoneal dialysis patients in China. Health and quality of life
outcomes. 2007;5(1):49.
.27 Zazzeroni L, Pasquinelli G, Nanni E, Cremonini V, Rubbi I.
Comparison of quality of life in patients undergoing hemodialysis and
peritoneal dialysis: a systematic review and meta-analysis. Kidney and
Blood Pressure Research. 2017;42(4):717-27.
.28 Dąbrowska-Bender M, Dykowska G, Żuk W, Milewska M,
Staniszewska A. The impact on quality of life of dialysis patients with
renal insufficiency. Patient preference and adherence. 2018;12:577.
.29 Powe NR, Klag MJ, Sadler JH, Anderson GF, Bass EB, Briggs WA, et
al., editors. Choices for healthy outcomes in caring for end stage renal
disease. Seminars in Dialysis; 1996: Wiley Online Library.
.32 Dalal P, Sangha H, Chaudhary K. In peritoneal dialysis, is there
sufficient evidence to make “PD first” therapy? International journal of
nephrology. 2011;2011.
.31 Ferreira RC, Silva Filho CRd. Quality of life of chronic renal patients
on hemodialysis in Marília, SP, Brazil. Brazilian Journal of
Nephrology. 2011;33(2):129-35.
.32 Merkus MP, Jager KJ, Dekker FW, Boeschoten EW, Stevens P, Krediet
RT, et al. Quality of life in patients on chronic dialysis: self-assessment
3 months after the start of treatment. American journal of kidney
diseases. 1997;29(4):584-92.
.33 Jiang J, Zheng X, Qin J, Zheng M, Mao Q, Zhang Z, et al. Healthrelated quality of life after hand-assisted laparoscopic and open radical
nephrectomies of renal cell carcinoma. International urology and
nephrology. 2009;41(1):23-7.
.34 Kutner NG, Zhang R, Barnhart H, Collins AJ. Health status and quality
of life reported by incident patients after 1 year on haemodialysis or
peritoneal dialysis. Nephrology Dialysis Transplantation.
2005;20(10):2159-67.
.35 Szabo E, Moody H, Hamilton T, Ang C, Kovithavongs C, Kjellstrand
C. Choice of treatment improves quality of life :a study on patients
undergoing dialysis. Archives of Internal Medicine.
1997;157(12):1352-6.
.36 Khalil AA, Abed MA. Perceived social support is a partial mediator of
the relationship between depressive symptoms and quality of life in
patients receiving hemodialysis. Archives of Psychiatric Nursing.
2014;28(2):114-8.
.37 Rambod M, Rafii F. Perceived social support and quality of life in
Iranian hemodialysis patients. Journal of Nursing Scholarship.
2010;42(3):242-9.
Quarterly of Clinical Psychology Studies, Vol. 11, No. 41, Winter 2021 112
.38 Sadoughi M, Hesampour F. The relationship between anxiety,
depression and perceived social support and quality of life among
hemodialysis patients. Journal of Clinical Nursing and Midwifery.
2017;6(3):56-71.
.39 Sathvik B, Parthasarathi G, Narahari M, Gurudev K. An assessment of
the quality of life in hemodialysis patients using the WHOQOL-BREF
questionnaire. Indian journal of nephrology. 2008;18(4):141.
.42 Smaeli M, Alikhani M, Hosseini F. The quality of life and self efficacy
of the patients under hemodialysis. Iran Journal of Nursing .
.84-77:)41(18;2225
.41 Harris LE, Luft FC, Rudy DW, Tierney WM. Clinical correlates of
functional status in patients with chronic renal insufficiency. American
journal of kidney diseases. 1993;21(2):161-6.
.42 Mingardi G, Cornalba L, Cortinovis E, Ruggiata R, Mosconi P,
Apolone G. Health-related quality of life in dialysis patients. A report
from an Italian study using the SF-36 Health Survey. DIA-QOL Group.
Nephrology, dialysis, transplantation: official publication of the
European Dialysis and Transplant Association-European Renal
Association. 1999;14(6):1503-10.
.43 Soleymanian T, Kokabeh Z, Ramaghi R, Mahjoub A, Argani H.
Clinical outcomes and quality of life in hemodialysis diabetic patients
versus non-diabetics. Journal of nephropathology. 2017;6.81:)2(
Chkhotua A, editors. Assessment of health-related quality of life in
renal transplant recipients and dialysis patients. Transplantation
proceedings; 2011: Elsevier.
.2 Jansz TT, Bonenkamp AA ,Boereboom FT, Van Reekum FE, Verhaar
MC, Van Jaarsveld BC. Health-related quality of life compared between
kidney transplantation and nocturnal hemodialysis. PloS one.
2018;13(9):e0204405.
.3 Li Y-N, Shapiro B, Kim JC, Zhang M, Porszasz J, Bross R, et al .
Association between quality of life and anxiety, depression, physical
109 Investigating the Efficacy of Implicit Stimulation in Visual
….
activity and physical performance in maintenance hemodialysis
patients. Chronic diseases and translational medicine. 2016;2(2):110-9.
.4 Brunner LS. Brunner & Suddarth's textbook of medical-surgical
nursing: Lippincott Williams & Wilkins; 2010.
.5 Yildiz N, Erguven M, Yildiz M, Ozdogan T, Turhan Pn. Acute
peritoneal dialysis in neonates with acute kidney injury and
hypernatremic dehydration. Peritoneal Dialysis International.
2013;33.6-292:)3(
.6 Rahimimoghadam Z, Rahemi Z, Sadat Z, Ajorpaz NM. Pilates exercises
and quality of life of patients with chronic kidney disease.
Complementary therapies in clinical practice. 2019;34:35-40.
.7 Ring A, Jacoby A, Baker GA, Marson A, Whitehead MM .Does the
concept of resilience contribute to understanding good quality of life in
the context of epilepsy? Epilepsy & Behavior. 2016;56:153-64.
.8 Gilbertson EL, Krishnasamy R, Foote C, Kennard AL, Jardine MJ,
Gray NA. Burden of care and quality of life among caregivers for adults
receiving maintenance dialysis: a systematic review. American Journal
of Kidney Diseases. 2019;73(3):332-43.
.9 Mittal SK, Ahern L, Flaster E, Maesaka JK, Fishbane S. Self‐assessed
physical and mental function of haemodialysis patients. Nephrology
Dialysis Transplantation. 2001;16(7):1387-94.
.12 Tamura Y, Urawa A, Watanabe S, Hasegawa T, Ogura T, Nishikawa K,
et al., editors. Mood status and quality of life in kidney recipients after
transplantation. Transplantation proceedings; 2018: Elsevier.
.11 De Pasquale C, Veroux M, Pistorio M, Papotto A, Basile G, Patanè M,
et al., editors. Return to work and quality of life: a psychosocial survey
after kidney transplant. Transplantation proceedings; 2019: Elsevier.
.12 Lee M-C, Wu S-FV, Hsieh N-C, Tsai J-M. Self-management programs
on eGFR, depression, and quality of life among patients with chronic
kidney disease: a meta-analysis. Asian Nursing Research.
2016;10(4):255-62.
.13 Moreiras-Plaza M, Blanco-García R, Cossio-Aranibar CR ,RodriguezGoyanes G. Assessment of health-related quality of life: the cinderella
of peritoneal dialysis? International journal of nephrology. 2011;2011.
.14 Zyga S, Alikari V, Sachlas A, Stathoulis J, Aroni A, Theofilou P, et al.
Management of pain and quality of life in patients with chronic kidney
disease undergoing hemodialysis. Pain Management Nursing.
2015;16(5):712-20.
.15 Paniagua R, Amato D, Vonesh E, Guo A, Mujais S. Health-related
quality of life predicts outcomes but is not affected by peritoneal
clearance: The ADEMEX trial. Kidney international. 2005;67(3):1093-
104.
Quarterly of Clinical Psychology Studies, Vol. 11, No. 41, Winter 2021 110
.16 Ellis RJ, Small DM, Ng KL, Vesey DA, Vitetta L, Francis RS, et al.
Indoxyl sulfate induces apoptosis and hypertrophy in human kidney
proximal tubular cells. Toxicologic Pathology. 2018;46(4):449-59.
.17 Diaz-Buxo JA, Lowrie EG, Lew NL, Zhang H, Lazarus JM. Quality-oflife evaluation using Short Form 36: comparison in hemodialysis and
peritoneal dialysis patients. American Journal of Kidney Diseases.
2000;35(2):293-300.
.18 Chan R, Brooks R, Steel Z, Heung T, Erlich J, Chow J, et al. The
psychosocial correlates of quality of life in the dialysis population: a
systematic review and meta-regression analysis. Quality of Life
Research. 2012;21(4):563-80.
.19 Theofilou P. Quality of life in patients undergoing hemodialysis or
peritoneal dialysis treatment. Journal of clinical medicine research.
2011;3(3):132.
.22 de Abreu MM, Walker DR, Sesso RC, Ferraz MB. Health-related
quality of life of patients recieving hemodialysis and peritoneal dialysis
in São Paulo, Brazil: a longitudinal study. Value in health.
2011;14(5):S119-S21.
.21 Zeraati AA, Naghibi M, Ahmad Zadeh S, Hasan Zamani B.
Comparison of quality of life between hemodialysis and peritoneal
dialysis patients in Imam Reza and Ghaem hospital dialysis centers in
Mashhad. medical journal of mashhad university of medical sciences.
2010;53(3):169-76.
.22 Abbaszadeh A, Javanbakhtian R, Salehee S, Motvaseliyan M.
Comparative assessment of quality of life in hemodialysis and kidney
transplant patients. SSU_Journals. 2010;18(5):461-8.
.23 Zeraati AA, Naghibi M, Ojahedi MJ, Ahmad Zadeh S, Hasan Zamani
B. Comparison of quality of life between hemodialysis and peritoneal
dialysis patients in Imam Reza and Ghaem hospital dialysis centers in
Mashhad. medical journal of mashhad university of medical sciences.
2010;53(3):169-76.
.24 Liem YS, Bosch JL, Arends LR, Heijenbrok-Kal MH, Hunink MM.
Quality of life assessed with the Medical Outcomes Study Short Form
36-Item Health Survey of patients on renal replacement therapy: a
systematic review and meta-analysis. Value in Health. 2007;10(5):390-
7.
.25 Sayin A, Mutluay R, Sindel S, editors. Quality of life in hemodialysis,
peritoneal dialysis, and transplantation patients. Transplantation
proceedings; 2007: Elsevier.
.26 Zhang A-H, Cheng L-T, Zhu N, Sun L-H, Wang T. Comparison of
quality of life and causes of hospitalization between hemodialysis and
111 Investigating the Efficacy of Implicit Stimulation in Visual
….
peritoneal dialysis patients in China. Health and quality of life
outcomes. 2007;5(1):49.
.27 Zazzeroni L, Pasquinelli G, Nanni E, Cremonini V, Rubbi I.
Comparison of quality of life in patients undergoing hemodialysis and
peritoneal dialysis: a systematic review and meta-analysis. Kidney and
Blood Pressure Research. 2017;42(4):717-27.
.28 Dąbrowska-Bender M, Dykowska G, Żuk W, Milewska M,
Staniszewska A. The impact on quality of life of dialysis patients with
renal insufficiency. Patient preference and adherence. 2018;12:577.
.29 Powe NR, Klag MJ, Sadler JH, Anderson GF, Bass EB, Briggs WA, et
al., editors. Choices for healthy outcomes in caring for end stage renal
disease. Seminars in Dialysis; 1996: Wiley Online Library.
.32 Dalal P, Sangha H, Chaudhary K. In peritoneal dialysis, is there
sufficient evidence to make “PD first” therapy? International journal of
nephrology. 2011;2011.
.31 Ferreira RC, Silva Filho CRd. Quality of life of chronic renal patients
on hemodialysis in Marília, SP, Brazil. Brazilian Journal of
Nephrology. 2011;33(2):129-35.
.32 Merkus MP, Jager KJ, Dekker FW, Boeschoten EW, Stevens P, Krediet
RT, et al. Quality of life in patients on chronic dialysis: self-assessment
3 months after the start of treatment. American journal of kidney
diseases. 1997;29(4):584-92.
.33 Jiang J, Zheng X, Qin J, Zheng M, Mao Q, Zhang Z, et al. Healthrelated quality of life after hand-assisted laparoscopic and open radical
nephrectomies of renal cell carcinoma. International urology and
nephrology. 2009;41(1):23-7.
.34 Kutner NG, Zhang R, Barnhart H, Collins AJ. Health status and quality
of life reported by incident patients after 1 year on haemodialysis or
peritoneal dialysis. Nephrology Dialysis Transplantation.
2005;20(10):2159-67.
.35 Szabo E, Moody H, Hamilton T, Ang C, Kovithavongs C, Kjellstrand
C. Choice of treatment improves quality of life :a study on patients
undergoing dialysis. Archives of Internal Medicine.
1997;157(12):1352-6.
.36 Khalil AA, Abed MA. Perceived social support is a partial mediator of
the relationship between depressive symptoms and quality of life in
patients receiving hemodialysis. Archives of Psychiatric Nursing.
2014;28(2):114-8.
.37 Rambod M, Rafii F. Perceived social support and quality of life in
Iranian hemodialysis patients. Journal of Nursing Scholarship.
2010;42(3):242-9.
Quarterly of Clinical Psychology Studies, Vol. 11, No. 41, Winter 2021 112
.38 Sadoughi M, Hesampour F. The relationship between anxiety,
depression and perceived social support and quality of life among
hemodialysis patients. Journal of Clinical Nursing and Midwifery.
2017;6(3):56-71.
.39 Sathvik B, Parthasarathi G, Narahari M, Gurudev K. An assessment of
the quality of life in hemodialysis patients using the WHOQOL-BREF
questionnaire. Indian journal of nephrology. 2008;18(4):141.
.42 Smaeli M, Alikhani M, Hosseini F. The quality of life and self efficacy
of the patients under hemodialysis. Iran Journal of Nursing .
.84-77:)41(18;2225
.41 Harris LE, Luft FC, Rudy DW, Tierney WM. Clinical correlates of
functional status in patients with chronic renal insufficiency. American
journal of kidney diseases. 1993;21(2):161-6.
.42 Mingardi G, Cornalba L, Cortinovis E, Ruggiata R, Mosconi P,
Apolone G. Health-related quality of life in dialysis patients. A report
from an Italian study using the SF-36 Health Survey. DIA-QOL Group.
Nephrology, dialysis, transplantation: official publication of the
European Dialysis and Transplant Association-European Renal
Association. 1999;14(6):1503-10.
.43 Soleymanian T, Kokabeh Z, Ramaghi R, Mahjoub A, Argani H.
Clinical outcomes and quality of life in hemodialysis diabetic patients
versus non-diabetics. Journal of nephropathology. 2017;6.81:)2(
)