Time of diagnosis of chronic renal failure and assessment of quality of life in haemodialysis patients

Abstract

Background. Time of diagnosis of chronic renal failure and predialysis care may be important factors related to the quality of life of patients on dialysis treatment.Methods. We evaluated the quality of life of 113 haemodialysis patients who had a late (less than or equal to 1 month before starting dialysis, n = 53) or early (greater than or equal to 6 months, n = 60) diagnosis of chronic renal failure. At the time of the survey patients had been on dialysis for a median duration of 55 days (range 1-109). Quality of life was measured by the Kidney Disease Questionnaire (KDQ), including five dimensions with scales ranging from 1.0 to 7.0 (1.0 = more impairment); the health and life satisfaction indices (higher score = more dissatisfied), functional status (Karnofsky scale), and the time trade-off technique.Results. Mean scores of quality of life measures were worse in the late-than in the early-diagnosis group. A significant difference (P < 0.05) was observed in the depression (4.46 +/- 1.45 vs 5.23 +/- 1.36), relationships with others (3.95 +/- 1.31 vs 4.53 +/- 1.31) and frustration (4.08 +/- 1.51 vs 5.21 +/- 1.34) dimensions of the KDQ, and in life satisfaction (4.11 +/- 1.92 vs 3.32 +/- 1.57). Functional status declined compared to 1 year before dialysis, particularly in the late-diagnosis group. Among the elderly patients, the magnitude of the difference was more pronounced, (including in the physical symptoms item of the KDQ).Conclusions. Our findings demonstrate that late diagnosis of chronic renal failure and the consequent lack of predialysis care adversely affect the quality of life of haemodialysis patients. Early diagnosis and regular predialysis care should be encouraged to improve the quality of life during dialysis treatment.