SP613THE DIFFERENCE IN QUALITY OF LIFE AND EMOTIONAL DISTRESS BETWEEN PATIENTS ON PERITONEAL DIALYSIS VERSUS HEMODIALYSIS

INTRODUCTION AND AIMS: In Japan, hemodialysis (HD) is the most popular modality for the patients with end stage renal disease, while the number of patients on peritoneal dialysis (PD) is accounting for only 2.8%. This observational study was aimed to detect the impact of the two modalities of dialysis on quality of life (QOL), cognitive impairment and depression status for two years. Moreover, we conduct the reason of low PD penetration. METHODS: Thirty five incident PD and 21 incident dialysis HD patients were recruited in this study. The questionnaires of SF-36 for QOL, minimental state examination (MMSE) for cognitive impairment and CES-D for depression were assessed in all patients at the time of dialysis initiation and every 12 months for two years. RESULTS: Characteristics of the studied patients at baseline; Ten patients were withdrawn from this protocol due to malignancy (2 PD and 1 HD patients, respectively), death (2 PD and 1 HD patients, respectively), being transferred to other clinic (1 PD and 1 HD patients, respectively) and transplantation in 2 PD patients, resulting in total 28 PD and 18 HD patients were continued this protocol. The mean age were 63.6±9.6 and 69.3±6.2 years old for PD and HD patients, respectively (P=0.357). The MMSE and CES-D scores in HD patients was significantly decreased at 12 and 24 months (*:P<0.01 and **:P<0.05 vs at baseline, respectively), however there were no significant changes in PD patients for both scores. Summary of physical components in SF-36 revealed that the score at 24 months in PD patients was improved significantly (**:P<0.05 vs at baseline), but not in HD patients. Summary of mental components were not changed in both groups. As for the summary of role of social components, the score was improved at 24months significantly (**: P<0.05 vs at baseline, a:P<0.01 vs HD) only in PD patients. The residual renal function was preserved in PD patients more than that of HD patients.(**:P<0.01 vs at baseline, and b:P<0.001 vs HD)(Table 1). CONCLUSIONS: PD provides better QOL and emotional change, especially in physical and role of social aspects and cognitive function. PD preserved more residual renal function and provided better QOL and MMSE findings. Nevertheless, HD is more prevalent than PD in Japan. Japanese are thought to have the tendency to leave all to others, or dependence on others. Those personalities may make HD modality popular. Finally, it is important to inform patients that PD provide better QOL and better effect on cognitive function.$$table_{FF67AF99-28ED-482D-9634-A344D394394D}$$