SP498COMPARISON OF QUALITY OF LIFE IN PATIENTS UNDERGOING HEMODIALYSIS AND PERITONEAL DIALYSIS

INTRODUCTION AND AIMS: Chronic Kidney Disease is a progressive disease. The health-related quality of life (HRQoL) of dialysis patients is lower than that of the general population or patients who undergo kidney transplantation. Low HRQoL is is an index to calculate wellbeing of patients and is associated with decreased survival and more frequent hospitalization in dialysis patients The Kidney disease quality of life (KDQOL ) questionnare combines the generic SF-36 instrument and disease specific components for assessing the HRQOL of CKD. Our study examines differences regarding quality of life between in centre hemodialysis (HD) and ambulatory peritoneal dialysis (PD) patients. METHODS: The study enrolled 104 HD patients mean age (49.9 ± 12.4years old) with dialysis vintage 51.5 ± 28.7 years and 61 PD patients mean age 55.5 ± 14.5years old and dialysis vintage 28.7 ± 20.0 years. Comorbidity was assessed using the index of coexistent diseases (ICED), including two subindexes: index of disease severity (IDS) and index of physical impairment (IPI). Patient's self-assessment of HRQoL was measured by the 36-item short form health survey questionnaire (SF-36), encompassing eight summary scales and two summary dimensions. Multiple linear regression analysis was performed to evaluate the effects of dialysis modality on HRQoL. RESULTS: Compared with HD patients, PD patients had higher scores in five of the eight SF-36 subscales, including perception of health in general, physical functioning, bodily pain, vitality, and mental health. However, only perception of health in general, bodily pain and mental health reached significant difference levels (p < 0.05). HD patients indicated significantly lower mean score in GHQ-28 subclasses of anxiety, insomnia, and depression indicating more symtoms in these areas of mental health. After controlling for patient characteristics, comorbid conditions and laboratory values, the bodily pain score was 8.58 points and emotional scores where7.67 points higher for PD patients compared with HD patients. while social functioning score was 6.3 points higher for HD patients compared with PD patients (p < 0.05). Comorbid conditions have negative and statistically significant correlation with parameters of HRQoL in both modalities, and could explain poor HRQoL to a remarkable extent. Older age and poor income substantially reduce HRQoL in greater part of our patients. CONCLUSIONS: The present study provides cross-sectional confirmation that PD and HD patients have equivalent health related quality of life, although PD performed better in some quality domains such as bodily pain, emotional functioning and mental health. Improvement could be achievable in both groups if pain/discomfort and anxiety/depression could be more effectively treated.