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Quality of Life for Patients Using Hemodialysis (HD) vs. Peritoneal Dialysis (PD) Modalities in Taiwan

      Objectives

      Health-related quality of life (HRQOL) affects morbidity and mortality in patients with end-stage renal disease (ESRD). This study aims to analyze differences in QOL in patients starting dialysis on hemodialysis (HD) or on peritoneal dialysis (PD) in Taiwan.

      Methods

      Face-to-face patient interviews on patients aged older than 20 years old have been carried out at the Nephrology outpatient clinics of ten hospitals located in northern, central, southern and eastern part of Taiwan since April of 2015, and will be continued until the desired sample size is attained. QoL and health state utilities were elicited using Kidney Disease Quality of Life Short Form 36 (KDQOL-36), visual analogue scale (VAS) and EQ-5D. Out-of-pocket payment resulted by ESRD were measured. The Mann-Whitney U test and t-tests were performed to assess the differences between PD and HD.

      Results

      A total of 455 patients were recruited in the study, with 217 HD patients and 238 PD patients. The PD patients had significantly higher scores in the physiological domain (63.89 vs. 56.75; p=0.0093) of KDQOL-36 than HD patients. The proportion of PD patients who reported bad or very bad in mobility (10.50% vs. 21.66%; p=0.0011), self-care (8.82% vs. 14.05%; p=0.0495), and usual-activities (10.50% vs. 23.04%; p=0.0003) domains of EQ-5D were significantly higher than those of HD patients. However, there was no significant difference in out-of-pocket expenses between PD and HD.

      Conclusions

      PD patients tended to have a better HRQOL in terms of mobility and physiological conditions than HD patients. QOL needs to be included in assessing health outcomes of different modalities of dialysis.