Item #7
Unplanned
Dialysis Leeds to Severely Impaired Quality of Life
When
the first session has not been anticipated and planned for, the QOL of
patients is severely impaired.
In older patients with end-stage renal disease (ESRD), the status of
the first dialysis session--planned or unplanned--has a strong impact
on quality of life (QOL), according to a report published in the
February issue of the Journal of the American Geriatrics Society.
When
the first session is planned, ESRD patients experience a QOL that is
similar to that of subjects without chronic renal failure, the authors
found. When this session has not been anticipated and planned for, the
QOL of such patients is severely impaired.
The
current findings are based on study of 169 ESRD patients who were just
starting dialysis and 169 matched control subjects. The short-form
health survey was given to the subjects to assess QOL. The average
patient age was 76.2 years.
Compared
with control subjects, ESRD patients had significantly lower scores in
3 of the 8 QOL dimensions tested, Dr. Serge Briancon, from Hopital
Marin in Nancy, France, and colleagues report. However, when the
analysis was limited to ESRD patients with planned first sessions, the
significant differences disappeared.
Among
ESRD patients, those with planned first sessions scored significantly
higher on the physical function dimension of the short-form survey
than those with unplanned sessions (p = 0.014).
"These
results reinforce the argument that predialysis care of older renal
failure patients should be improved to achieve better conditions when
starting dialysis," the authors write. "Further studies are
justified to identify factors with an influence on QOL in this context
and to devise a comorbidity index predictive of QOL," they add.
J
Am Geriatr Soc 2003;51:000-000.
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