Issue 142 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.