How much is enough? An investigation of the relationship between haemodialysis adequacy and quality of life of elderly patients

作者：Zimbudzi Edward^*; Samlero Reggie; Kerr Peter G; Zoungas Sophia

来源：Nephrology, 2016, 21(4): 314-320.

DOI：10.1111/nep.12594

• comorbidity
• dialysis adequacy
• elderly
• quality of life
• urea reduction ratio

AimThe average age of patients requiring haemodialysis is on the rise and has resulted in an increase in the number of elderly people receiving dialysis. While haemodialysis is one of the treatment options for this patient group, questions about its effectiveness have been raised. A second question centres on how much haemodialysis is actually needed to maintain quality of life (QoL). This study examined the relationship between dialysis adequacy and the QoL of elderly patients on haemodialysis.
MethodA prospective cohort of 40 haemodialysis patients aged 75years and above was recruited and studied over 3months. Quality of life was assessed with the European Quality of Life-5 Dimensions questionnaire and dialysis adequacy with the urea reduction ratio (URR), and the relationship between the two examined using a simple linear regression model.
ResultsThe average age of the participants was 79.8(3.9years; 45% were women, and diabetes was the main cause of kidney disease (42.5%). The mean URR, visual analogue scale, European Quality of Life-5 Dimensions indices score and Charlson comorbidity index scores were 78.1(5.5)%, 65.4(13.7)%, 0.7 +/-(0.27) and 6.3 +/-(2.15), respectively. There was no clear relationship between dialysis adequacy and QoL, r=0.093. Dialysis adequacy did not significantly predict QoL (P=0.09).
ConclusionThere was no evidence for an association between haemodialysis adequacy and QoL in elderly patients receiving haemodialysis across a URR range of 64.0% to 88.9%. Attempts to improve dialysis adequacy beyond these levels may not be necessary for maintaining the QoL of elderly patients on dialysis.
Key messageModern therapy should embrace the concept of quality of life and focus more on symptom relief and optimization of self-management skills to improve the well-being of the elderly patients with ESKD.
Summary at a Glance A small but important study looking at the quality of life in elderly patients on hemodialysis. The study suggested that a higher dose of hemodialysis is not associated with an improved quality of life.

• 出版日期2016-4