Al wakeel J, Bayoumi M, Al Ghonaim M, Al Harbi A, Al Swaida A, Mashraqy A.

End stage renal disease (ESRD) is a

progressive irreversible deterioration

in renal function in which the body’s

ability to maintain metabolic and fluid

electrolyte balance fails, resulting in

uremia.

The condition may be caused by systemic

diseases such as diabetes mellitus (leading cause),

hypertension, chronic glomerulonephritis,

pyelonephritis, obstruction of the urinary tract,

heredity lesions as in polycystic kidney disease,

vascular disorders, infections, medication, or toxic

agents.

Hemodialysis (HD) and peritoneal

dialysis (PD) are important renal

replacement therapy in end stage renal

disease (ESRD). It is worth noting that

ESRD is a disease with serious effects on

the patients' QoL, negatively affecting

their social, financial and psychological

well-being.

Regarding relevant research, renal

patients undergoing HD or CAPD/PD

treatment were found to experience

QoL deficits.

Patients' quality of life is determined

by their subjective interpretation of

their losses and gains in the process

of being ill.

Health related quality of life is a

multidimensional concept that includes

physical functioning, social and role

functioning, mental health, and general

health perceptions.

WHO has defined "QOL" as "individual’s perceptions of their position in life in the context of the culture and value systems where they live and in relation to their goals, expectations, standards and concerns”.

QoL decline over time, with the

perception of the quality of physical

health deteriorating more than mental

health, however many patients

continue to feel hopeless, anxious,

and worry about finances, loss of

sexual function, family burden, and

loss of independence.

Introduction

The reported annual incidence of end-stage renal disease in Saudi Arabia is 100 to 120 patients per million population (Shaheen & Souqiyyeh; 2004).

The recent statistics for The saudi organ transplant center the total number for patients with ESRD more than 9500 on HD and 900 on PD.

Assessment of quality of life is still a developing area of clinical research, with researchers continuing to refine the concept.

Recently, it has been recognized that patients’ quality of life and patient satisfaction with care are important domains that need to be understood better and addressed more fully.

Aim of the study

Compare The Quality Of Life Between Hemodialysis

And Peritoneal Dialysis Patients.

AIM of the STUDY

Subjects and Methods

RESEARCH DESIGNA cross-sectional descriptive design.

SETTINGking Khalid university hospital in dialysis unit, King Saud university, and security forces hospital in dialysis unit

SUBJECT :

All patient on hemodialysis and

peritoneal dialysis in the

aforementioned setting.

Their total number was 100 patients on

HD and 100 on PD.

Age above 18 years old, both sex.

Patients were excluded from the study

if they had neurological illness.

INSTRUMENT

An interview form was prepared and included two sections. The first was concerned with patient’s basic demographic data, as well as the main caregiver, and dialysis duration.The second section consisted of the Kidney Disease Quality of Life scale short form - KDQOL-SFTM-1.3 (Hays et al, 1994).

The KDQOL includes 36 items are categorized into six domains, namely: General health, Physical, Emotional, Social status, Illness impact, and Medical & Financial satisfaction. The scoring of the tool responses was done according to the guidelines of the KDQOL-SFTM (Hays et al,

1997). The scoring direction was done so that higher scores indicate better QoL.

<4040-

60+

Mal

e

Fem

ale

Singl

e

Mar

ried

no fo

rmal

edu

catio

n

basic/in

term

edia

tehi

gh

28

48

24

53

47

40

60

38

45

17 19

53

28

43

57

29

71

34

47

19

60 +40< -40Age

HDPD

Socio-demographic characteristics 

JOB STATUS

HDPD

37

21

63

79

Working Unemployed

Caregiver

Parent Spouse Sibling Children Self Housekeeper

12

37

3

29

910

3

22

4

41

24

6

HD PD

12

42

46

15

70

15

PD HD

Duration of dialysis (months) in HD & PD patients

60 +12< -12

Quality of life % of HD & PD patients

Gen

eral

Hea

lth

phys

ical

Emot

iona

l

Social

Illne

ss Im

pact

Satis

fact

ion

Tota

l QoL

39,3

47.947

58.1

43.249.3

45.65

60

43.4

61.3

70.3

62.6565.3

62.6

PD HD

Quality of life of HD and PD patients in Median

Gen

eral

Hea

lth

physical

Emot

ional

Socia

l

Illnes

s Im

pact

Satisfa

ctio

n

Tota

l QoL

39.3

47.947

58.1

43.249.3

45.65

60

43.4

61.3

70.3

62.6565.3

62.6PD HD

UnstandardizedCoefficients Standardized

Coefficients

B Std. Error

Constant 56.668 4.474

Age -0.454 0.058 -0.435

Sex (reference: male) 4.341 1.586 0.152

Dialysis duration -0.041 0.014 -0.174

Dialysis type (reference: hemodialysis)

11.208 1.708 0.392R-square=0.40Model ANOVA: F=34.25, p<0.001Variables excluded by model: education, marital status, job status

Best fitting linear regression model for the scores of quality of life of hemodialysis and peritoneal dialysis patients

Conclusion Hemodialysis is a negative predictor of QoL score compared to peritoneal dialysis.A negative predictors effect of QoL score are age, sex, dialysis duration.Also male sex is a negative predictor, compared to female sex.Peritoneal dialysis patients more satisfied financial and with medical care compared to hemodialysis patients.

RECOMMENDATIONS

Patient QoL should be the main objective for doctors and nurses during care of dialysis patients.

Develop Educational program for dialysis patient to improve all aspects of quality of life.

A family member or significant other should attend the educational program sessions to help dialysis patients to cope.

A simple manual of guidelines of care for patients undergoing hemodialysis and peritoneal dialysis should be made available in all units and provided to newly admitted patients.

Design exercise program for both hemodialyis and peritoneal therapy to improve physical QoL.

Further research is suggested to assess the effect on the QoL of children and adolescents.