HRQoL on the Decline Preceding Initiation of Dialysis for Seniors

In the year following start of dialysis, stabilization with mean changes of +2 and –2 seen in mental and physical component summaries

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FRIDAY, July 29, 2022 (HealthDay News) -- Older patients with kidney failure have a decline in health-related quality of life before initiation of dialysis, which stabilizes thereafter, according to a study published online July 28 in the Clinical Journal of the American Society of Nephrology.

Esther N.M. de Rooij, M.D., from the Leiden University Medical Center in the Netherlands, and colleagues conducted an ongoing prospective, multicenter study in patients aged 65 years and older with an incident estimated glomerular filtration rate ≤20 mL/min/1.73 m2 to examine the evolution of health-related quality of life before and after starting dialysis. Health-related quality of life was assessed every three to six months between April 2012 and December 2021 using the 36-item Short-Form Health Survey, providing a mental component summary (MCS) and a physical component summary (PCS). Data were included for 457 patients starting dialysis.

The researchers found that at dialysis initiation, the median MCS was 53 and median PCS was 39. The estimated mean change in MCS and PCS was −13 and −11, respectively, during the year preceding dialysis. In the year following dialysis, the estimated mean change in MCS and PCS was +2 and −2, respectively. For most mental and physical domains, the patterns in health-related quality of life were similar.

"Our results indicate that mental and physical health-related quality of life worsened considerably during the year preceding dialysis, but this decline stabilized at dialysis initiation," the authors write. "However, mental and physical health-related quality of life did not completely recover during the year after dialysis initiation."

Several authors disclosed financial ties to the pharmaceutical industry.

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