Health-related quality of life and symptom burden in patients on haemodialysis

Mathijs van Oevelen*, Anna A Bonenkamp, DOMESTICO study group, Anita van Eck van der Sluijs, Willem Jan W Bos, Caroline E Douma, Marjolijn van Buren, Yvette Meuleman, Friedo W Dekker, Brigit C van Jaarsveld, Alferso C Abrahams, Ewout Hoorn, David Severs

*Corresponding author for this work

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Background. Patients on haemodialysis (HD) generally experience poor health-related quality of life (HRQoL) and a broad range of physical and mental symptoms, but it is unknown whether this differs between younger and older patients. We aimed to describe the trajectories of HRQoL and symptom burden of patients <70 and ≥70 years old and to assess the impact of symptom burden on HRQoL. Methods. In incident Dutch HD patients, HRQoL and symptoms were measured with the 12-item Short Form Health Survey and Dialysis Symptom Index. We used linear mixed models for examining the trajectories of HRQoL and symptom burden during the first year of dialysis and linear regression for the impact of symptom burden on HRQoL. Results. In 774 patients, the trajectories of physical HRQoL, mental HRQoL and symptom burden were stable during the first year of dialysis. Compared with patients <70 years of age, patients ≥70 years reported similar physical HRQoL {mean difference -0.61 [95% confidence interval (CI) -1.86–0.63]}, better mental HRQoL [1.77 (95% CI 0.54–3.01)] and lower symptom burden [-2.38 (95% CI -5.08–0.32)]. With increasing symptom burden, physical HRQoL declined more in older than in younger patients (β = -0.287 versus -0.189, respectively; P-value for interaction = .007). For mental HRQoL, this decrease was similar in both age groups (β = -0.295 versus -0.288, P = .847). Conclusion. Older HD patients generally experience a better mental HRQoL and a (non-statistically significant) lower symptom burden compared with younger patients. Their physical HRQoL declines more rapidly with increasing symptom burden.

Original languageEnglish
Article numbergfad179
Pages (from-to)436-444
Number of pages9
JournalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Issue number3
Early online date14 Aug 2023
Publication statusPublished - 1 Mar 2024

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