Quality of life in patients undergoing renal replacement therapy.
Rehabilitation can be achieved by renal replacement therapy. The evidence to date would indicate that most successfully transplanted patients achieve rehabilitation both on objective and subjective criteria and in a cost effective manner; however, unsuccessful transplantation has a poor quality of life outcome. Some home dialysis patients achieve the same goals; these two groups comprise predominantly younger patients free of systemic disease. For the high risk group of patients which are predominantly managed by ICHD and CAPD, the objective evidence of rehabilitation is lacking; however, perceived quality of life on subjective measures shows results comparable to a normal population. Comparisons between ICHD and CAPD populations are difficult with different modality related stressors imparting stress to the patients. CAPD has marginal advantage over ICHD. Overall, from these studies, it seems that while successful transplantation imparts the best quality of life on both objective and subjective parameters, the differentiation between ICHD and CAPD is that much more difficult; what evidence there is would suggest that CAPD patients are marginally to moderately better rehabilitated, certainly on subjective parameters. The results in the studies suggest that patients with end-stage renal disease are able to adapt to very adverse life circumstances, nevertheless expressing considerable satisfaction with their lives.
Gokal
R
R
Manchester Royal Infirmary, England, United Kingdom.
D005260:Female; D017048:Health Care Costs; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000534:rehabilitation / Q000628:therapy*; D016030:Kidney Transplantation / Q000523:psychology; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000523:psychology; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology