[Health related quality of life (HRQoL) assessment in uremic patients: a qualitative review of concepts, methods, available instruments and results].
The health related quality of life (HRQoL) assessment is a complex and multidimensional concept usually defined as the perception by individuals of the impact of diseases and medical treatments on physical, psychological and social aspects of health and life. HRQoL has become more popular in the last 20 yrs as an important indicator of the effectiveness of the medical care in clinical research protocols, and as part of so-called patient-reported outcomes (PRO), which are concepts concerning aspects of health perceived, reported and rated by study subjects or patients. Generic and disease specific questionnaires are usually used to assess the individual's perceptions about health and life, and more valid and reliable instruments are now available to use in research settings. Instruments that can be useful in daily clinical practice, in the management of the single patient, are not yet available. A large portion of the scientific literature dealing with HRQoL is actually focused on many aspects of uremic syndrome, renal transplantation and dialysis therapies, probably because several reasons make this clinical setting particularly favorable for HRQoL assessment. Early referral to a nephrologist, anemia treatment with epoetin, daily and nocturnal dialysis, kidney transplantation, a program of physical exercise and the treatment of some co-existent conditions and symptoms (i.e. depression, pain, erectile dysfunction and restless leg symptoms) are the most effective ways to ameliorate HRQoL in renal patients. Moreover, HRQoL is a reliable prognostic factor for morbidity and mortality in uremic patients.
Mingardi
G
G
USC di Nefrologia e Dialisi, Azienda Ospedaliera Ospedali Riuniti di Bergamo, Largo Barozzi 1, 24128 Bergamo, Italy. gmingardi@ospedaliriuniti.bergamo.it
Apolone
G
G
D006304:Health Status; D006801:Humans; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014511:Uremia / Q000150:complications / Q000628:therapy