title: Factors associated with health-related quality of life among hemodialysis patients in the DOPPS.
abstract: OBJECTIVE
  To identify modifiable factors associated with health-related quality of life (HRQOL) among chronic hemodialysis patients.
  
  
  METHODS
  Analysis of baseline data of 9,526 hemodialysis patients from seven countries enrolled in phase I of the Dialysis Outcomes and Practice Patterns Study (DOPPS). Using the Kidney Disease Quality of Life Short Form (KDQOL-SF(TM)), we determined scores for 8 generic scale summaries derived from these scales, i.e., the physical component summary [PCS] and mental component summary [MCS], and 11 kidney disease- targeted scales. Regression models were used to adjust for differences in comorbidities and sociodemographic and treatment factors. The Benjamini-Hochberg procedure was used to correct P-values for multiple comparisons.
  
  
  RESULTS
  Unemployment and psychiatric disease were independently and significantly associated with lower scores for all generic and several kidney disease-targeted HRQOL measures. Several other comorbidities, lower educational level, lower income, and hypoalbuminemia were also independently and significantly associated with lower scores of PCS and/or MCS and several generic and kidney disease-targeted scales. Hemodialysis by catheter was associated with significantly lower PCS scores, partially explained by the correlation with covariates.
  
  
  CONCLUSIONS
  Associations of poorer HRQOL with preventable or controllable factors support a greater focus on psychosocial and medical interventions to improve the well-being of hemodialysis patients.
authors.affiliation: Department of Medicine, Federal University of Bahia, Salvador, Brazil.
authors.forename: Antonio Alberto
authors.initials: AA
authors.lastname: Lopes
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Bragg-Gresham
authors.forename: David A
authors.initials: DA
authors.lastname: Goodkin
authors.forename: Shunichi
authors.initials: S
authors.lastname: Fukuhara
authors.forename: Donna L
authors.initials: DL
authors.lastname: Mapes
authors.forename: Eric W
authors.initials: EW
authors.lastname: Young
authors.forename: Brenda W
authors.initials: BW
authors.lastname: Gillespie
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa
authors.forename: Roger N
authors.initials: RN
authors.lastname: Greenwood
authors.forename: Vittorio E
authors.initials: VE
authors.lastname: Andreucci
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiba
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Held
authors.forename: Friedrich K
authors.initials: FK
authors.lastname: Port
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D005060:Europe; D005260:Female; D006801:Humans; D038622:Internationality; D007564:Japan; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology*; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States