Factors associated with health-related quality of life among hemodialysis patients in the DOPPS.
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.
Lopes
Antonio Alberto
AA
Department of Medicine, Federal University of Bahia, Salvador, Brazil.
Bragg-Gresham
Jennifer L
JL
Goodkin
David A
DA
Fukuhara
Shunichi
S
Mapes
Donna L
DL
Young
Eric W
EW
Gillespie
Brenda W
BW
Akizawa
Tadao
T
Greenwood
Roger N
RN
Andreucci
Vittorio E
VE
Akiba
Takashi
T
Held
Philip J
PJ
Port
Friedrich K
FK
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