title: Low health-related quality of life is associated with all-cause mortality in patients with diabetes on haemodialysis: the Japan Dialysis Outcomes and Practice Pattern Study.
abstract: OBJECTIVE
  Whether health-related quality of life (HRQoL) can be accurately predicted in patients with extremely low HRQoL as a result of diabetic complications is unclear. We investigated the impact of HRQoL on mortality risk in patients with diabetes on haemodialysis.
  
  
  METHODS
  Data from the Dialysis Outcomes Practice Pattern Study (DOPPS) were analysed for randomly selected patients receiving haemodialysis in Japan. Information regarding the diagnosis of diabetes and clinical events during follow-up was abstracted from the medical records at baseline and HRQoL was assessed by a self-reported short form (SF)-36 questionnaire. The association between physical component score and mental component score in the SF-36 and mortality risk was analysed using a Cox proportional hazard model.
  
  
  RESULTS
  Data from 527 patients with diabetes on haemodialysis were analysed. The mortality age-adjusted hazard ratio of having a physical component score greater than or equal to the median was 0.27 [95% confidence interval (CI) 0.08-0.96] and the multivariable-adjusted mortality hazard ratio of having an mental component score greater than or equal to the median was 1.21 (95% CI 0.44-3.35).
  
  
  CONCLUSIONS
  The physical component score derived from the SF-36 is an independent risk factor for mortality in patients with diabetes on haemodialysis who generally had very low HRQoL scores. Baseline mental component score was not predictive of mortality. Patient self-reporting regarding the physical component of health status may aid in risk stratification and clinical decision making for patients with diabetes on haemodialysis.
authors.affiliation: Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine, Kyoto, Japan 606-8501. hayasino-y@umin.net
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashino
authors.forename: S
authors.initials: S
authors.lastname: Fukuhara
authors.forename: T
authors.initials: T
authors.lastname: Akiba
authors.forename: T
authors.initials: T
authors.lastname: Akizawa
authors.forename: Y
authors.initials: Y
authors.lastname: Asano
authors.forename: S
authors.initials: S
authors.lastname: Saito
authors.forename: K
authors.initials: K
authors.lastname: Kurokawa
mesh_terms: D003928:Diabetic Nephropathies / Q000401:mortality*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors; D016019:Survival Analysis