Changes in quality of life over time--Dutch haemodialysis patients and general population compared.
BACKGROUND
Improving the health-related quality of life (HRQOL) for haemodialysis patients is a considerable challenge. The aim of the present study was to compare changes in HRQOL in haemodialysis patients with those observed in the general population over a 10-year period and explore factors that might explain possible differences.


METHODS
We compared 126 haemodialysis patients assessed in 1995 in the Netherlands Cooperative Study on the Adequacy of Dialysis-1 (NECOSAD-I) with 515 patients enrolled in 2006 in the ongoing Convective Transport Study (CONTRAST). Changes in HRQOL in these cohorts were compared with two representative samples from the general Dutch population, assessed in 1992 (n = 1,063) and 2001 (n = 10,600). HRQOL was measured with the SF-36 questionnaire. Differences in HRQOL were analysed with ANCOVA to adjust for demographic variables. To assess possible differences, we used multivariable regression analysis.


RESULTS
HRQOL in haemodialysis patients in 2006 [CONTRAST, mean age 63 ± 14 years (SD), 62% male] was significantly better than in 1995 (NECOSAD-I, 59 ± 16 years, 53% male) in four domains of the SF-36: bodily pain (+ 5 points, P = 0.009), vitality (+ 7, P < 0.001), role-emotional (+ 14, P < 0.001) and mental health (+ 8, P < 0.001), after adjusting for demographic variables. This increment could partly be explained by improved haemoglobin and phosphate levels. Compared to the general population, HRQOL improvement was most outspoken in two domains: bodily pain (+ 6, P = 0.01) and role-emotional (+ 8, P = 0.007).


CONCLUSIONS
This study showed an improvement of HRQOL in haemodialysis patients over an 11-year period of time, independent of global changes in the general population.
Department of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands.
Albert H A
AH
Mazairac
G Ardine
GA
de Wit
E Lars
EL
Penne
Neelke C
NC
van der Weerd
Boudewijn
B
de Jong
Muriel P C
MP
Grooteman
Marinus A
MA
van den Dorpel
Erik
E
Buskens
Friedo W
FW
Dekker
Menso J
MJ
Nubé
Piet M
PM
Ter Wee
Els W
EW
Boeschoten
Michiel L
ML
Bots
Peter J
PJ
Blankestijn
D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D011788:Quality of Life; D006435:Renal Dialysis; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013997:Time Factors