title: Comparison of quality of life between hemodialysis patients waiting and not waiting for kidney transplant from a poor region of Brazil.
abstract: BACKGROUND
  There are few data about the quality of life (QOL) level among patients undergoing hemodialysis (HD) and not eligible for kidney transplant.
  
  
  OBJECTIVE
  The QOL level was compared between HD patients waiting and not waiting for kidney transplant.
  
  
  METHODS
  We included 161 end-stage renal disease patients undergoing HD, during April, 2009. All patients were older than 18 years old, had been on HD at least three months, and had no previous transplantation. To measure QOL, the SF-36 was used. We also collected data about death and transplants in the 12 months after April, 2009. QOL scores were compared by analysis of variance with covariates.
  
  
  RESULTS
  Patients not awaiting transplantation were older (53.7 versus 36.3 years old; p < 0.001), more often had diabetes (15.8 versus 4.7%; p = 0.032) and hypertension (35.5 versus 12.9%; p < 0.001), and had no lupus (0 versus 4.7%; p = 0.001). They also presented lower creatinine levels (11.5 versus 13.5 mg/dL; p = 0.001) and were submitted to a lower dose of dialysis, estimated by Kt/V (1.6 versus 2.0; p = 0.026). Patients not awaiting transplant died more often in the following 12 months (21.1 versus 5.9%; p = 0.005). Adjusted mean scores were lower among patients not awaiting transplant regarding six dimensions of QOL: functional capacity (42.0 versus 53.4; p = 0.022), physical limitation (29.9 versus 49.2; p = 0.030); pain (45.0 versus 64.0; p = 0.003), social aspects (56.3 versus 75.9; p = 0.003), emotional aspects (45.1 versus 79.0; p = 0.001), and mental health (50.1 versus 64.3; p = 0.004).
  
  
  CONCLUSIONS
  Patients undergoing HD and not awaiting transplant are at risk of poor QOL level, mainly regarding role-emotional and role-physical aspects. We recommend psychological approaches and physical rehabilitation for this group of patients.
authors.affiliation: Nephrology and Urology Sector, Faculty of Medicine of Sobral, Federal University of Ceará. prsantos@fortalnet. com.br
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Santos
mesh_terms: D000328:Adult; D001938:Brazil; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011788:Quality of Life; D006435:Renal Dialysis; D014850:Waiting Lists