Women on hemodialysis have lower self-reported health-related quality of life scores but better survival than men.
BACKGROUND
Hemodialysis patients suffer from poor quality of life and survival. A retrospective cohort study was performed to examine the sex differences in self-reported quality of life and mortality in a Taiwanese hemodialysis cohort.


METHODS
A total of 816 stable hemodialysis patients were included. Patients completed two questionnaires: the 36-item Short Form Health Survey Questionnaire (SF-36, Taiwan Standard Version 1.0) to assess health-related quality of life (HRQoL) and the Beck Depression Inventory (BDI, Chinese Version) to assess depressive mood. Mortality outcomes were recorded for a seven-year follow-up period.


RESULTS
After adjustment for confounding factors, women had significantly higher BDI scores (P=.003), lower physical functioning (P<.001), bodily pain (P<.001), mental health (P=0007), and physical component scale (PCS) scores (P<.001). There were 284 deaths recorded. In the Cox-proportional hazard model, women had significantly lower mortality than men (P<.001).


CONCLUSIONS
Women on hemodialysis had more depression-related symptoms and poor self-reported HRQoL, but better survival than men. The sex difference in psychological and HRQoL issues deserves greater concern because this relates to clinical care and further study.
Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Yu-Sen
YS
Peng
Jenq-Wen
JW
Huang
Kuan-Yu
KY
Hung
Bing-Shi
BS
Lin
Chien-Yu
CY
Lin
Chwei-Shiun
CS
Yang
Tzen-Wen
TW
Chen
Ching-Chih
CC
Hsia
Da-Lung
DL
Chen
Wen-Ding
WD
Hsu
Chao-Fu
CF
Chang
Kwan-Dun
KD
Wu
Ru-Ping
RP
Lin
Tun-Jun
TJ
Tsai
Wang-Yu
WY
Chen
D000328:Adult; D000368:Aged; D003863:Depression / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects / Q000401:mortality* / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D057566:Self Report; D012720:Severity of Illness Index; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome