title: Health-related quality of life, depression and mortality in peritoneal dialysis patients in Turkey: seven-year experience of a center.
abstract: BACKGROUND
  Impairment of health-related quality of life (HRQoL) and being in a depressive mood were found to be associated with increased mortality in peritoneal dialysis (PD) patients. We aimed to investigate the association between HRQoL, depression, other factors and mortality in PD patients.
  
  
  METHODS
  Totally 171 PD patients were included and followed for 7 years in this prospective study.
  
  
  RESULTS
  Of 171 PD patients, 45 (26.3%) deceased, 18 (10.5%) maintained on PD, 87 (50.9%) shifted to hemodialysis (HD) and 21 (12.3%) underwent transplantation. The most common cause of death was cardiovascular disease (32, 71.1%) followed by infection (6, 13.3%), cerebrovascular accident (5, 11.2%). The etiology of patients who shifted to HD was PD failure (41, 47.1%), peritonitis (33, 37.9%), leakage (6, 6.9%), catheter dysfunction (3, 3.4%), self willingness (4, 4.6%). Non-survivors were older than survivors (56.6 ± 15.0 vs. 43.6 ± 14.6, p = 0.003). There were also statistically significant difference in terms of albumin, residual urine, presence of diabetes and co-morbidity. When the groups were compared regarding HRQoL scores, non-survivors had lower physical functioning (p < 0.001), role-physical (p = 0.0045), general health (p = 0.004), role-emotional (p = 0.011), physical component scale (PCS) (p = 0.004), mental component scale (MCS) (p = 0.029). Age, presence of residual urine, diabetes, albumin, PCS and MCS were entered in regression analysis. Decrease of 1 g/dL of albumin and being diabetic were found to be the independent predictors of mortality.
  
  
  CONCLUSIONS
  Diabetes and hypoalbuminemia but not HRQOL scores were associated with higher mortality in PD patients after 7 years of following period.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Erzincan University Mengucek Gazi Training and Research Hospital , Erzincan , Turkey .
authors.forename: Kultigin
authors.initials: K
authors.lastname: Turkmen
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Guney
authors.forename: Raziye
authors.initials: R
authors.lastname: Yazici
authors.forename: Sevket
authors.initials: S
authors.lastname: Arslan
authors.forename: Lutfullah
authors.initials: L
authors.lastname: Altintepe
authors.forename: Mehdi
authors.initials: M
authors.lastname: Yeksan
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000401:mortality; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D014421:Turkey / Q000453:epidemiology
keywords: Depression; diabetes; health-related quality of life; hypoalbuminemia; mortality; peritoneal dialysis