title: Health-related quality of life of Asian patients with end-stage renal disease (ESRD) in Singapore.
abstract: BACKGROUND
  This study aimed to identify factors associated with the health-related quality of life (HRQOL) of multiethnic Asian end-stage renal disease (ESRD) patients treated with dialysis. The role of dialysis modality was also explored.
  
  
  METHODS
  Data used in this study were from two cross-sectional surveys of Singaporean ESRD patients on haemodialysis (HD) or peritoneal dialysis (PD). In both surveys, participants were assessed using the kidney disease quality of life (KDQOL) instrument and questions assessing socio-demographic characteristics. Clinical data including co-morbidity (measured by Charlson comorbidity index [CCI]), albumin level, haemoglobin level, and dialysis-related variables (e.g. dialysis vintage and dialysis adequacy) were retrieved from medical records. The 36-item KDQOL (KDQOL-36) was used to generate three summary scores (physical component summary [PCS], mental component summary [MCS] and kidney disease component summary [KDCS]) and two health utility scores (Short Form 6-dimension [SF-6D] and EuroQol 5-dimension [EQ-5D]). Linear regression analysis was performed to examine the association of factors with each of the HRQOL scale scores.
  
  
  RESULTS
  Five hundred and two patients were included in the study (mean age 57.1 years; male 52.4 %; HD 236, PD 266). Mean [standard deviation (SD)] PCS, MCS and KDCS scores were 37.9 (9.7), 46.4 (10.8) and 57.6 (18.1), respectively. Mean (SD) health utility score was 0.66 (0.12) for SF-6D and 0.60 (0.21) for EQ-5D. In multivariate regression analysis, factors found to be significantly associated with better HRQOL included: young (<45 years) or old age (>60 years), low CCI (<5), high albumin (≥37 g/l) and high haemoglobin (≥11 g/dl) with PCS; long dialysis vintage (≥3.5 years) with MCS; old age, Malay ethnicity and PD modality with KDCS; low CCI, high albumin and high haemoglobin with EQ-5D and high albumin with SF-6D.
  
  
  CONCLUSIONS
  Clinical characteristics are better predictors of HRQOL in ESRD patients than socio-demographics in Singapore. Dialysis modality has no impact on the health utility of those patients.
authors: Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, Singapore, 117549, Singapore.
authors: F
authors: F
authors: Yang
authors: K
authors: K
authors: Griva
authors: T
authors: T
authors: Lau
authors: A
authors: A
authors: Vathsala
authors: E
authors: E
authors: Lee
authors: H J
authors: HJ
authors: Ng
authors: N
authors: N
authors: Mooppil
authors: M
authors: M
authors: Foo
authors: S P
authors: SP
authors: Newman
authors: K S
authors: KS
authors: Chia
authors: N
authors: N
authors: Luo
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis / Q000523:psychology*; D012846:Singapore