title: A comparison of self-reported quality of life for an Australian haemodialysis and haemodiafiltration cohort.
abstract: OBJECTIVE
  Haemodiafiltration (HDF) has been widely studied for evidence of superior outcomes in comparison with conventional haemodialysis (HD), and there is increasing interest in determining if HDF confers any benefit in relation to quality of life. Studies have been conducted with randomized incident patients; however, little is known regarding HDF and quality of life for prevalent patients. This study examined and compared self-reported quality of life at two time points, 12 months apart in a cohort of satellite HD and HDF patients, using a disease specific questionnaire to determine if HDF conferred an advantage.
  
  
  METHODS
  A longitudinal study with a linear mixed-effect model measuring quality of life in a cohort of 171 patients (HD, n = 85, HDF, n = 86) in seven South Australian satellite dialysis centres.
  
  
  RESULTS
  Factors associated with significant reduction across the Kidney Disease Quality Of Life™ domains measured were younger age (- 20 to - 29) and comorbid diabetes (- 4.8 to - 11.1). HDF was not associated with moderation of this reduction at either time point (P > 0.05). Baseline physical functioning was reported as very low (median 33.9) and further reduced at time point two. In addition, dialysing for more than 12 h per week in a satellite dialysis unit was associated with reduced quality of life in relation to the burden of kidney disease (- 13.69).
  
  
  CONCLUSIONS
  This study has demonstrated that younger age and comorbid diabetes were responsible for a statistically significant reduction in quality of life, and HDF did not confer any advantage.
authors.affiliation: Renal Unit, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA, Australia.
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Hill
authors.affiliation: Flinders Centre for Epidemiology and Biostatistics, School of Medicine, Flinders University, Bedford Park, SA, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Kim
authors.affiliation: Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Crail
authors.affiliation: Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, Australia.
authors.forename: Tony J
authors.initials: TJ
authors.lastname: Elias
authors.affiliation: Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, Australia.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Whittington
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006304:Health Status; D017583:Hemodiafiltration; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors; D057566:Self Report; D013021:South Australia / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: haemodiafiltration; haemodialysis; ‘chronic kidney disease’; ‘quality of life’