Health-related quality of life and symptom burden in patients on haemodialysis
Mathijs van Oevelen, Anna A. Bonenkamp, Anita van Eck van der Sluijs, Willem Jan W. Bos, Caroline E. Douma, Marjolijn van Buren, Yvette Meuleman, Friedo W. Dekker, Brigit C. van Jaarsveld, Alferso C Abrahams, the DOMESTICO study group, Alferso C Abrahams, Marianne C. Verhaar, B C van Jaarsveld, Friedo W. Dekker, Frans J. van Ittersum, W Konij, M H Hemmelder, Marc A G J ten Dam, Anita van Eck van der Sluijs, Esmee Driehuis, Anna A. Bonenkamp, Thomas Sebastiaan van Lieshout, A. J. Roeterdink, Paul Leurs, S. Mechiel Korte, Jeroen B. van der Net, A M Schrander-van der Meer, Trijntje T. Cnossen, B C van Jaarsveld, G. Fenna van Breda, An S. De Vriese, J. P. Lips, Harmen Krepel, Marc A G J ten Dam, Constantijn Konings, Anita van Eck van der Sluijs, Andrea Lips, Akin Özyilmaz, Aegida Neradová, F. T. J. Boereboom, Sadie van Esch, Christopher Susanto, Ewout J. Hoorn, David Severs, Arnold H. Boonstra, Robert W. Nette, Martine A M Verhoeven, Yolande M. Vermeeren, Daphne H.T. IJpelaar, Nienke Hommes, Marjolijn van Buren, Julia M. Hofstra, Kwok-Wai Mui, S. Heleen Binnenmars, Sabine H.A. Diepeveen, Ellen K. Hoogeveen, T. Cornelis, Siska Boorsma, Joris I. Rotmans, Adriaan M. van Alphen, Elisabeth J R Litjens, M H Hemmelder, W. M. T. Janssen, Arjan Kuijper, Charles Beerenhout, Louwine Bierma, Aaltje Y Adema, Renate M. J. Wijering, Wolfgang Rüger, R J Bosma, E. Lars Penne, C. W. H. de Fijter, Harald F. H. Brulez, Henk W. van Hamersvelt, Wilbert A. G. van der Meijden, S Huisman, Jacobien C. Verhave, Gijs van Kempen, Henny Klein, C. E. Douma, Willem Jan W. Bos, Jaapjan D. Snoep, J. Mulder, Casper Franssen, Alferso C Abrahams, Karlien François, Antinus J. Luik, Robert J. Klaassen, A. van Tellingen, M. M. G. Dekker, Anne G. Weenink, Mariëlle Krekels
Abstract
BACKGROUND: Patients on haemodialysis (HD) generally experience poor health-related quality of life (HRQoL) and a broad range of physical and mental symptoms, but it is unknown whether this differs between younger and older patients. We aimed to describe the trajectories of HRQoL and symptom burden of patients <70 and ≥70 years old and to assess the impact of symptom burden on HRQoL. METHODS: In incident Dutch HD patients, HRQoL and symptoms were measured with the 12-item Short Form Health Survey and Dialysis Symptom Index. We used linear mixed models for examining the trajectories of HRQoL and symptom burden during the first year of dialysis and linear regression for the impact of symptom burden on HRQoL. RESULTS: In 774 patients, the trajectories of physical HRQoL, mental HRQoL and symptom burden were stable during the first year of dialysis. Compared with patients <70 years of age, patients ≥70 years reported similar physical HRQoL {mean difference -0.61 [95% confidence interval (CI) -1.86-0.63]}, better mental HRQoL [1.77 (95% CI 0.54-3.01)] and lower symptom burden [-2.38 (95% CI -5.08-0.32)]. With increasing symptom burden, physical HRQoL declined more in older than in younger patients (β = -0.287 versus -0.189, respectively; P-value for interaction = .007). For mental HRQoL, this decrease was similar in both age groups (β = -0.295 versus -0.288, P = .847). CONCLUSION: Older HD patients generally experience a better mental HRQoL and a (non-statistically significant) lower symptom burden compared with younger patients. Their physical HRQoL declines more rapidly with increasing symptom burden.