Quality of life and associated factors in patients with chronic kidney disease on hemodialysis

Fukushima, Raiana Lídice Mor; Menezes, Ana Laura Costa; Inouye, Keika; Pavarini, Sofia Cristina Iost; Orlandi, Fabiana de Souza

doi:10.1590/1982-0194201600072

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Acta Paulista de Enfermagem

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Original Article • Acta Paul Enferm. 29 (5) • Nov-Dec 2016 • https://doi.org/10.1590/1982-0194201600072 copy

Quality of life and associated factors in patients with chronic kidney disease on hemodialysis

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To identify sociodemographic and clinical factors associated with health-related quality of life of patients with chronic kidney disease on hemodialysis.

Methods:

This was a descriptive, cross-sectional, quantitative study conducted with 101 patients with chronic kidney disease on hemodialysis. An instrument for subject characteristics, and the Kidney Disease and Quality of Life - Short Form were used. For multivariate analysis, logistic regression with Stepwise selection criteria variables was used.

Results:

The sociodemographic and clinical factors found to be associated with a better health-related quality of life were: male gender, younger age, black skin color, having a partner, higher education, practicing a religion, high serum levels of albumin and hematocrit.

Conclusion:

These factors are important for the improvement of care in patients with chronic kidney disease who are on hemodialysis.

Keywords
Renal insufficiency; chronic; Renal dialysis; Quality of life; Geriatric nursing

Variables		SPro	QoSI	SeF	SI	SS	PhyF	Pain	GH	EF	SF	EF	PhyB	MeB
Sex
	Male	78.53	82.90	89.13	66.88	90.34	49.06	73.91	51.81	81.16	53.07	63.84	37.08	49.53
	Female	70.83	83.12	69.94	66.41	84.90	41.56	58.83	44.06	60.42	51.95	53.28	34.71	45.15
	p-value ^* * Mann-Whitney test	0.041	0.997	0.020	0.933	0.065	0.230	0.030	0.029	0.008	0.413	0.005	0.324	0.026
Ethnicity
	White/mixed	75.93	81.81	81.77	63.98	87.65	46.60	67.53	48.52	75.72	53.24	60.06	36.06	47.83
	Black	76.77	87.67	95.83	77.88	92.50	47.00	75.63	52.75	70.00	64.38	62.45	37.41	49.43
	p-value ^* * Mann-Whitney test	0.743	0.138	0.094	0.001	0.392	0.824	0.466	0.262	0.468	0.086	0.647	0.517	0.615
Marital status
	With partner	77.19	82.78	79.17	67.88	91.67	47.17	71.42	51.00	77.78	56.25	61.08	36.78	48.85
	Without partner	74.49	83.25	97.22	65.06	84.15	45.98	65.79	46.95	69.92	54.27	59.63	35.67	47.12
	p-value ^* * Mann-Whitney test	0.467	0.977	0.024	0.312	0.051	0.838	0.390	0.223	0.592	0.693	0.934	0.663	0.266
Level of education
	IEE	67.21	82.72	75.00	65.28	87.65	32.78	55.46	45.00	67.90	41.20	54.44	32.74	46.38
	CEE or more	79.34	83.06	86.98	67.26	88.96	51.76	74.12	50.95	77.03	60.64	62.70	37.63	48.79
	p-value ^* * Mann-Whitney test	0.001	0.913	0.181	0.559	0.458	0.006	0.008	0.132	0.278	<0.001	0.037	0.022	0.133
Religion
	Practicing	76.37	84.82	80.98	67.70	89.04	46.32	66.74	51.12	75.88	57.40	60.72	36. 67	48.49
	Non-practicing	76.56	78.06	94.43	65.21	87.50	49.58	76.77	44.58	69.44	50.52	60. 63	35.77	46.92
	p-value ^* * Mann-Whitney test	0.613	0.002	0.097	0.639	0.880	0.630	0.121	0.121	0.755	0.230	0.884	0.513	0.578

Domains		Age	Income^* * 94 subjects reported income; HD- Hemodialysis;	Time on HD	Hematocrit	Albumin
Burden of kidney disease
	rho	−0.048	0.201	0.041	0.126	−0.031
	p-value	0. 631	0.042	0. 684	0.211	0.760
Work status
	rho	0.403	0.132	0.088	−0.035	−0.085
	p-value	<.0001	0.205	0.384	0.725	0.399
Cognitive function
	rho	−0.226	−0.001	0.103	0.069	0.147
	p-value	0.008	0.990	0.306	0.492	0.144
Sexual function^ 30 subjects answered the question relating to sexual function, and of these, only 26 reported income; applied test: Spearman correlation test
	rho	−0.404	−0.066	0.156	0.040	0.183
	p-value	0.027	0.749	0.411	0.833	0.333
Sleep
	rho	−0.161	−0.214	−0.028	−0.126	−0.068
	p-value	0.108	0.039	0.779	0.208	0.499
Physical functioning
	rho	−0.513	0.052	−0.062	0.154	0.215
	p-value	<.0001	0. 619	0.540	0.125	0.030
Social function
	rho	−0.215	−0.061	0.030	0.040	−0.068
	p-value	0.031	0.557	0.767	0. 690	0.500
Energy/fatigue
	rho	−0.142	0.219	−0.086	0.084	0.041
	p-value	0.157	0.034	0.395	0.402	0. 681
Physical behavior
	rho	−0.304	0.042	0.109	0.128	0.028
	p-value	0.002	0. 688	0.276	0.200	0.783

Domains of KDQOL-SF	Selected variable	Categories	p-value	OR^* * OR - Odds Ratio - risk ratios for lowest score; CI 95%;	CI 95% OR^ O.R. - 95% confidence interval for risk ratio. Stepwise selection criterion variables Ref.: level of reference
Symptoms/Problems	Education	Over IEE (ref.)	–	1.00	–
		Up to IEE	0.006	4.66	1.56 - 13.90
Work status	Age	continuous variable	<0.001	0.903	0.863 - 0.946
Cognitive function	Age	continuous variable	0.023	1.038	1.005 - 1.072
Quality of social interaction	Religion	Practicing(ref.)	–	1.00	–
		no Practicing	0.003	7.29	1.98 - 26.87
Sexual function	Ethnicity	Black (ref.)	–	1.00	–
		White/mixed	0.015	17.47	1.01 - 357.84
Sleep	Ethnicity	Black (ref.)	–	1.00	–
		White/mixed	0.030	3.49	1.13 - 10.80
Social support	Marital status	With partner (ref.)	–	1.00	–
		Without partner	0.038	2.55	1.05 - 6.18
Dialysis staff encouragement	Hematocrit	continuous variable	0.013	0.855	0.755 - 0.968
Physical functioning	Age	continuous variable	<0.001	1.099	1.051 - 1.149
Pain	Education	Over IEE (ref.)	–	1.00	–
		Up to IEE	0.004	4.67	1.65 - 13.24
Emotional Well-being	Ethnicity	Black (ref.)	–	1.00	–
		White/Mixed	0.042	3.93	1.05 - 14.72
Social function	Education	Over IEE (ref.)	–	1.00	–
		Up to IEE	0.005	4.27	1.56 - 11.71
Energy/fatigue	Sex	Male (ref.)	–	1.00	–
		Female	0.030	2.74	1.10 - 6.80
Physical functioning	Age	continuous variable	0.043	1.033	1.001 - 1.065

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[1] Corresponding author Fabiana de Souza Orlandi Highway Washington Luis, km 235, 13565-905, São Carlos, SP, Brazil. fabi_ferreira@yahoo.com.br