Comparison of quality of life in end‐stage renal disease patients undergoing hemodialysis and peritoneal dialysis in a Moroccan city

Abstract : Introduction: Peritoneal dialysis (PD) is as effective as hemodialysis and often provides a better quality of life for patients. Despite this, the replacement therapy remains little established in our country with a prevalence of less than 1% of patients with end-stage renal disease. The objective of this work is to report the development and complications of PD in our center. Patients and methods: This is a retrospective study including all patients on PD between October 2008 and March 2019. We noted their demographic and clinical data at their initiation in peritoneal dialysis and we followed their evolution to discuss infectious and mechanical complications as well as the causes of PD exit. Results: During the study period, 456 patients were admitted for end-stage renal disease. Among these patients, only 28 (6.1%) were put on PD including two diabetics. Their average age was 37.7 years with a sex ratio of 0.8. The average body surface area was 1.59 m² with an average residual renal function of 6.05 ml / min. PD was chosen as the first intention in 20 patients while 8 patients were on hemodialysis. The evolution was marked by a median survival of the technique of 18.5 months characterized by 8 episodes of peritonitis in 4 patients corresponding to a rate of 1 episode over 56 months. Regarding mechanical complications, we noted 9 omentum aspirations, 1 leak in one case and 1 umbilical hernia requiring surgical recovery in a patient. Out of 28 patients, 17 discharges were identified; 10 patients (67%) were transferred to hemodialysis, 4 died and only 3 patients (18%) were transplanted. The final transfer to hemodialysis was related to mechanical complications in 5 cases, loss of ultrafiltration in one case, repeated hydro-sodium overload in one case, peritonitis in one case and social reasons in two cases. Conclusion: PD is an effective technique which preserves residual renal function and quality of life but its prevalence remains low in the order of 6% of patients treated for end-stage renal disease. The complications are dominated in our context by the mechanical complications main cause of final transfer in hemodialysis.

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Age-related differences in the quality of life in end-stage renal disease in patients enrolled in hemodialysis or continuous peritoneal dialysis

Medical Science Monitor ◽

10.12659/msm.883916 ◽

2013 ◽

Vol 19 ◽

pp. 378-385 ◽

Cited By ~ 24

Author(s):

Stanislaw Niemczyk

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Renal Disease ◽

End Stage Renal Disease ◽

Age Related ◽

Continuous Peritoneal Dialysis ◽

Stage Renal Disease ◽

End Stage

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Chronic Peritoneal Dialysis in the Elderly: A Review

Peritoneal Dialysis International ◽

10.1177/089686080002000302 ◽

2000 ◽

Vol 20 (3) ◽

pp. 276-283 ◽

Cited By ~ 21

Author(s):

Nada Dimkovic ◽

Dimitrios G. Oreopoulos

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Elderly Patients ◽

Renal Disease ◽

Family Support ◽

End Stage Renal Disease ◽

Good Control ◽

Stage Renal Disease ◽

End Stage

During the past few decades, the pattern of end-stage renal disease has changed significantly with the emerging predominance of elderly patients. Because this heterogeneous population is characterized by a physiological decline in function of all organs, the nephrologist must contemplate the special needs of individual patients when they develop end-stage renal disease. Before the initiation of dialysis, these patients must be given detailed information to help them select the particular mode that will maximize their quality of life. According to available data, peritoneal dialysis offers some advantages for elderly patients, such as hemodynamic stability, steady-state metabolic control, good control of hypertension, independence from hospital, and avoidance of repeated vascular access. Early referral promotes the establishment of peritoneal access and minimizes the consequences of uremia, subsequent morbidity, and frequent hospitalization. Elderly patients are compliant and highly motivated to cooperate with their treatment. They have no higher modality-related complications than younger patients and their quality of life is satisfactory. Although most have comorbid conditions that interfere with self-performance of dialysis, such as impaired vision and reduced physical and mental activity, they can perform peritoneal dialysis successfully if they have a high level of family support. Patients who do not have family support may have successful peritoneal dialysis if they have access to a network of medical and social support, that is, private home nurses, rehabilitation and chronic care dialysis units, or nursing homes.

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Predictors of Quality of Life among Peritoneal Dialysis Patients with End-Stage Renal Disease in Kuwait

Peritoneal Dialysis International ◽

10.3747/pdi.2018.00140 ◽

2019 ◽

Vol 39 (2) ◽

pp. 180-182

Author(s):

Boubakari Ibrahimou ◽

Ahmed N. Albatineh

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Renal Disease ◽

End Stage Renal Disease ◽

Living Alone ◽

Daily Dialysis ◽

Stage Renal Disease ◽

End Stage ◽

At Home

Quality of life (QOL) is an important indicator of quality of healthcare. Measuring QOL and its correlates for peritoneal dialysis (PD) patients is important for public health policy, intervention, and clinical decision-making. Data from 62 patients treated at 6 dialysis centers were collected using short form (SF)-36. Multiple linear regression was used to assess the relationship between QOL and several covariates. Results indicated most patients were ≥ 60 years old (51.6%), retired (40.3%), diagnosed with end-stage renal disease (ESRD) > 1 year (82.3%), with diabetes as primary cause of ESRD (38.7%), and performing daily dialysis (77.4%). After adjustment of covariates, males (P = 19.03, p = 0.0001) scored on average 19.03 higher on QOL than females. Patients 41 - 60 years (P = 11.4, p = 0.018) scored on average 11.4 higher than those ≥ 60 years. Kuwaitis (P = -9.61, p = 0.057) scored on average 9.61 lower than non-Kuwaitis. Patients living with family/others (P = 13.02, p = 0.076) scored on average 13.02 higher than those living alone. Patients satisfied with their dialysis (P = 28.37, p = 0.001) scored on average 28.37 higher than non-satisfied patients. Performing dialysis at home (P = -15.52, p = 0.006) resulted in an average decrease of 15.52 in QOL compared with those in dialysis centers. Finally, patients with diabetes as the primary cause of ESRD (P = -9.8, p = 0.047) saw an average 9.8 decrease in QOL compared with patients with other ESRD causes. Gender, age, nationality, living status, satisfaction and place of dialysis, and causes of ESRD are independent predictors of QOL. Healthcare providers should pay more attention to females, those living alone, and those older than 60 years. Patients performing PD at home should have assistance from a nurse or health practitioner.

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