To assess the quality of life in patients with chronic kidney disease undergoing hemodialysis at a satellite clinic, comparing patients from a median low-income household with patients from median middle- and upper-income households: cross-sectional study
Abstract Background: Chronic kidney disease is a financial challenge for global public health due to rising costs, a poorer quality of life. Globally, there has been an increase in the number of diabetic, hypertensive and obese patients, with a tendency to rise as life expectancy increases. Objective: To assess the quality of life of patients with chronic kidney disease on hemodialysis at a satellite clinic in Recife, Northeast Brazil, and comparing low-income patients funded by the national healthcare system with middle- and higher-income patients funded by private health insurance. Methods: The Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36) was applied, together with a complementary interview with socio-demographic data for all patients at a conventional hemodialysis clinic. All patients were submitted to the same hemodialysis protocol, 4 hours and 10 minutes, high flow biocompatible membranes with high mass transfer coefficient and an adequacy of Kt/V ≥1.2. Results: The poorest quality of life scores with the SF-36 were related to physical functioning and pain. The best scores were attributed to mental health, social functioning, general health and vitality with no differences between the household incomes. There was a positive association between education, role-emotional and physical functioning. Longer hemodialysis treatment times demonstrated a positive association with aspects of general health. Patients who had undergone hemodialysis between one and five years presented better quality of life scores with the SF-36. Conclusions: Hemodialysis treatment negatively influences the quality of life of patients with chronic kidney disease. Education seems to help patients to better understand and accept treatment, by raising the scores of the physical functioning and role-physical. The first year of hemodialysis seems to exert a more negative influence on the quality of life. Among all patients, pain and physical aspects seem to be the critical points, regardless of social class or income.