In hemodialysis (HD) patients, poor health-related quality of life (HRQoL) is frequent and is associated with adverse outcome. It is well known that HRQoL and nutritional status are strictly linked. HFR is an alternative dialysis technique that reduces inflammation burden and malnutrition but it has never been evaluated the effect on HRQoL.
We designed a cross-sectional multicentre study in order to compare the HRQoL in patients treated with HFR versus BHD. We enrolled patients treated for at least 6 months HFR, with life expectancy greater than six months and without remarkable cognitive deficit. The recruited patients in HFR were matched for age, gender, dialytic vintage and performance in activities of daily living (Barthel index) with BHD treated patients. Demographic, clinical, laboratory and treatment data were collected and SF-36 questionnaire for the assessment of QoL was administered.
One hundred-fourteen patients were enrolled (age 65.4±13.5 years; dialysis vintage 5.4 (3.3-10.3) years; 53%males) from 18 dialysis non-profit centres in central and southern Italy. As result of matching, no difference in age, gender, dialytic age and Barthel index was found between HFR and BHD patients. KTV, hemoglobin and serum albumin were similar between the two treatment groups. In HFR patients we observed higher values of SF-36 physical component score than BHD patients, whereas no significant difference emerged in the mental component score. The following table illustrates the SF-36 results:
HFR (n=57)
BHD (n=57)
P
Physical Component
56±20
48±23
0.048
Mental Component
57±21
55±19
0.698
Physical Functioning
61±26
51±30
0.045
Role Physical
66±47
45±46
0.027
Bodily Pain
63±25
58±31
0.346
General health
40±17
39±19
0.676
Vitality
51±22
48±21
0.492
Social Functioning
64±25
69±20
0.290
Role Emotional
64±40
60±43
0.595
Mental Health
64±24
60±22
0.437
HFR is associated with a better physical component of HRQoL than BHD, independently of age, gender, dialysis vintage and invalidity score.