Impact of Dialysis Modalities on HRQoL: A Study on ESKD Patients

The study conducted in Bandung, Indonesia, examined the health-related quality of life (HRQoL) among patients with end-stage kidney disease (ESKD) and concurrent hypertension. These patients were undergoing hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD). Using the EQ-5D-5L as a measuring instrument, the study assessed how these dialysis modalities impact HRQoL over a four-week period, considering socio-demographic, clinical, and treatment-related factors.

Comparative Analysis of Dialysis Modalities

A total of 91 patients participated, with 58 receiving HD and 33 receiving CAPD. The demographic data showed CAPD patients were generally younger and had higher educational attainment than those on HD. Clinically, CAPD patients had a higher comorbidity burden and more frequent rehospitalizations, yet benefitted from more extensive use of multiple antihypertensive medications.

Implications for Treatment and HRQoL

Upon reviewing HRQoL, both HD and CAPD groups revealed similar mean EQ-5D-5L utility scores, indicating stability in reported health status. While EQ-VAS scores suggested modest advantages for CAPD at certain points, these were not statistically significant. The flexibility and self-management potential of CAPD could enhance patients’ psychological well-being, whereas HD offers consistent clinical support but imposes physical and logistical burdens.

Strategic Considerations for Dialysis Decisions

Insurance type and socio-demographic factors influence dialysis modality choice, thereby impacting HRQoL outcomes. The research suggests selecting a dialysis modality should consider broader socioeconomic and comorbidity contexts beyond the direct effects of treatment. Highlighting the need for larger scale investigations, the study seeks to determine best practices in dialysis treatment, particularly concerning HRQoL in complex medical profiles such as hypertensive ESKD patients.