The important determinants of quality of life in patients on continuous ambulatory peritoneal dialysis

Aim: The aim of this study was to determine the level of health- related quality of life (HRQofL) and the most important factors affecting HRQofL in patients on continuous ambulatory peritoneal dialysis (CAPD).
Method: This cross-sectional study was performed on 156 patients over 18 years of age followed up at Erciyes University CAPD Unit during the last year. HRQofL was measured by means of the Short Form-36. Depression, fatigue and sexual dysfunctions were determined by using  Beck Depression Inventory (BDI) , Fatigue Severity Scale (FSS), and the Arizona Sexual Experiences Scales (ASEX), respectively. In the statistical analysis, samples t test, Mann-Whitney U test, Pearson’s rank correlation coefficients and multiple linear regression analysis were used.

Results: It was found that HRQofL was substantially impaired in CAPD patients. The mental component summary scores  were found to be higher than physical component summary scores. The proportion of patients with depression, fatigue, and sexual dysfunction were 42.3%, 67.3%, 72.1%, respectively. The mean score for BDI was 28.3±8.3, and for FSS was 5.6±6.8. ASEX score was 15.7±6.3 for male patients, and 17.5±8.0 for females. A significant inverse correlation was found between all the SF-36 domain scores and BDI and FSS scores. Depression and fatigue were the most important factors affecting QoL. Depression was associated with lower QoL in both mental (OR:-24.4, (-30.1)-(18.6) and physical (OR:-16.5, (-22.4)-(-10.5) health dimensions, whereas, fatigue was only associated with lower HRQofL in physical health dimension (OR:-7.74, (11.1)-(-4.4).
Conclusion: HRQofL was substantially impaired in our CAPD patients. Depression and fatigue accounted for 37% of the impairment physical health HRQofL. Depression as a sole factor was responsible for 31% of the impairment mental health HRQofL.The physical health HRQofL scores were significantly lower in  patients with sexual dysfunctions.