Interpretation of health-related quality of life (HRQOL) results of patients on renal replacement therapy (RRT)

Statement: Older age is associated with a worse Healt-Related Quality of Life (HRQOL) in patients with End-Stage Renal Disease (ESRD). The aim of this study is to demonstrate that differences on HRQOL between two groups of patients, defined according to age (< 65 years and <greater than or equal to> 65 years or elderly), change according to the form in which the results are analysed. Methods: We evaluated the HRQOL of 170 patients undergoing hemodialysis and 210 transplant patients from Asturias (Spain), using the SF-36 Health Survey. Sociodemographic and clinical data, Karnofsky Scale and a Comorbidity Index were also collected. The raw scores of the SF-36 and the standardised scores according to age and gender were employed. Results: The majority of elderly patients on hemodialysis lived alone, constituted a smaller percentage on the transplant waiting list, had a lower serum albumin and lower score of the Karnofsky Scale, than patients under 65 years. No differences were found in transplant patients. The raw scores on the SF-36 were less for the elderly patients on hemodialysis and transplant. The raw scores for elderly undergoing hemodialysis were less than those obtained by the general population, and raw scores for elderly transplant patients were similar or slightly greater The standardized scores of the SF-36 were greater for the elderly in both treatment groups. Conclusions: Important differences exist in the evaluation of HRQOL differences between the two groups of age according to the method of analysing the results. The HRQOL of elderly patients is better than that of patients under 65 years of age.