Differences in health-related quality of life between elderly and younger patients on hemodialysis

BACKGROUND: It has been demonstrated that elderly patients have a great capacity of adaptation to renal replacement therapy (RRT). The aim of this study was to assess the health-related quality of life (HRQoL) of a cohort of patients at 3 and 12 months after the start of hemodialysis, searching for differences between elderly (aged>or=65 years) and younger (aged <65 years) patients. METHODS: This was a longitudinal prospective study of 93 patients starting RRT. HRQoL was assessed using the SF-36 health survey and the physical symptom dimension of the Kidney Disease Questionnaire (KDQ) at 3 and 12 months from the start of RRT. Physical component summary (PCS), mental component summary (MCS) and standardized scores, in which a lower score indicated lower HRQoL, by age and sex were obtained. RESULTS: Mean (SD) age was 66 years (12.26 years). At 3 months, differences between younger patients and elderly ones were statistically significant in the general health dimension, and at 12 months in physical functioning, role physical, general health dimensions and PCS, indicating less loss of HRQoL in elderly patients. At 3 months it was found that the functional state measured on the Karnofsky scale was independently associated with PCS (p=0.003), and hematocrit to MCS (p=0.036). At 1 year, PCS was independently associated with age (p=0.043) and Karnofsky score (p=0.039). CONCLUSIONS: Using scores standardized by age and sex, elderly patients had less loss of HRQoL in the physical aspects, than younger patients at 1 year from the start of hemodialysis.