Individual Quality of Life in Chronic Kidney Disease: Influence of Age and Dialysis Modality

Background and objectives: Novel individualized quality-of-life (IQOL) measures permit patients with chronic kidney disease (CKD) to nominate unique areas of their lives that contribute to their well-being. This study assessed for differences in domains nominated by patients with CKD. We also examined the strength of association between (1) multidimensional health-related quality-of-life measures and IQOL and (2) psychosocial factors and IQOL. Design, setting, participants, & measurements: We performed a cross-sectional study of 151 patients who were undergoing peritoneal dialysis or hemodialysis or had stages 4 through 5 CKD. Patients completed the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQOL-DW), an instrument that assesses IQOL on the basis of patient-identified domains. Patients also completed health-related quality-of-life and psychosocial health measures. Results: Patients with CKD nominated many domains on the SEIQOL-DW, but family and health were the most common for all groups. Kidney disease was listed more frequently by peritoneal dialysis compared with hemodialysis patients or patients with CKD (31 versus 14 versus 5%, respectively). There were no significant differences in SEIQOL-DW scores between subgroups. SEIQOL-DW scores correlated with mental well-being and inversely correlated with chronic stress and depression. Conclusions: Patients with advanced CKD demonstrate compromised quality-of-life scores comparable to dialysis patients. IQOL measures provide unique information that may help guide interventions that are better tailored to address patients' concerns about their well-being. These findings also suggest that renal clinics should have staff available to address psychosocial aspects of patient well-being.