Journal Article

Does ethnicity influence perceived quality of life of patients on dialysis and following renal transplant?

Anne B. Bakewell, Rob M. Higgins and Mair E. Edmunds

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 16, issue 7, pages 1395-1401
Published in print July 2001 | ISSN: 0931-0509
Published online July 2001 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/16.7.1395
Does ethnicity influence perceived quality of life of patients on dialysis and following renal transplant?

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Background. Quality of life (QoL) as perceived by patients with end‐stage renal disease (ESRD) is an important measure of patient outcome. There is a high incidence of ESRD in the Indo‐Asian population in the UK and a lower rate of transplantation compared with white Europeans. The aim of this study was to determine whether perceived quality of life was influenced by treatment modality and ethnicity.

Methods. Sixty Indo‐Asians treated with either peritoneal dialysis (n=20), hospital haemodialysis (n=20) or with a renal transplant (n=20) for >3 months were compared with 60 age‐matched white Europeans closely matched for gender, diabetes and duration of renal replacement therapy. QoL was measured using the Kidney Disease and Quality of Life questionnaire (KDQOL‐SF). The KDQOL‐SF measures four QoL dimensions: physical health (PH), mental health (MH), kidney disease‐targeted issues (KDI) and patient satisfaction (PS). Adequacy of treatment was measured by biochemistry, 24 h urine collection and dialysis kinetics. The number of comorbid conditions was scored. Social deprivation was calculated from the patient's postal address using Townsend scoring.

Results. QoL was significantly lower in Indo‐Asians than white Europeans for PH, MH and KDI. This was not related to treatment adequacy, which was similar in both for each modality. Indo‐Asians had a worse index of social deprivation than white Europeans (P=0.008). PH and KDI were related to social deprivation (P=0.007 and P=0.005, respectively). QoL (except PS) was inversely correlated with comorbidity. Dialysis patients had higher comorbidity than transplant patients (P<0.02). Comparing only those dialysis patients considered fit for transplantation (n=51) with transplant patients, comorbidity was similar, but differences in QoL persisted.

Conclusion. This study demonstrates a lower perceived QoL in Asians compared with white Europeans with ESRD. Analysis of QoL indicates that Asian patients in particular perceive kidney disease as a social burden, even if successfully transplanted.

Keywords: comorbidity; end‐stage renal disease; ethnicity; quality of life; townsend score

Journal Article.  4438 words.  Illustrated.

Subjects: Nephrology

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