Type of vascular access and location in online hemodiafiltration and its association with patient's perception of health-related quality of life

Alexandra Moura, José Madureira, Pablo Alija, João Carlos Fernandes, José Gerardo Oliveira, Martin Lopez, Madalena Filgueiras, Leonilde Amado, Maria Sameiro-Faria, Vasco Miranda, Margarida Vieira, Alice Santos-Silva, Elísio Costa*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Purpose: The aim of this work is to evaluate the patient-reported health-related quality of life (HRQOL), according to the type and location of vascular access used for dialysis procedure. Methods: In this transversal study, 322 end-stage renal disease (ESRD) patients under online hemodiafiltration (OL-HDF, 59.63% males; 64.9±14.3 years) were enrolled. Arteriovenous fistula (AVF) was used by 252 patients (78.3%), whereas 70 patients (21.7%) had a central venous catheter (CVC). Besides AVF location, data on comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected. Moreover, the patients' reported HRQOL score, using the Kidney Disease Quality of Life-Short Form, was evaluated. Results: ESRD patients using CVC as vascular access presented a decrease in four SF-36 domain scores, namely physical functioning, emotional well-being, role-emotional and energy/fatigue when compared with those using AVF as vascular access. Additionally, these patients also showed significant differences in ESRD target areas, namely decline in cognitive function and quality of social interaction domains. When comparing the variables according to the localization of the AVF, significant differences were found in three SF-36 domain scores, namely physical functioning, pain and general health. Moreover, we also found significant differences in ESRD target areas, namely symptoms/problem list, effects of kidney disease and quality of social interaction domains. Conclusions: Our results showed that ESRD patients under OL-HDF using AVF as vascular access had higher HRQOL scores in several domains when compared with those using CVC. Additionally, we also found that dialysis patients using AVF in the left forearm presented with higher HRQOL scores.
Original languageEnglish
Pages (from-to)175-182
Number of pages8
JournalJournal of Vascular Access
Volume15
Issue number3
DOIs
Publication statusPublished - 2014

Keywords

  • Health-related quality of life
  • Online hemodiafiltration
  • Vascular access

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