Avaliação da qualidade de vida e fatores associatdos na doença renal crônica em hemodiálise diária versustratamento conservador

Abstract

Introduction: Chronic Kidney Disease (CKD) is recognized as an epidemic and a significant public health issue. Hemodialysis directly impacts patients’ quality of life due to changes in daily routines, physical limitations, and dietary restrictions. Understanding kidney disease and its effects on conservative treatment as well as hemodialysis is crucial to identify potential deficits and promote comprehensive health care strategies. Objective: This study aims to evaluate the quality of life and associated factors of people with chronic kidney disease undergoing daily hemodialysis compared to those receiving conservative treatment. Method: This is an observational, quantitative, analytical, and cross-sectional study. Two control groups were formed, each consisting of 200 participants of both sexes: 100 patients with kidney disease undergoing daily hemodialysis and 100 patients receiving outpatient conservative treatment. Results: The median age of the participants was 41.5 years (range: 31.0-52.0), with a predominance of females (60% or 120 individuals). The daily hemodialysis group had a higher median age of 47.0 years (range: 32.0-68.0) compared to the conservative treatment group, which had a median age of 35.0 years (range: 29.0-48.0), with a significant difference (p < 0.001). The prevalence of systemic arterial hypertension was higher in the hemodialysis group (95%) than in the conservative treatment group (69%), which was also statistically significant (p < 0.001). Additionally, the diagnosis of heart failure was more common in the hemodialysis group (16%) compared to the conservative treatment group (6%), with a significant difference (p = 0.024). In terms of quality of life, the hemodialysis group had lower physical composite scores on the SF-12 assessed by KDQOL-SF™ compared to the conservative treatment group (34.6 vs. 54.2, p < 0.001). Similarly, the mental composite scores were also lower in the hemodialysis group (43.4) compared to the conservative group (49.5, p < 0.001). The multivariate analysis revealed that patients on hemodialysis had a significantly higher risk of obtaining a mental composite score of less than 50 compared to those on conservative treatment (Odds Ratio [OR] 4.617, 95% Confidence Interval [CI] 2.089-10.204, p < 0.001). Furthermore, there was a higher risk of obtaining a physical composite score of less than 43 for individuals on hemodialysis compared to those receiving conservative treatment (OR 6,804.26; 95% CI 245.24-188,016.26, p < 0.001). Conclusion: Hemodialysis negatively impacts the quality of life, both physically and mentally. These findings offer valuable insights that can be used to promote overall health and devise strategies to enhance the quality of life for individuals with chronic kidney disease.