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Health-related quality of life and all-cause mortality in patients with diabetes on dialysis

Østhus, Tone Britt H; Lippe, Nanna von der; Ribu, Lis; Rustøen, Tone; Leivestad, Torbjørn; Dammen, Toril; Os, Ingrid
Journal article, Peer reviewed
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URI
https://hdl.handle.net/10642/1347
Date
2012
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  • HV - Institutt for sykepleie og helsefremmende arbeid [1576]
Original version
Østhus, T.B.H., Lippe, N.von der, Ribu, L., Rustøen, T., Leivestad, T., Dammen, T., Os, I. (2012). Health-related quality of life and all-cause mortality in patients with diabetes on dialysis. BMC Nephrology, 13(78)   http://dx.doi.org/10.1186/1471-2369-13-78
http://www.biomedcentral.com/1471-2369/13/78
Abstract
Background: This study tests the hypotheses that health-related quality of life (HRQOL) in prevalent dialysis patients with diabetes is lower than in dialysis patients without diabetes, and is at least as poor as diabetic patients with another severe complication, i.e.. foot ulcers. This study also explores the mortality risk associated with diabetes in dialysis patients.

Methods: HRQOL was assessed using the Short Form-36 Health Survey (SF-36), in a cross-sectional study of 301 prevalent dialysis patients (26% with diabetes), and compared with diabetic patients not on dialysis (n = 221), diabetic patients with foot ulcers (n = 127), and a sample of the general population (n = 5903). Mortality risk was assessed using a Kaplan-Meier plot and Cox proportional hazards analysis. Results: Self-assessed vitality, general and mental health, and physical function were significantly lower in dialysis

patients with diabetes than in those without. Vitality (p = 0.011) and general health (p <0.001) was impaired in diabetic patients receiving dialysis compared to diabetic patients with foot ulcers, but other subscales did not differ. Diabetes was a significant predictor for mortality in dialysis patients, with a hazard ratio (HR) of 1.6 (95% CI 1.0-2.5)

after adjustment for age, dialysis vintage and coronary artery disease. Mental aspects of HRQOL were an independent predictor of mortality in diabetic patients receiving dialysis after adjusting for age and dialysis vintage (HR 2.2, 95% CI 1.0-5.0). Conclusions: Physical aspects of HRQOL were perceived very low in dialysis patients with diabetes, and lower than

in other dialysis patients and diabetic patients without dialysis. Mental aspects predicted mortality in dialysis patients with diabetes. Increased awareness and measures to assist physical function impairment may be particularly important in diabetes patients on dialysis
Publisher
BioMed Central
Series
BMC Nephrology;13(78)

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