Health related quality of life among haemodialysis and kidney transplant recipients from Nepal: a cross sectional study
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RESEARCH ARTICLE
Open Access
Health related quality of life among haemodialysis and kidney transplant recipients from Nepal: a cross sectional study using WHOQOL-BREF Kamal Ranabhat1,2, Pratik Khanal2* , Shiva Raj Mishra3, Anu Khanal2, Sangita Tripathi2 and Mahesh Raj Sigdel2
Abstract Background: Very less is known about health-related quality of life (HRQOL) among patients with kidney diseases in Nepal. This study examined HRQOL among haemodialysis and kidney transplant recipients in Nepal. Methods: The Nepali version of World Health Organization Quality of Life Instruments -(WHOQOL-BREF) questionnaire was administered using face to face interviews among end stage renal disease (ESRD) patients, from two large national referral centers in Nepal. The differences in socio-demographic characteristics among ESRD patients were examined using the Chi-square test. The group differences in quality of life (QOL) were examined using the Mann-Whitney U test and Kruskal-Wallis tests. Results: Of the 161 participants, 92 (57.1%) were renal transplant recipients and 69 (42.9%) patients were on maintenance haemodialysis. Hypertension (70.9%) was the most common co-morbidity among ESRD patients. Haemodialysis patients scored significantly lower than the transplant recipients in all four domains as well as in overall perception of quality of life and general health. Ethnicity (p = 0.020), socio-economic status (p < 0.001), educational status (p < 0.001) and employment status (p = 0.009) were significantly associated with the overall QOL in ESRD patients. Across patient groups, educational status (p = 0.012) was positively associated with QOL in dialysis patients, while urban residence (p = 0.023), higher socio-economic status (p < 0.001), higher educational status (p = 0.004) and diabetes status (p = 0.010) were significantly associated with better QOL in transplant recipients. Conclusion: The overall QOL of the renal transplant recipients was higher than that of the patients on maintenance haemodialysis; this was true in all four domains of the WHOQOL-BREF. ESRD patients with low HRQOL could benefit from targeted risk modification intervention. Keywords: Kidney, Nepal, End stage renal disease, Quality of life, haemodialysis, transplant
Background The incidence and prevalence of end-stage renal disease (ESRD) has been rising globally, yet the burden in South Asia is not known precisely due to improper registration systems [1]. A population-based study assessed the age* Correspondence: [email protected] 2 Institute of Medicine, Tribhuvan University, Kathmandu, Nepal Full list of author information is available at the end of the article
adjusted incidence of ESRD at 232 cases per million populations per year in India [2]. In Nepal, the estimated incidence of ESRD is approximately 2900/year [3, 4]. ESRD is an increasingly recognized pandemic that is associated with high cost and financial burden to patients, families and the health system of any country [5–7]. In Nepal, the burden of ESRD is growing, however only a fraction
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