Skip to main content
Top
Published in: BMC Nephrology 1/2016

Open Access 01-12-2016 | Research article

Health related quality of life in patients with end stage kidney disease treated with haemodialysis in Malawi: a cross sectional study

Authors: Thokozani Masina, Bernadette Chimera, Martin Kamponda, Gavin Dreyer

Published in: BMC Nephrology | Issue 1/2016

Login to get access

Abstract

Background

Haemodialysis in Malawi consumes a disproportionate amount of the national health budget, costing approximately $20,000 per patient per year. Adjunctive therapeutic agents for end stage kidney disease and laboratory services to measure standard dialysis outcomes are not routinely available. Therefore, alternative outcome measures of the efficacy of haemodialysis in Malawi are required. We measured health related quality of life of adult patients in Malawi treated with haemodialysis for end stage kidney disease.

Methods

We performed a cross-sectional study of patients receiving haemodialysis for end stage kidney disease at 4 dialysis centres in Malawi between 24/10/2012 and 30/11/012. Patients were included if they were >18 years of age and had been receiving haemodialysis for >3 months. We used the Kidney Disease Quality of Life Instrument Short Form to assess health related quality of life.

Results

We recruited 22 of 24 eligible patients (mean age 44.8 ± 16.0 years, 59.1 % male, median duration on haemodialysis 12 months (Inter-quartile range 6–24 months)). Overall health related quality of life was low (mean score 59.9 ± 8.8, maximum possible score 100) with the lowest scores recorded for physical health component summary score (50.4 ± 22.8) compared to mental health component summary (61.3 ± 23.0) and kidney disease component summary (67.9 ± 13.2). Low household income (<$4000 per year) was associated with lower mental health component scores (adjusted r2 = 0.413, p = 0.033).

Conclusions

Quality of life of haemodialysis patients in Malawi can be easily measured using a validated questionnaire and provides an alternative and important measure of the efficacy of haemodialysis therapy. Physical health scores were particularly low and this may affect income generating capacity. Increased efforts are required to improve the quality of life of haemodialysis patients in Malawi with a particular focus on the burden of physical symptoms.
Appendix
Available only for authorised users
Literature
1.
go back to reference Mtika VG, Muula AS, Chipolombwe J, Nyirongo J, Rajabu J. Renal replacement therapy at Lilongwe Central Hospital. Trop Doct. 2002;32:163–5.PubMed Mtika VG, Muula AS, Chipolombwe J, Nyirongo J, Rajabu J. Renal replacement therapy at Lilongwe Central Hospital. Trop Doct. 2002;32:163–5.PubMed
2.
go back to reference Dreyer G, Dobbie H, Banks R, Allain T, Gonani A, Turner NLV. Supporting Malawi’s dialysis services in the international community. Br J Ren Med. 2012;17:24–6. Dreyer G, Dobbie H, Banks R, Allain T, Gonani A, Turner NLV. Supporting Malawi’s dialysis services in the international community. Br J Ren Med. 2012;17:24–6.
3.
go back to reference Abd ElHafeez S, Sallam SA, Gad ZM, Zoccali C, Torino C, Tripepi G, ElWakil HS, Awad NM. Cultural adaptation and validation of the “Kidney Disease and Quality of Life--Short Form (KDQOL-SFTM) version 1.3” questionnaire in Egypt. BMC Nephrol. 2012;13:170. Abd ElHafeez S, Sallam SA, Gad ZM, Zoccali C, Torino C, Tripepi G, ElWakil HS, Awad NM. Cultural adaptation and validation of the “Kidney Disease and Quality of Life--Short Form (KDQOL-SFTM) version 1.3” questionnaire in Egypt. BMC Nephrol. 2012;13:170.
4.
go back to reference AL-Jumaih A, Al-Onazi K, Binsalih S, Hejaili F, Al-Sayyari A. A study of quality of life and its determinants among hemodialysis patients using the KDQOL-SF instrument in one center in Saudi Arabia. Arab J Nephrol Transplant. 2011;4:125–30.PubMed AL-Jumaih A, Al-Onazi K, Binsalih S, Hejaili F, Al-Sayyari A. A study of quality of life and its determinants among hemodialysis patients using the KDQOL-SF instrument in one center in Saudi Arabia. Arab J Nephrol Transplant. 2011;4:125–30.PubMed
5.
go back to reference Fukuhara S, Lopes AA, Bragg-Gresham JL, Kurokawa K, Mapes DL, Akizawa T, Bommer J, Canaud BJ, Port FK, Held PJ. Health-related quality of life among dialysis patients on three continents: the Dialysis Outcomes and Practice Patterns Study. Kidney Int. 2003;64:1903–10. Fukuhara S, Lopes AA, Bragg-Gresham JL, Kurokawa K, Mapes DL, Akizawa T, Bommer J, Canaud BJ, Port FK, Held PJ. Health-related quality of life among dialysis patients on three continents: the Dialysis Outcomes and Practice Patterns Study. Kidney Int. 2003;64:1903–10.
6.
go back to reference Okpechi IG, Nthite T, Swanepoel CR. Health-related quality of life in patients on hemodialysis and peritoneal dialysis. Saudi J Kidney Dis Transpl. 2013;24:519–26.CrossRefPubMed Okpechi IG, Nthite T, Swanepoel CR. Health-related quality of life in patients on hemodialysis and peritoneal dialysis. Saudi J Kidney Dis Transpl. 2013;24:519–26.CrossRefPubMed
7.
go back to reference Korevaar JC, Merkus MP, Jansen MAM, Dekker FW, Boeschoten EW, Krediet RT. Validation of the KDQOL-SF: a dialysis-targeted health measure. Qual Life Res. 2002;11:437–47.CrossRefPubMed Korevaar JC, Merkus MP, Jansen MAM, Dekker FW, Boeschoten EW, Krediet RT. Validation of the KDQOL-SF: a dialysis-targeted health measure. Qual Life Res. 2002;11:437–47.CrossRefPubMed
8.
go back to reference Bouidida B, Rhou H, Ezaitouni F, Ouzeddoun N, Bayahia R, Elhajji K, Roudiès R, Sekkat FZ, Razine R, Abouqal R, Alghadi A, Azennoud A, Benamar L. Translation, cultural adaptation and validation of the kidney disease quality of life-short form 1.3 in an African country. Transplant Proc. 2014;46:1295–301. Bouidida B, Rhou H, Ezaitouni F, Ouzeddoun N, Bayahia R, Elhajji K, Roudiès R, Sekkat FZ, Razine R, Abouqal R, Alghadi A, Azennoud A, Benamar L. Translation, cultural adaptation and validation of the kidney disease quality of life-short form 1.3 in an African country. Transplant Proc. 2014;46:1295–301.
10.
go back to reference Gataa R, Ajmi TN, Haouala F, Mtiraoui A. Quality of life patterns of dialysed patients in the region of Kairouan. Tunis Med. 2008;86:68–74.PubMed Gataa R, Ajmi TN, Haouala F, Mtiraoui A. Quality of life patterns of dialysed patients in the region of Kairouan. Tunis Med. 2008;86:68–74.PubMed
11.
go back to reference Mapes DL, Lopes AA, Satayathum S, McCullough KP, Goodkin DA, Locatelli F, Fukuhara S, Young EW, Kurokawa K, Saito A, Bommer J, Wolfe RA., Held PJ, Port FK. Health-related quality of life as a predictor of mortality and hospitalization: The dialysis outcomes and practice patterns study (DOPPS). Kidney Int. 2003;64:339–49. Mapes DL, Lopes AA, Satayathum S, McCullough KP, Goodkin DA, Locatelli F, Fukuhara S, Young EW, Kurokawa K, Saito A, Bommer J, Wolfe RA., Held PJ, Port FK. Health-related quality of life as a predictor of mortality and hospitalization: The dialysis outcomes and practice patterns study (DOPPS). Kidney Int. 2003;64:339–49.
12.
go back to reference Yildirim A, Ogutmen B, Bektas G, Isci E, Mete M, Tolgay HI. Translation, cultural adaptation, initial reliability, and validation of the Kidney Disease and Quality of Life-Short Form (KDQOL-SF 1.3) in Turkey. Transplant Proc. 2007;39:51–4.CrossRefPubMed Yildirim A, Ogutmen B, Bektas G, Isci E, Mete M, Tolgay HI. Translation, cultural adaptation, initial reliability, and validation of the Kidney Disease and Quality of Life-Short Form (KDQOL-SF 1.3) in Turkey. Transplant Proc. 2007;39:51–4.CrossRefPubMed
13.
go back to reference Lopes AA, Bragg-Gresham JL, Satayathum S, McCullough K, Pifer T, Goodkin DA, Mapes DL, Young EW, Wolfe RA, Held PJ, Port FK. Health-related quality of life and associated outcomes among hemodialysis patients of different ethnicities in the United States: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis. 2003;41:605–15. Lopes AA, Bragg-Gresham JL, Satayathum S, McCullough K, Pifer T, Goodkin DA, Mapes DL, Young EW, Wolfe RA, Held PJ, Port FK. Health-related quality of life and associated outcomes among hemodialysis patients of different ethnicities in the United States: the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis. 2003;41:605–15.
14.
go back to reference Murtagh FEM, Addington-Hall J, Higginson IJ. The prevalence of symptoms in end-stage renal disease: a systematic review. Adv Chronic Kidney Dis. 2007;14:82–99.CrossRefPubMed Murtagh FEM, Addington-Hall J, Higginson IJ. The prevalence of symptoms in end-stage renal disease: a systematic review. Adv Chronic Kidney Dis. 2007;14:82–99.CrossRefPubMed
15.
go back to reference Sehgal AR. Outcomes of renal replacement therapy among blacks and women. Am J Kidney Dis. 2000;35(4 Suppl 1):S148–52.CrossRefPubMed Sehgal AR. Outcomes of renal replacement therapy among blacks and women. Am J Kidney Dis. 2000;35(4 Suppl 1):S148–52.CrossRefPubMed
16.
go back to reference Liyanage T, Ninomiya T, Jha V, Neal B, Patrice HM, Okpechi I, Zhao M, Lv J, Garg AX, Knight J, Rodgers A, Gallagher M, Kotwal S, Cass A, Perkovic V. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385:1975–82. Liyanage T, Ninomiya T, Jha V, Neal B, Patrice HM, Okpechi I, Zhao M, Lv J, Garg AX, Knight J, Rodgers A, Gallagher M, Kotwal S, Cass A, Perkovic V. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385:1975–82.
17.
go back to reference Cisse MM, Ka EF, Gueye S, Tall AOL, Faye M, Niang A, Diouf B. [Quality of life in hemodialysis patients in Dakar: differences for the tropics?]. Med Sante Trop. 2012;22:198–202. Cisse MM, Ka EF, Gueye S, Tall AOL, Faye M, Niang A, Diouf B. [Quality of life in hemodialysis patients in Dakar: differences for the tropics?]. Med Sante Trop. 2012;22:198–202.
18.
go back to reference Moreno F, Lopez Gomez JM, Sanz-Guajardo D, Jofre R, Valderrabano F. Quality of life in dialysis patients. A Spanish multicentre study. Nephrol Dial Transplant. 1996;11 Suppl 2:125–9. Moreno F, Lopez Gomez JM, Sanz-Guajardo D, Jofre R, Valderrabano F. Quality of life in dialysis patients. A Spanish multicentre study. Nephrol Dial Transplant. 1996;11 Suppl 2:125–9.
19.
go back to reference Duarte PS, Ciconelli RM, Sesso R. Cultural adaptation and validation of the “Kidney Disease and Quality of Life--Short Form (KDQOL-SF 1.3)” in Brazil. Brazilian J Med Biol Res. 2005;38:261–70.CrossRef Duarte PS, Ciconelli RM, Sesso R. Cultural adaptation and validation of the “Kidney Disease and Quality of Life--Short Form (KDQOL-SF 1.3)” in Brazil. Brazilian J Med Biol Res. 2005;38:261–70.CrossRef
Metadata
Title
Health related quality of life in patients with end stage kidney disease treated with haemodialysis in Malawi: a cross sectional study
Authors
Thokozani Masina
Bernadette Chimera
Martin Kamponda
Gavin Dreyer
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2016
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-016-0292-9

Other articles of this Issue 1/2016

BMC Nephrology 1/2016 Go to the issue