Patients should be consulted before dialysis treatment begins

to which treatment is better. What patients value about their quality of life should be a factor in the choice of different treatments. Physicians should be doing what is best for each individual patient's quality of life."

Over 900 patients (698 hemodialysis; 230 peritoneal) in 19 states were enrolled in the Choices for Health Outcomes in Caring for ESRD study (CHOICE), a national, prospective cohort study from 1995-1998. Dr. Wu and his colleagues developed the CHOICE Health Experience Questionnaire (CHEQ) to comprehensively measure quality of life of patients on dialysis using patients' reports of the importance they attach to different aspects of their life. Using the CHEQ they assessed self-reported health-related quality of life at the onset of dialysis therapy and one year later. The researchers looked at general domains, or the aspects of life anyone might be concerned about, such as physical and social functioning, and ESRD specific domains, which are problems specific to dialysis patients, such as diet restrictions, body image and problems with dialysis catheters.

The researchers found that both hemodialysis and peritoneal dialysis patients had improvement in nearly all aspects of general functioning and well-being. However, peritoneal dialysis patients did better in some areas of quality of life while hemodialysis patients did better in others. Peritoneal dialysis patients had improvement in their finances. Hemodialysis patients had improvements in physical functioning and general health perceptions, and better sleep.

A report by some of the same Johns Hopkins researchers was recently published in the Feb. 11 issue of the Journal of the American Medical Association. They found that when compared to the more common hemodialysis, peritoneal dialysis patients were 1.5 times more likely to rate their overall care as excellent. Dr. Wu explained that this latest study looked at the quality of life patients experienced at the start of dia

Contact: Kenna L. Brigham
Johns Hopkins University Bloomberg School of Public Health

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