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Abstract: SA-PO299

Regional Differences in Quality of Life in a Large Multinational Population of Chronic Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Santos Araujo, Carla Alexandra R., Diaverum Renal Services Group, Lund, Scania, Sweden
  • Silva, Eliana Mendonça Almeida, Diaverum Renal Services Group, Lund, Scania, Sweden
  • Haarhaus, Mathias, Diaverum Renal Services Group, Lund, Scania, Sweden
  • Silva, Israel Pereira, Diaverum Renal Services Group, Lund, Scania, Sweden
  • Pearce, Suzanne H., Diaverum Renal Services Group, Lund, Scania, Sweden
  • Lucas, Carlos, Diaverum Renal Services Group, Lund, Scania, Sweden
  • Macario, Fernando, Diaverum Renal Services Group, Lund, Scania, Sweden

Health-related quality of life (QoL) is increasingly recognized as an important patient-centered outcome in hemodialysis (HD). Relevant differences between countries may exist, despite high standardization in HD care. We aimed to evaluate the effect of regional location in QoL in a large, multinational population of HD patients.


This was a multicenter prospective observational study using a quality database from a large HD organization. All adult patients that voluntarily responded to KDQOL-36 were included. Six months after the survey, demographic (age, gender and country) and clinical data (diabetes, comorbidity index, type of vascular access, death) were collected. Patients were allocated to different regions, according to the country of origin: Western and East Europe, Euroasia, Latin America and Iberia. Various domains of KDQOL-36 (2 generic and 3 kidney specific) were analyzed and related to the different covariates using multiple linear regression (results presented as hazard ratios and 95% confidence intervals).


30 614 HD patients with valid responses to KDQOL-36 were included. The majority reported poor QoL: this was particularly evident for Burden of kidney disease (46.57±26.68) and Mental (MCS) (45.29±10.31) and Physical Composite Scales (PCS) (37.80±9.40). In multivariate analysis, female gender and comorbidity index were independently associated with a poorer QoL in all domains. Older age was an independent predictor of lower PCS, but of a higher MCS, whereas time on HD was positively correlated with both MCS (1.36 [0.90–1.82], p<0.01) and PCS (0.73 [0.34–1.12], p<0.01). Six-month mortality was independently associated with worst scores in all levels of QoL. Western Europe patients presented significantly worst scores, particularly in MCS (−3.37 [(−3.81)–(−2.92)],p<0.01) and general scales, when compared to kidney specific domains.


In our population, we have documented a lower QoL in Western Europe patients, more evident in general and social than in kidney specific domains. These results may reflect the high level of standardization of HD care worldwide and prompt the adoption of region specific QoL strategies, oriented to the particular necessities of HD patients in certain locations of the globe.