Health Status using 9-THAI: Comparison between Hemodialysis and Peritoneal Dialysis Patients at Chachoengsao Province - การเปรียบเทียบสถานะสุขภาพของผู้ป่วยที่ได้รับการฟอกเลือดและล้างไตทางช่องท้องโดยใช้ 9-THAI ในจังหวัดฉะเชิงเทรา

Abstract

          Health-related quality of life (HRQOL) is associated with mortality and mobidity in dialysis patients.  9-THAI is a very valid, easy, simple HRQOL instrument for Thai people consisting of nine questions compressed into five scales and two primary dimensions: the physical and mental component score.  This descriptive study was aimed to compare health status between hemodialysis (HD) and peritoneal dialysis (CAPD) patients using 9-THAI at Chachoengsao province from February to March 2008.  Baseline characteristic as age, sex, married status, payment, duration of dialysis, past hospitalization, comorbid disease, erythropoietin use and laboratory data as creatinine, hematocrit, albumin, adequacy of dialysis were collected.  The six domains were calculated as physical health score (PHS) including าmotilityำ, าself careำ, าusual activitiesำ, าillness/discomfortำ and mental health score (MHS) including าanxiety/depressionำ, าcognitionำ, าsocial functionำ.  Sixty-one HD and eighteen CAPD patients from two dialysis units were analysed. 

                               There were 30 (49.2%) males in HD patients and 5 (27.8%) in CAPD patients.  The mean (SD) age of HD and CAPD patients were 51.6 (15.9) and 42.8 (12.3) years.  The CAPD patients were more limited in self-care than the HD qroup (38.9% and 8.2%; p=0.001) although there were no significant differences in the other domains between the two groups.  The median (interquartile range) of PHS was higher in HD patients than that of CAPD significantly HD:42.5 (20.9), CAPD:18.2 (19.6); p<0.001).  No difference on MHS of the two could be found.  PHS and MHS less than 30 were defined in poor condition or at 2SD below normal population score.  Independent risk factors affecting poor PHS in HD patients were history of hospitalization during the past year (p=0.003) and duration of hemodialysis less than 3 years (p=0.02).  Poor PHS was associated with low hematocrit (Hct<33%) in peritoneal dialysis patients.  All CAPD patients having negative mental score were hypoalbuminemia (<3.0 g/dL), anemia (Hct<20%) and multiple comorbid diseases. In conclusion, physical health status is higher in hemodialysis patients than peritoneal dialysis patients without any difference in mental health status.

Key words:  9-THAI, health status, hemodialysis, peritoneal dialysis