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

Abstract

Health-related quality of life (HRQOL) is associated with mortality and mobidity in dialysispatients. 9-THAI is a very valid, easy, simple HRQOL instrument for Thai people consisting of ninequestions compressed into five scales and two primary dimensions: the physical and mental compo-nent 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 toMarch 2008. Baseline characteristic as age, sex, married status, payment, duration of dialysis, pasthospitalization, comorbid disease, erythropoietin use and laboratory data as creatinine, hematocrit,albumin, adequacy of dialysis were collected. The six domains were calculated as physical healthscore (PHS) including “motility”, “self care”, “usual activities”, “illness/discomfort” and mentalhealth score (MHS) including “anxiety/depression”, “cognition”, “social function”. Sixty-one HDand 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 weremore limited in self-care than the HD qroup (38.9% and 8.2%; p=0.001) although there were nosignificant differences in the other domains between the two groups. The median (interquartilerange) 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 30were defined in poor condition or at 2SD below normal population score. Independent risk factorsaffecting 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 hema-tocrit (Hct<33%) in peritoneal dialysis patients. All CAPD patients having negative mental scorewere hypoalbuminemia (<3.0 g/dL), anemia (Hct<20%) and multiple comorbid diseases.

In conclusion, physical health status is higher in hemodialysis patients than peritoneal dialysispatients without any difference in mental health status.