TY - JOUR
T1 - Health-related quality of life in dialysis patients with HCV infection
AU - Fabrizi, Fabrizio
AU - Messa, Piergiorgio
AU - Martin, Paul
PY - 2009
Y1 - 2009
N2 - Measuring the impact of chronic kidney disease (CKD) treatment on patient quality of life has become increasingly recognized as an important outcome measure. Despite improvements in the treatment of chronic kidney disease, health-related quality of life (HRQOL) is lower than in the general population. HRQOL measures, particularly the Physical Component Summary (PCS), have predictive validity for risk of both mortality and hospitalization in dialysis populations. For every 10-point lower PCS score, the relative risk (RR) of death increases by 29% (RR=1.29; 95% CI=1.23 to 1.35; p<0.001) and the risk of hospitalization increases by 15% (RR=1.15; 95% CI=1.11 to 1.19, p<0.001), according to the Dialysis Outcomes and Practice Patterns Study (DOPPS). Hepatitis C virus (HCV) infection remains prevalent among dialysis patients with a recent meta-analysis showing that anti-HCV seropositive status was an independent and significant risk factor for death in patients on maintenance dialysis. Seven studies with 11,589 unique patients on maintenance dialysis were identified; the summary estimate for adjusted relative risk (aRR) (all-cause mortality) was 1.34 with a 95% confidence interval (CI) of 1.13-1.59. In non-uremic populations HCV diminishes HRQOL, and individuals with HCV scored lower than controls across all scales of the short form 36 (SF-36). Patients achieving sustained virological responses (SVR) scored higher across all scales versus patients without SVR, especially in the physical health domains. Whether the adverse influence of HCV on survival in dialysis population is related to the negative impact of HCV on HRQOL requires further research. Information on HRQOL indices in patients with HCV on maintenance dialysis is extremely limited but the available evidence shows that HCV infection impairs HRQOL, especially in mental aspects, among patients on maintenance hemodialysis.
AB - Measuring the impact of chronic kidney disease (CKD) treatment on patient quality of life has become increasingly recognized as an important outcome measure. Despite improvements in the treatment of chronic kidney disease, health-related quality of life (HRQOL) is lower than in the general population. HRQOL measures, particularly the Physical Component Summary (PCS), have predictive validity for risk of both mortality and hospitalization in dialysis populations. For every 10-point lower PCS score, the relative risk (RR) of death increases by 29% (RR=1.29; 95% CI=1.23 to 1.35; p<0.001) and the risk of hospitalization increases by 15% (RR=1.15; 95% CI=1.11 to 1.19, p<0.001), according to the Dialysis Outcomes and Practice Patterns Study (DOPPS). Hepatitis C virus (HCV) infection remains prevalent among dialysis patients with a recent meta-analysis showing that anti-HCV seropositive status was an independent and significant risk factor for death in patients on maintenance dialysis. Seven studies with 11,589 unique patients on maintenance dialysis were identified; the summary estimate for adjusted relative risk (aRR) (all-cause mortality) was 1.34 with a 95% confidence interval (CI) of 1.13-1.59. In non-uremic populations HCV diminishes HRQOL, and individuals with HCV scored lower than controls across all scales of the short form 36 (SF-36). Patients achieving sustained virological responses (SVR) scored higher across all scales versus patients without SVR, especially in the physical health domains. Whether the adverse influence of HCV on survival in dialysis population is related to the negative impact of HCV on HRQOL requires further research. Information on HRQOL indices in patients with HCV on maintenance dialysis is extremely limited but the available evidence shows that HCV infection impairs HRQOL, especially in mental aspects, among patients on maintenance hemodialysis.
KW - Dialysis
KW - Health-related quality of life (HRQOL)
KW - Hepatitis C virus (HCV)
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=70350539704&partnerID=8YFLogxK
U2 - 10.1177/039139880903200801
DO - 10.1177/039139880903200801
M3 - Review article
C2 - 19844890
AN - SCOPUS:70350539704
SN - 0391-3988
VL - 32
SP - 473
EP - 481
JO - International Journal of Artificial Organs
JF - International Journal of Artificial Organs
IS - 8
ER -