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Nephrol Dial Transplant (2003) 18: 2622-2628
© 2003 European Renal Association-European Dialysis and Transplant Association

Original Article

A simple risk score predicts poor quality of life and non-survival at 1 year follow-up in dialysis patients

Peter de Jonge1, G. Maarten-Friso Ruinemans2, Frits J. Huyse2 and Piet M. ter Wee3

1Department of Psychiatry, University of Groningen, 2Department of Psychiatry and 3Department of Nephrology, VU Medical Center, Amsterdam, The Netherlands

Correspondence and offprint requests to: P. de Jonge, PhD, Department of Social Psychiatry, Disciplinegroep Psychiatrie, RijksUniversiteit Groningen, Hanzeplein 1 Gebouw 32, Postbus 30001, 9700 RB Groningen, The Netherlands. Email: p.de.jonge{at}med.rug.nl

Background. Quality of life (QoL) in end-stage renal disease patients has become an important focus of attention in evaluating dialysis. We studied risk factors of poor QoL at 1 year follow-up.

Methods. Of a baseline sample of 80 dialysis patients, we contacted 60 patients who were alive at 1 year follow-up. QoL data were obtained for 46 (76.7%) of these patients. QoL measured with the SF-36 [physical health component score (PCS) and mental health component score (MCS)] at 1 year-follow-up was predicted by means of multivariate regression analysis by data collected at baseline using INTERMED—an observer-rated method to assess biopsychosocial care needs—and several indicators for disease severity and comorbidity.

Results. The regression models explained 32% of the variance in PCS and 40% in MCS. INTERMED score (P < 0.01) was the only independent risk factor for low MCS, while for low PCS, diabetic comorbidity (P = 0.02) and age (P = 0.03) were independent risk factors. A simple risk score consisting of INTERMED >=21, diabetic comorbidity and age >=65 was significantly correlated with non-survival (P = 0.02) and with PCS (P < 0.01) and MCS (P < 0.01) in surviving patients, although not with hospital admissions during follow-up.

Conclusions. A simple risk score based on INTERMED, age (>=65) and comorbid diabetes (yes/no) can be used to detect patients at risk of poor QoL and non-survival at an early stage of treatment.

Keywords: dialysis; end-stage renal disease; INTERMED; quality of life; SF-36


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