Quality of life of patients in renal replacement therapy in Brazil: comparison of treatment modalities

This study aimed to analyze and compare the quality of life of renal replacement therapy patients undergoing hemodialysis,
peritoneal dialysis and those with renal transplantation in Brazil. In addition, we aimed to verify factors associated with
patients’ quality of life and the relationship between quality of life and treatment modality, socioeconomic and demographic
conditions as well as aspects related to the disease and health services.

A representative sample of the dialysis units and transplant centers was obtained. Structured questionnaires were used to
interview 3,036 patients in one of three treatment modalities: hemodialysis, peritoneal dialysis and renal transplant. Information
was collected about socioeconomic and demographic characteristics and quality of life measures.

There were significant differences between renal transplants and both forms of dialysis for all dimensions of the SF-36. Hemodialysis
patients showed better results in the dimensions of functional capacity, physical aspects and social aspects, compared to
peritoneal dialysis patients. Renal transplant patients had the best mean score in the physical component of quality of life.
There were no significant differences among treatment groups regarding the mental component of quality of life. The physical
and mental components were associated with comorbidities and age; however, older patients had better mental quality of life
but worse physical quality of life. Patients in a higher socioeconomic class and patients that were not hospitalized also
reported better quality of life. Unmarried and male patients presented better physical quality of life. The dialysis units
and transplant centers influenced the patients’ quality of life.

Renal transplant patients have the best quality of life of the three treatment modalities. It is necessary to increase access
to renal transplants.