Quality of life and rehabilitation differences among four end-stage renal disease therapy groups

This study investigates the quality of life of patients on alternative therapies for end-stage renal disease. The quality of life of 766 patients who experienced one of the following therapies for at least one year are compared: a successful transplant performed in the 1970's (N = 82), a successful transplant performed in 1980-1984 (N = 91), in-center hemodialysis (N = 83, 8 centers), and continuous ambulatory peritoneal dialyses (CAPD) (N = 510, 185 centers). All patients were aged 19-56 and nondiabetic. Survey questionnaires were administered containing measures of physical, emotional and social well-being, vocational rehabilitation, and sexual adjustment. Case-mix differences were controlled, insofar as possible, with an Analysis of Covariance; adjusted means were compared. Findings indicate that the quality of life for successful transplant patients exceeds that of both dialysis groups for almost all variables (p less than 0.05 for 9/11 measures). This advantage persists when transplant patients are compared to dialysis patients who have experienced no prior, failed therapies.