Impacto da qualidade de vida na morbi-mortalidade e fatores relacionados a sua manutenção em pacientes em diálise peritoneal

Abstract

Nowadays has been sought not only a prolongation of survival of patients with chronic kidney disease, but also a greater appreciation of quality of life of these patients, seeking not only improves the physical aspects but also social and emotional. Thus, the hypothesis is that the quality of self-determined life may have an impact on admission and outcome of patients undergoing peritoneal dialysis. The objectives were to determine the quality of life in the admission of patients on peritoneal dialysis, to observe the factors associated with maintaining the quality of life in peritoneal dialysis patients and to evaluate the influence of quality of life selfdetermined at the time of admission on survival. We evaluated 1624 patients participating in a multicenter prospective cohort study, using data from BRAZPD. The assessment of quality of life was performed using the SF-36 physical and performance through the Karnofsky index. It was observed that patients starting peritoneal dialysis in Brazil have a poor quality of life since the beginning of treatment, which is maintained throughout the duration of therapy. The quality of life in these patients is related to factors such as age and presence of diabetes, and has a significant impact on survival in peritoneal dialysis patients. The avaliation of physical performance realized by a health professional didn’t have good compability with the self avaliation quality of life realized by the patients. Besides, the familiar rent and the school level weren’t predictors of life quality. Life quality was more associated to high mortality risk, being considered as a predictor independently of low surviving among the evaluated patients. The results showed that social economic factors don’t have to be seen as a barrier to the selection of patients in peritoneal dialysis, suggesting that the earlier investiment in the quality of life of this population can be seen as a prevention for unfavourable endings.