Health-related quality of life and symptom burden in patients on haemodialysis
Authors: van Oevelen Mathijs , Bonenkamp Anna A , van Eck van der Sluijs Anita , Bos Willem Jan W , Douma Caroline E , van Buren Marjolijn , Meuleman Yvette , Dekker Friedo W , van Jaarsveld Brigit C , Abrahams Alferso C ,   the DOMESTICO study group, Abrahams A C , Verhaar M C , van Jaarsveld B C , Dekker F W , van Ittersum F J , Konij W , Hemmelder M H , ten Dam M A G J , van Eck van der Sluijs A , Driehuis E , Bonenkamp A A , van Lieshout T S , Roeterdink A J , Leurs P B , Korte M R , van der Net J B , Schrander-van der Meer A M , Cnossen T T , van Jaarsveld B C , van Breda G F , De Vriese A , Lips J , Krepel H P , ten Dam M A G J , Konings C J A M , van Eck van der Sluijs A , Lips A , Özyilmaz A , Neradova A , Boereboom F T J , van Esch S , Susanto C R , Hoorn E J , Severs D , Boonstra A H , Nette R W , Verhoeven M A M , Vermeeren Y M , IJpelaar D H T , Hommes N H , van Buren M , Hofstra J M , Mui K W , Binnenmars S H , Diepeveen S H A , Hoogeveen E K , Cornelis T , Boorsma S , Rotmans J I , van Alphen A M , Litjens E J R , Hemmelder M H , Janssen W M T , Kuijper A , Beerenhout C H , Bierma L , Adema A Y , Wijering R M J , Rüger W , Bosma R J , Penne E L , de Fijter C W H , Brulez H F H , van Hamersvelt H W , van der Meijden W A G , Huisman S J , Verhave J C , van Kempen G , Klein H H T I , Douma C E , Bos W J W , Snoep J D , Mulder J , Franssen C F M , Abrahams A C , François K , Luik A J , Klaassen R J L , van Tellingen A , Dekker M M G , Weenink A G , Krekels M M E 
Published: August 2023

ABSTRACT

Background
Patients on haemodialysis (HD) generally experience poor health-related quality of life (HRQoL) and a broad range of physical and mental symptoms, but it is unknown whether this differs between younger and older patients. We aimed to describe the trajectories of HRQoL and symptom burden of patients &lt;70 and ≥70 years old and to assess the impact of symptom burden on HRQoL.

Methods
In incident Dutch HD patients, HRQoL and symptoms were measured with the 12-item Short Form Health Survey and Dialysis Symptom Index. We used linear mixed models for examining the trajectories of HRQoL and symptom burden during the first year of dialysis and linear regression for the impact of symptom burden on HRQoL.

Results
In 774 patients, the trajectories of physical HRQoL, mental HRQoL and symptom burden were stable during the first year of dialysis. Compared with patients &lt;70 years of age, patients ≥70 years reported similar physical HRQoL {mean difference −0.61 [95% confidence interval (CI) −1.86–0.63]}, better mental HRQoL [1.77 (95% CI 0.54–3.01)] and lower symptom burden [−2.38 (95% CI −5.08–0.32)]. With increasing symptom burden, physical HRQoL declined more in older than in younger patients (β = −0.287 versus −0.189, respectively; P-value for interaction = .007). For mental HRQoL, this decrease was similar in both age groups (β = −0.295 versus −0.288, P = .847).

Conclusion
Older HD patients generally experience a better mental HRQoL and a (non-statistically significant) lower symptom burden compared with younger patients. Their physical HRQoL declines more rapidly with increasing symptom burden.