Autori: Signorotti S (1), Spaltini F (1), Pane M (1), Timio F (2), Errico R (2), Taglioni C (2), Ciao G (3), Leveque A (3), Fiorucci G (3), Santoni S (3), Selvi A (3), Reboldi G (1)
Affiliazioni: (1) Scuola di Specializzazione in Nefrologia, Università Chieti-Perugia, (2) SC Nefrologia Dialisi e Trapianto, Azienda Ospedaliera di Perugia, (3) Nefrologia e Dialisi, ASL Umbria 1
Current literature suggests that among dialysis patients, women (W) perceive a lower health-related quality of life (HRQoL) than men (M). However, it is unclear which HRQoL dimensions are most influenced by gender.
The aim of our study was to evaluate HRQoL dimensions and the extent to which there are gender differences.
We conducted a multi-center survey in the Perugia area using the Kidney Disease Quality of Life Instrument (KDQoL). The required number of respondents was calculated assuming a prevalent dialysis population of 400 patients, 5% margin of error, 95% confidence level, and 60% anticipated response rate.
Mixed models were used to evaluate gender related differences in HRQoL scores. SAS 9.4 was used for the analyses.
The survey response rate was not influenced by gender (W 70/101 M 149/212; p=0.998) and the mean age of respondents was similar (W 69±13 vs M 70±15; p=0.687). As expected, age had a significant effect (p<0.001) on all HRQoL scores. In age-adjusted analyses, female gender was associated with worse physical composite score (W 31.1±1.2 vs M 35.3±0.8; p<0.01) and mental composite score (W 38.6±1.4 vs M 42.1±1.0; p=0.04). Kidney disease (KD) related scores showed sizeable differences between gender for KD effects (W 58.9±2.5 vs M 65.3±1.7; p=0.02), KD symptoms (W 69.7±1.8 vs M 75.5±1.2; p<0.01), KD burden (W 25.2±1.8 vs M 30.8±1.9; p=0.04). KD in W also influenced cognitive function (W 68.0±2.8 vs M 76.8±2.0; p=0.01) and physical functioning (W 35.6±3.3 vs M 47.9±2.3; p<0.01).
Taken together our findings depict a worse HRQoL profile (figure 1) in women compared to men. These observations highlight the profound impact dialysis has on women HRQOL and suggest potential areas that can be targeted with specific interventions
