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Assessing and improving the health-related quality of life of patients with ESRD

Abstract

Impairment of the health-related quality of life (HRQOL) of patients with end-stage renal disease (ESRD) is now well documented. These impairments involve a wide variety of domains and can be assessed using an array of well-validated instruments. Incorporation of at least some of these instruments into routine patient care is important in order to measure the physical and psychological impact of a disease and its treatment on the HRQOL of patients. How this implementation can be achieved in a practical way is, however, a challenge. As more research focuses on improving the HRQOL of patients with ESRD, the systematic evaluation of HRQOL and incorporation into patient care is becoming increasingly important. Whether strategies to improve the HRQOL of patients will translate into improved patient outcomes—as evidenced by reduced mortality and hospitalizations—and lower costs, remains to be determined.

Key Points

  • The assessment of health-related quality of life provides important information about patients with end-stage renal disease (ESRD)

  • Routine assessment of patient-reported outcomes (PROs) should be incorporated into the standard care of patients with ESRD

  • Improvements in PROs can result from various interventions, such as treatment of depression and alterations in the dialysis therapy regimen

  • Whether treatment algorithms designed to improve PROs will reduce rates of mortality and hospitalization remains to be determined

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All authors contributed equally to discussion of content for the article, researching data to include in the manuscript, and reviewing and editing of the manuscript before submission.

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Correspondence to Fredric O. Finkelstein.

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F. Finkelstein is a consultant and has received grant or research support from Amjen. He is on the speakers bureau for Baxter and is a consultant for NxStage Medical. F. Finkelstein, K. L. Arsenault, A. Taveras and K. Awuah are affiliated with New Haven Home Dialysis, which is owned by Fresenius Medical Care.

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Finkelstein, F., Arsenault, K., Taveras, A. et al. Assessing and improving the health-related quality of life of patients with ESRD. Nat Rev Nephrol 8, 718–724 (2012). https://doi.org/10.1038/nrneph.2012.238

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