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Int J Med Sci 2016; 13(9):686-695. doi:10.7150/ijms.16372 This issue Cite

Research Paper

Overhydration Negatively Affects Quality of Life in Peritoneal Dialysis Patients: Evidence from a Prospective Observational Study

Hye Eun Yoon¹, Young Joo Kwon², Ho Cheol Song³, Jin Kuk Kim⁴, Young Rim Song⁵, Seok Joon Shin¹, Hyung Wook Kim⁶, Chang Hwa Lee⁷, Tae Won Lee⁸, Young Ok Kim⁹, Byung Soo Kim¹⁰, Kyoung Hyoub Moon¹¹, Yoon Kyung Chang¹², Seong Suk Kim¹³, Kitae Bang¹⁴, Jong Tae Cho¹⁵, Sung Ro Yun¹⁶, Ki Ryang Na¹⁷, Yang Wook Kim¹⁸, Byoung Geun Han¹⁹, Jong Hoon Chung²⁰, Kwang Young Lee²¹, Jong Hyeok Jeong²², Eun Ah Hwang²³, Yong-Soo Kim^24✉, the Quality of Life of Dialysis Patients (QOLD) Study Group

1. Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
2. Department of Internal Medicine, Guro Hospital, Korea University;
3. Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea
4. Department of Internal Medicine, Soonchunhyang University Bucheon Hospital;
5. Department of Internal Medicine, Hallym University Sacred Heart Hospital;
6. Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea
7. Department of Internal Medicine, Hanyang University Medical Center;
8. Department of Internal Medicine, KyungHee University Medical Center;
9. Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea
10. Department of Internal Medicine, St. Paul's Hospital, The Catholic University of Korea
11. Department of Internal Medicine, Veterans Health Service Medical Center;
12. Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea
13. Department of Internal Medicine, Daejeon Sun Hospital;
14. Department of Internal Medicine, Eulji University Hospital;
15. Department of Internal Medicine, Dankook University Hospital;
16. Department of Internal Medicine, Konyang University Hospital;
17. Department of Internal Medicine, Chungnam National University Hospital;
18. Department of Internal Medicine, Inje University Haeundae Paik Hospital;
19. Department of Internal Medicine, Yonsei University Wonju College of Medicine;
20. Department of Internal Medicine, Chosun University Hospital;
21. Department of Internal Medicine, Presbyterian Medical Center
22. Department of Internal Medicine, St. Carollo Hospital;
23. Department of Internal Medicine, Keimyung University Dongsan Medical Center;
24. Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

✉ Corresponding author: Yong-Soo Kim, MD, PhD. Department of Internal medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea. Tel: 822-2258-6036 Fax: 822-599-3589 E-mail: kimcmcac.kr. More

Abstract

Backgound: This study evaluated whether the hydration status affected health-related quality of life (HRQOL) during 12 months in peritoneal dialysis (PD) patients.

Methods: The hydration status and the HRQOL were examined at baseline and after 12 months using a bioimpedance spectroscopy and Kidney Disease Quality of Life-Short Form, respectively in PD patients. Four hundred eighty-one patients were included and divided according to the baseline overhydration (OH) value; normohydration group (NH group, -2L≤ OH ≤+2L, n=266) and overhydration group (OH group, OH >+2L, n=215). Baseline HRQOL scores were compared between the two groups. The subjects were re-stratified into quartiles according to the OH difference (OH value at baseline - OH value at 12 months; <-1, -1 - -0.1, -0.1 - +1, and ≥+1L). The relations of OH difference with HRQOL scores at 12 months and the association of OH difference with the HRQOL score difference (HRQOL score at baseline - HRQOL score at 12 months) were assessed.

Results: The OH group showed significantly lower baseline physical and mental health scores (PCS and MCS), and kidney disease component scores (KDCS) compared with the NH group (all, P<0.01). At 12 months, the adjusted PCS, MCS, and KDCS significantly increased as the OH difference quartiles increased (P<0.001, P=0.002, P<0.001, respectively). In multivariate analysis, the OH difference was independently associated with higher PCS (β = 2.04, P< .001), MCS (β=1.02, P=0.002), and KDCS (β=1.06, P<0.001) at 12 months. The OH difference was independently associated with the PCS difference (β = -1.81, P<0.001), MCS difference (β=-0.92, P=0.01), and KDCS difference (β=-0.90, P=0.001).

Conclusion: The hydration status was associated with HRQOL and increased hydration status negatively affected HRQOL after 12 months in PD patients.

Keywords: bioimpedance, fluid overload, overhydration, peritoneal dialysis, quality of life.

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