Kidney Transplants May Improve Life

Kidney transplantation for chronic kidney disease may be better than dialysis for improving quality of life

(RxWiki News) Both dialysis and kidney transplantation can save the lives of patients with chronic kidney disease. But dialysis patients may feel differently than transplant patients about their quality of life.

Kidney transplantation may be a better treatment option than dialysis to improve the quality of life of chronic kidney disease patients.

For those on dialysis, a home-based type of dialysis may boost quality of life more than other kinds of dialysis.

"Consider kidney donation."

In a recent study, Melanie Wyld from the University of Sydney and colleagues wanted to see which treatment option for chronic kidney disease led to the best quality of life for patients. To compare treatments, the researchers reviewed 190 past studies.

On average, kidney transplant patients had the highest quality of life, followed by pre-dialysis patients, dialysis patients, and then patients on non-dialysis treatment (also called conservative care).

Past studies have suggested that kidney disease patients with a working kidney transplant may enjoy a higher quality of life than those on dialysis.

However, according to an Editors' Summary of the current study, "it is unclear whether the type of dialysis affects quality of life: hemodialysis is a highly technical process that directly filters the blood, usually must be done 2-4 times a week, and can only be performed in a health facility." Peritoneal dialysis, on the other hand, can be done at home throughout the day or at night.

When comparing types of dialysis, Wyld and her fellow researchers found that there was little difference in quality of life between patients on hemodialysis and peritoneal dialysis.

However, patients on a home-based type of dialysis (automated peritoneal dialysis) had a higher quality of life than those on another type (continuous ambulatory peritoneal dialysis).

These findings suggest that home-based dialysis may boost quality of life more than other types of dialysis - which is an important finding because peritoneal dialysis is not as expensive or commonly used as hemodialysis.

To rate quality of life, the researchers used a measure called a utility. A utility is a score from 0 to 1, where 0 means death and 1 means full health. Unlike similar measures, utilities take into account the feelings and views of the patients.

The researchers found that transplant patients had a utility of 0.82 - the highest average utility of all the treatment groups. Utilities for other treatment groups were as follows:

  • 0.80 among pre-dialysis patients
  • 0.71 among dialysis patients
  • 0.62 among those receiving conservative care

According to the Editors' Summary, "The information from this analysis can help guide clinicians caring for patients with chronic kidney disease in their discussions about possible treatment options."

The researchers received no specific funding for this study. Study co-authors Rachael Morton and Andrew Hayen were supported by grants from the National Health and Medical Research Council.

The study was published September 11 in PLOS Medicine.

Review Date: 
September 13, 2012