International Journal of Medical Sciences

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14 December 2017

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

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 Kim24✉, 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

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.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Yoon HE, Kwon YJ, Song HC, Kim JK, Song YR, Shin SJ, Kim HW, Lee CH, Lee TW, Kim YO, Kim BS, Moon KH, Chang YK, Kim SS, Bang K, Cho JT, Yun SR, Na KR, Kim YW, Han BG, Chung JH, Lee KY, Jeong JH, Hwang EA, Kim YS, the Quality of Life of Dialysis Patients (QOLD) Study Group. Overhydration Negatively Affects Quality of Life in Peritoneal Dialysis Patients: Evidence from a Prospective Observational Study. Int J Med Sci 2016; 13(9):686-695. doi:10.7150/ijms.16372. Available from http://www.medsci.org/v13p0686.htm