Saudi Journal of Kidney Diseases and Transplantation

: 2014  |  Volume : 25  |  Issue : 4  |  Page : 881--882

Remarks about the study of predictors of quality of life in hemodialysis patients

Behzad Einollahi, Mohsen Motalebi 
 Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

Correspondence Address:
Mohsen Motalebi
Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran

How to cite this article:
Einollahi B, Motalebi M. Remarks about the study of predictors of quality of life in hemodialysis patients.Saudi J Kidney Dis Transpl 2014;25:881-882

How to cite this URL:
Einollahi B, Motalebi M. Remarks about the study of predictors of quality of life in hemodialysis patients. Saudi J Kidney Dis Transpl [serial online] 2014 [cited 2020 Sep 24 ];25:881-882
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Full Text

To the Editor,

We read with great interest the article by Bayoumi et al recently published in your most valuable journal titled "Predictors of quality of life in hemodialysis patients." [1] This cross-sec­tional study focused its message on drawing the attention of factors predicting the quality of life (QoL) scores among 100 hemodialysis (HD) patients. [1]

It is of interest that Bayoumi et al showed reduced QoL scores in male patients; [1] how­ever, we have shown in a study on 6930 HD patients [2] that the mean score of all domains, including SF-36 (8 items) and kidney disease component summary (KDCS, 11 items), was higher in male patients, which is consistent with other studies. [3],[4] It seems likely that healthy behaviors and outlooks also vary in different countries between males and females. In addition, some factors including perception of social support, religious conviction and spi­rituality that persuade health outlook are dif­ferent too. Moreover, previous studies [5],[6] have shown that females with chronic kidney di­sease (CKD) have lower handgrip force, lower exercise tolerance, greater arm fat region and less muscle area than males. Therefore, ques­tions hooked on physical strength may be scored with different values in both genders. On the other hand, Zender and coworkers [7] have reported that the prevalence and the seve­rity of psychological disorders were much higher in females when compared with males; hence, these disorders can lead to a lower QoL in female patients.

Bayoumi and his colleagues showed that the lower QoL scores were significantly correlated with lower level of education. [1] We have also found that the higher educational level was significantly associated with better scores on all domains except the quality of social inter­actions, which was abruptly decreased in pa­tients with academic education. In addition, dialysis staff encouragement and patients' satisfaction decreased with high educational level, as was shown in the HEMO study. [8] It seems that it was related to a high-expectation level in educated patients.

The mean age of the patients in the current study [1] was younger than our patients (47.5 ± 13.8 vs. 54.4 ± 17.1 years, respectively). We had also evaluated 19 different studies from various regions and found that the mean age of the patients in each study was dissimilar. [2] Although a study has shown that the preva­lence of end-stage renal disease varies widely between different ethnic groups, [9] these diffe­rent results may be due to the small size of patients in the present study. [1]

Finally, gender differences of QoL in HD pa­tients may be related to various factors such as geographic areas, ethnicity, sample size, etc.


1Bayoumi M, Al Harbi A, Al Suwaida A, Al Ghonaim M, Al Wakeel J, Mishkiry A. Pre­dictors of quality of life in hemodialysis pa­tients. Saudi J Kidney Dis Transpl 2013;24: 254-9.
2Rostami Z, Einollahi B, Lessan-Pezeshki M, et al. Health-Related Quality of Life in Hemo-dialysis Patients: An Iranian Multi-Center Study. Nephrourol Mon 2013;5:901-12.
3Braga SF, Peixoto SV, Gomes IC, Acurcio Fde A, Andrade EI, Cherchiglia ML. Factors associated with health-related quality of life in elderly patients on hemodialysis. Rev Saude Publica 2011;45:1127-36.
4Turkmen K, Yazici R, Solak Y, et al. Health-related quality of life, sleep quality, and depression in peritoneal dialysis and hemo-dialysis patients. Hemodial Int 2012;16:198-206.
5Constantin-Teodosiu D, Young S, Wellock F, et al. Gender and age differences in plasma carnitine, muscle strength, and exercise tole­rance in haemodialysis patients. Nephrol Dial Transplant 2002;17:1808-13.
6Kimmel PL, Chawla LS, Amarasinghe A, et al. Anthropometric measures, cytokines and sur­vival in haemodialysis patients. Nephrol Dial Transplant 2003;18:326-32.
7Zender R, Olshansky E. Women's mental health: depression and anxiety. Nurs Clin North Am 2009;44:355-64.
8Unruh ML, Newman AB, Larive B, et al. The influence of age on changes in health-related quality of life over three years in a cohort undergoing hemodialysis. J Am Geriatr Soc 2008;56:1608-17.
9White SL, Cass A, Atkins RC, Chadban SJ. Chronic kidney disease in the general popu­lation. Advance Chron Kidney Dis 2005;12:5-13.