Quality of Life and Health Status Among Patients Receiving Renal Replacement Therapy in Trinidad and Tobago, West Indies

Sharlene Sanchez; Surujpal Teelucksingh; Ronan Ali; Henry Bailey; George Legall

doi:10.2147/IJNRD.S302157

Quality of Life and Health Status Among Patients Receiving Renal Replacement Therapy in Trinidad and Tobago, West Indies

Int J Nephrol Renovasc Dis. 2021 Jun 8:14:173-192. doi: 10.2147/IJNRD.S302157. eCollection 2021.

Authors

Sharlene Sanchez¹, Surujpal Teelucksingh², Ronan Ali², Henry Bailey³, George Legall⁴

Affiliations

¹ Department of Medicine, North Central Regional Health Authority, Arima General Hospital, Arima, Trinidad and Tobago, West Indies.
² Department of Clinical Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies.
³ Department of Economics, University of the West Indies, St Augustine, Trinidad and Tobago, West Indies.
⁴ Department of Natural Sciences, University of the West Indies, St Augustine, Trinidad and Tobago, West Indies.

Abstract

Purpose: The determinants of quality of life for patients on renal replacement therapy vary across the world. The aim of this study is to determine the quality of life of patients on renal replacement therapy in Trinidad and Tobago and predictors thereof.

Patients and methods: This cross-sectional study took place over a 1-year period. Data were obtained from 530 out of 1383 patients meeting inclusion criteria (100 transplants, 80 peritoneal dialyses, 350 hemodialyses) using the survey instruments. Stratified random sampling with proportional allocation was used to select patients at hemodialysis centres. The Kidney Disease Quality of Life questionnaire (KDQOL-36), EuroQol and demographic questionnaires were administered via face-to-face interviews. SPSS24, STATA14 and MINITAB18 were used for descriptive and inferential data analysis.

Results: Of the 530 patients, 52.5% were male, 37.5% were in the 56-65 years age group and 51.3% were of Indo-Trinbagonian descent. Hypertension (25.5%) and type 2 diabetes mellitus (62.0%) were reported as the main causes of kidney disease in the dialysis group. In the transplant category, chronic glomerulonephritis (45%) was the main aetiology of kidney disease. The KDQOL-36 domain scores and significantly associated variables included modality of renal replacement, Charlson's Comorbidity Index, ethnicity, income and employment status. Transplant patients had higher mean subcomponent Kidney Disease Quality of Life scores and performed better in the EuroQol than patients on dialysis. Patients on peritoneal dialysis had a better quality of life than hemodialysis patients. Among patients on hemodialysis, an arteriovenous fistula significantly impacted their quality of life.

Conclusion: Renal transplant recipients enjoy the best quality of life and health state among patients on renal replacement therapy in Trinidad and Tobago. Increasing patients' access to renal transplantation or peritoneal dialysis will markedly improve health status for the number of years of renal replacement therapy.

Keywords: EuroQol; Kidney Disease Quality of Life questionnaire; hemodialysis; peritoneal dialysis; renal transplant.

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.