Background: Patients with advanced chronic kidney disease (CKD) in different stages have lower quality of life relative to the general population. No study has yet compared all available renal replacement options and included patient self-assessment of the quality of healthcare received. Methods: Descriptive observational, cross-sectional, multicenter study conducted by applying Patient-Reported Outcome Measures (PROMs) VAS, SF36, FACIT, PFS, HADS and Patient-Reported Experience Measures (PREMs) questionnaires (PACIC), in patients with stage 4–5 CKD, kidney transplant (KT), in-center hemodialysis (HD), home hemodialysis (HHD), peritoneal dialysis (PD), and CKD stages 1–2 as controls. Results: A total of 319 patients were included, comprising 84 (26%) on HD, 48 (15%) on PD, 50 (16%) with KT, 50 (16%) with advanced CKD, 38 (12%) on HHD, and 49 (15%) individuals with stages 1 and 2 CKD (control group). Among PROMS, significant differences were found in the SF-36 physical functioning and fatigue scales (PFS and FACIT), with HHD patients showing the best results. In PREMS, the highest rating of quality of care received (using the PACIC scale) was also from HHD patients, followed by transplant recipients and patients on peritoneal dialysis. Conclusions: Patients on HHD reported the best physical functioning, resembling controls and transplant patients in fatigue symptoms, and this group also gave the best rating on healthcare received. Home hemodialysis is a renal replacement therapy option with high indices of quality of life and patient-reported experience, similar to those achieved in kidney transplant patients. This should be considered when informing patients and selecting the optimal renal replacement therapy option.
Daza et al. (Mon,) studied this question.