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[Life quality in patients at terminal stage of chronic renal failure with no access to dialysis].

A transversal prospective study of 69 patients with terminal stage renal disease covering a 12 month period - 1st January to 31st December 2010 - was conducted; the objective was to determine factors affecting their quality of life.
This is a questionnaire study covering a 12 month period. The study group were patients with ESRD whose clearance of creatinin were less than 15ml/min. patients who died shortly after arrival, those with acute renal failure and those undergoing dialysis were excluded.
We used the SF36 questionnaire [8] and classified the results in two groups: scores lower than 50/100=poor quality of life, scores exceed or equal to 50/100=good quality of life. Factors making quality of life also into two groups; for limitations: cessation of all activities and additional effort required; for pain: severe and mild; for health: good and bad; for social and physical activities: reduced and not reduced.
Terminal stage renal disease represents 30.8% of admissions in 12 months, for a total of 69 patients. Thirty-two (46.3%) had good quality of life and 37 (53.7%) poor quality of life. In the latter group, the average age was of 54±4, while in the good quality of life group: the average age was 47.6 ± 4 (p=0.01). Patients in the good quality of life group had better health overall (OR=0.42). Poor quality of life patients had more severe pain (p=0.001); however good quality of life didn't protect against mental problems (p=0.866). Limitations due to mental status were more frequent at the poor quality of life (p=0.01). Social activities were more reduced in the poor quality of life group (p=0.0001) and there were more co-morbidities (29.7% with more than 4).
In our study good quality of life is associated with younger age, fewer comorbidities, less severe physical pain and fewer physical plus social limitations. Quality of life could substantially be improved by acting on modifiable factors such as better treatment for the co-morbidities, more effective pain control and assistance with their social and physical limitations.