Quality of life in end stage renal disease : a comparison of peritonal dialysis and haemodialysis

Abstract

Dialysis is the process of removing waste products and excess water from the body for individuals with little or no renal function (Piira et al 2002). The dialysis treatment consists of two types of treatment modalities that are the HD and PD. In both cases they have their advantages and disadvantages which in the long run they can interfere with the QoL aspects of patients resulting in disturbing their daily life. The research question guiding this study is "In adults with end stage renal disease undergoing dialysis, is it more beneficial to do Peritoneal Dialysis rather than Haemodialysis to achieve a better quality of life? The study retrieved six different types of research designs such as quantitative, qualitative and mixed cohort studies to answer the PICO question. Correspondingly, certain CASP tools were applied to identify the inclusion and exclusion criteria for the study. Furthermore, an adult population was included in all research studies. The search included studies that where produced from 1997 to 2006 as none of the studies were found in years before. Additionally, in four studies the ethical issues were taken into consideration. Whilst, in the other two no ethical issues were observed as there was no contact with patients. The findings of this study show that neither treatment result is better in achieving QoL of these patients. In fact there are some QoL aspects better in PD treatment when compared to HD treatment and vice versa. A number of aspects ought to be considered, depending on the patient's age, determination, ethnicity, family and work. Furthermore, in particular studies it was found that some aspects of QoL were better in HD treatment while other studies suggest that other aspects are better in PO treatment. It is crucial that the patients know these differences that each treatment modality can offer before choosing which treatment to commence. Therefore, the treatment modality should be adopted according to the progress of the disease and the patient's lifestyle. The findings of this study show that there are differences in treatment with regards the QoL aspects. Hence, the findings of this study should be disseminated to nurses working in renal settings and where patients use this service, as well to students. With regards the inclusion and exclusion criteria all studies were obtained in English language and a date limit was set up from 1990 onwards. Furthermore, all participants were adults and had to undergo haemodialysis and peritoneal dialysis. Fundamentally, this knowledge should be disseminated through formal educational programs and leaflets to qualified health care professionals and nursing students as they can be used as a helpful tool when caring for ESRD patients. Therefore, management should do their utmost to implement these educational programmes as they present a sound approach for the health care professionals to assist the patients in make the best decision concerning their treatment modality. Academic search complete, Cochrane central registrar of control trails together with CINAHL plus were utilized as databases throughout the whole search together with Google scholar. Additionally, keywords such as End Stage Renal Disease, Haemodialysis, Peritoneal Dialysis, Quality of Life, Dialysis Facilities and Chronic Renal Failure were included in the search to limit the search.