The impact of dialysis modality on quality of life: a systematic review.

Background: This systematic review aims to generate evidence on which dialysis modality (in-centre haemodialysis HD, or peritoneal dialysis, PD) improves the quality of life (QOL) of end stage renal disease (ESRD) patients.

Methods: MEDLINE, CINAHL and EMBASE were searched from their inception to July 2010 for studies that compared QOL in both HD and PD patients.

Results: Only 26 of the 574 studies identified were included in this review. These were crosssectional, longitudinal or retrospective in design. QOL tools used include SF-36, Kidney Disease Quality of Life (KDQOL) and CHOICE Health Experience Questionnaire (CHEQ). PD patients mostly rate their QOL higher than HD patients. Yet HD patients may enjoy a relatively better QOL in the physical dimensions over time. Mental health components are comparable between both dialysis populations.

Conclusion: There is no simple 'yes' or 'no' answer to the question of which dialysis modality improves QOL. However a good understanding of the evidence base will facilitate individual decision-making.