Sex, Gender, and Quality of Life in Patients Initiating Hemodialysis
Lay Summary
Kidney failure is an irreversible, progressive decline in kidney function. As kidney function declines, the ability of the kidneys to function and excrete fluid and wastes is decreased. In Canada, more than 40,000 people are living with kidney failure that require life-sustaining kidney replacement therapy in the form of dialysis. Hemodialysis uses a dialysis machine that removes blood to filter and clean it, before returning it back to the body. Currently, all patients initiating hemodialysis are given the same treatment prescription of 4 hours thrice weekly. This is known as conventional hemodialysis. However, it has been shown that quality of life in the dialysis population is worse than the general population. Furthermore, females on dialysis have a worse quality of life than males. Quality of life is a predictor of hospitalizations and mortality in dialysis patients. This is important, and quality of life has been identified by patients as a research priority. Incremental hemodialysis is a new initiative in Alberta that aims to improve quality of life for dialysis patients. With incremental hemodialysis, patients start on a lower dose (less than thrice weekly) and gradually increase their dialysis prescription as their residual kidney function declines. The aim of incremental hemodialysis is to ease the transition onto hemodialysis and gradually adjust dialysis prescription to eventually be at thrice weekly dialysis. Easing patients onto hemodialysis reduces treatment burden and is associated with better tolerance of treatment and better quality of life. My project is a prospective cohort study with a 3-month follow-up time to find the association between quality of life and incremental and conventional hemodialysis, stratified by sex and gender. My population is incident kidney failure patient’s initiation hemodialysis in Alberta. My exposure is incremental hemodialysis which will be compared to conventional hemodialysis. My outcome is quality of life, which will be measured using the standardized and valid Kidney Disease Quality of life-36 item (KDQOL-36) questionnaire. The setting is all Alberta Kidney Care clinics.
