Etude de la qualité de vie des patients au stade terminal de l’insuffisance rénale chronique sans accès a la dialyse

This is a questionnaire based study of 69 patients with end stage renal disease (ESRD), our purpose was to determine factors affecting their quality of life (QOL). 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 QOL, scores exceed or equal to 50/100=good QOL. Factors making QOl 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. ESRD represents 30.8% of admissions in 12 months, for a total of 69 patients. Thirty-two (46.3%) had good QOL and 37 (53.7%) poor QOL. In the latter group, the average age was of 54±4, while in the good QOL group: the average age was 47.6 ± 4 (p=0.01). Patients in the good QOL group had better health overall (OR=0.42). Poor QOL patients had more severe pain (p=0.001); however good QOL didn’t protect against mental problems (p=0.866). Limitations due to mental status were more frequent at the poor QOL (p=0.01). Social activities were more reduced in the poor QOL group (p=0.0001) and there were more co-morbidities (29.7% with more than 4). In our study good QOL is associated with younger age, fewer comorbidities, less severe physical pain and fewer physical plus social limitations. QOL 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.