Health-Related Quality of Life in Patients End-Stage Kidney Disease with Hypertension - Hemodialysis Vs Continuous Ambulatory Peritoneal Dialysis Using EQ-5D-5L at a Tertiary Center in Indonesia

Sep 28, 2026

Health-related quality of life was compared between hemodialysis and continuous ambulatory peritoneal dialysis in adults with end-stage kidney disease and hypertension. A prospective observational cohort study assessed EQ-5D-5L and EQ-VAS at baseline, week 2, and week 4. Baseline differences were tested with chi-square/Fisher’s exact and Mann–Whitney U, while repeated longitudinal changes were analyzed using linear mixed-effects models with age and comorbidity effects. Overall short-term HRQoL was broadly comparable, with age–comorbidity and time–comorbidity interactions indicating less favorable trajectories in older, multimorbid patients.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Background

Study methods

Results

Conclusion

International Journal of Nephrology and Renovascular Disease Open Access Full Text Article ORIGINAL RESEARCH Health-Related Quality of Life in Patients End-Stage Kidney Disease with Hypertension: Hemodialysis Vs Continuous Ambulatory Peritoneal Dialysis Using EQ-5D-5L at a Tertiary Center in Indonesia Wening Wulandari 1–3 , Mohammed Alfaqeeh 1,2, Neily Zakiyah 2,4, Fredrick Dermawan Purba 5,6, Cherry Rahayu7, Asrul Akmal Shafie 8, Dwi Endarti 9, 10, Auliya A Suwantika 2,4,6 1Doctoral Program of Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia; 3Department of Pharmacy, Faculty of Health Sciences, Universitas Jenderal Soedirman, Banyumas, Central Java, Indonesia; 4Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia; 5Department of Clinical and Health Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, West Java, Indonesia; 6Center for Health Technology Assessment, Universitas Padjadjaran, Bandung, West Java, Indonesia; 7Hasan Sadikin Hospital, Bandung, West Java, Indonesia; 8Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, Malaysia; 9Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia; 10Center for Pharmacoeconomic and Health Technology Assessment, Universitas Gadjah Mada, Yogyakarta, Indonesia Correspondence: Auliya A Suwantika, Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jalan Raya Bandung-Sumedang KM 21, Bandung, West Java, 45363, Indonesia, Tel/Fax +62-878-2267-1010, Email [auliya@unpad.ac.id](auliya@unpad.ac.id) Background: Haemodialysis (HD) is the predominant kidney replacement therapy for end-stage kidney disease (ESKD) in Indonesia, whereas continuous ambulatory peritoneal dialysis (CAPD) is less frequently used. Hypertension is highly prevalent in this population and may impair health-related quality of life (HRQoL) . This study aimed to compare HRQoL between HD and CAPD patients using the EQ-5D-5L instrument. Methods: A prospective observational cohort study was conducted at Dr. Hasan Sadikin General Hospital, Bandung (September 2023– January 2024). Adults with ESKD and hypertension on HD or CAPD for ≥3 months were assessed at baseline, week 2 and week 4 using EQ-5D-5L and EQ-VAS. Socio-demographic and clinical data were obtained from medical records. Baseline differences were examined using χ2/Fisher’s exact and Mann–Whitney U-tests. Longitudinal changes in EQ-5D-5L utility and EQ-VAS were analysed using linear mixed-effects models (LMMs) with random intercepts and fixed effects for time, dialysis modality, age and comorbidity; age×comorbidity and time×comorbidity interactions were explored. Results: Ninety-one patients were included (58 HD, 33 CAPD) . Compared with HD, CAPD patients were younger, more highly educated, more often insured through non-PBI schemes, and had greater comorbidity burden, more frequent use of ≥3 antihypertensive drugs and higher rehospitalisation rates. Mean EQ-5D-5L utility and EQ-VAS scores were similar between modalities at all time points. In LMMs, neither modality nor time showed significant main effects on EQ-5D-5L utility or EQ-VAS (all p>0.05) . For utility, significant age×comorbidity (p=0.002) and time×comorbidity (p=0.032) interactions indicated less favourable trajectories among older, multimorbid patients. Conclusion: After accounting for repeated measurements and baseline confounding, short-term overall HRQoL appeared broadly comparable between HD and CAPD. Small numerical advantages for CAPD and the interaction patterns observed in LMMs should be considered hypothesis-generating and require confirmation in larger, methodologically robust studies.

FAQs

What was the study objective regarding HRQoL?

To compare health-related quality of life between hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients using the EQ-5D-5L instrument.

How were patients assessed and over what timeline?

Adults with ESKD and hypertension on HD or CAPD for at least 3 months were assessed at baseline, week 2, and week 4 using EQ-5D-5L and EQ-VAS.

What did the results show about overall short-term HRQoL between modalities?

After accounting for repeated measurements and baseline confounding, short-term overall HRQoL appeared broadly comparable between HD and CAPD.

Sep 28, 2026

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