The Course of Quality of Life in Patients on Peritoneal Dialysis: A 12-month Prospective Observational Cohort Study Haikel A. Lim 1,2 & Zhenli Yu 2 & Augustine W. C. Kang 2 & Marjorie W. Y. Foo 3 & Konstadina Griva 2 # International Society of Behavioral Medicine 2015 Abstract Background Quality of life (QOL) impairments are common in patients undergoing dialysis, and have been strongly associated with significant clinical outcomes like mortality and morbidity. Despite this, little is known about the course of QOL over time, especially for patients on peritoneal dialysis (PD). Purpose This prospective study was set to explore course and determinants of QOL over 12 months in PD patients. Methods A total of 115 PD patients completed the SF-12 and Kidney Disease Quality of Life Short Form (KDQOL-SF) at baseline and 12 months later. Intra-individual changes in physical (physical component summary, PCS), mental (men- tal component summary, MCS), and Kidney Disease Component Summary scores (KDCS) were identified based on the minimally important clinical difference threshold. Clinical information was extracted from medical records. Results Of the patients, 74–80 % reported physical QOL im- pairments, as compared to 29–33 % who reported mental/ emotional QOL impairments. PCS and MCS scores remained stable across 12 months. Significant deterioration was noted in the domains of patient satisfaction, staff encouragement, and social support, while there were significant increases in the perceived effects of kidney disease. Intra-individual trajectory analyses indicated that one in three patients reported deterio- rating QOL. No sociodemographic or clinical variables were found to be associated with course of outcomes. Conclusions Although PD offers the convenience of home- based care, it is associated with persisting QOL impairments and diminishing QOL over time, especially in domains related to quality of care and support. This highlights the need for improving or maintaining standards of care and support for PD patients as they become increasingly established on their regimes. Keywords End-stage kidney disease . Peritoneal dialysis . Quality of life . Asia Introduction For the majority of patients with end-stage renal disease, dial- ysis is a lifelong treatment commonly associated with in- creased impairments in their quality of life (QOL) [1, 2]. Home-based modalities like peritoneal dialysis (PD) are thought to offer enhanced opportunities for autonomy, reha- bilitation, and return to work, with flexibility in dialysis sched- ules in addition to cost savings and good clinical outcomes [3]. Attention has therefore been directed to increase the up- take of PD, which, in most settings, still remains underutilized relative to hemodialysis (HD) [4]. From the patients’ perspective, however, the PD regimen is often seen as time- and labor-intensive [5, 6]—involving the onerous commitment to daily self-care or caregiver- administered dialysis exchanges, alongside fluid and diet re- strictions, and the management of multiple medications [7]— which often results in dwindling motivation, non-adherence, and a deteriorating QOL. Because of strong associations be- tween poor QOL and clinical endpoints [8–10], such as * Konstadina Griva psygk@nus.edu.sg 1 Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore 119228, Singapore 2 Department of Psychology, National University of Singapore, Block AS4, #02-07, 9 Arts Link, Singapore 117570, Singapore 3 Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore 169856, Singapore Int.J. Behav. Med. DOI 10.1007/s12529-015-9521-z