JNEPHROL 2007; 20: 731-738 ORIGINAL ARTICLE 731 ABSTRACT Background: In hemodialysis patients, quality of life (QOL) may vary across a range of individual conditions and so- cial environments. In this study, we focused on ambulato- ry hemodialysis patients, examining their QOL compared with that of age-matched controls. Correlates of QOL in ambulatory hemodialysis patients were also examined. Methods: QOL was evaluated by WHOQOL in ambulatory hemodialysis patients and age-matched controls. Correla- tions of QOL with age, sex, body mass index (BMI), func- tional performance, physical activity, cognitive function, psychiatric disorders, diabetes status, comorbidities, du- ration of dialysis therapy, adequacy of dialysis, biochemi- cal variables and nutritional status were also examined in ambulatory hemodialysis patients. Results: In WHOQOL, we found decreased psychological domain scores (19.8 vs. 21.6, p=0.012) and overall QOL (89.0 vs. 94.3, p=0.035) for ambulatory hemodialysis pa- tients compared with age-matched controls, especially in the items: enjoying life (p=0.032), feeling life has meaning (p=0.023), having opportunity to take leisure time (p=0.003) and being satisfied with sexual life (p=0.044). Patients with male sex, BMI >24 and duration of dialysis shorter than 5 years had lower overall QOL than controls. Male dialysis patients also had lower QOL than female patients. As for correlates of QOL in ambulatory hemodialysis patients, age, BMI and psychiatric disorders were negatively corre- lated. By contrast, premorbid and current satisfaction with personal health were positively correlated. Conclusions: QOL in ambulatory hemodialysis patients was lower than in age-matched controls. QOL in ambula- tory hemodialysis patients was positively correlated with personal health satisfaction and negatively correlated with age, BMI and psychiatric disorders. Key words: Correlates, Functional performance, He- modialysis, Physical activity, Quality of life INTRODUCTION The growth rate for the number of end-stage renal disease (ESRD) patients is 5 times that of the world population (1). It is expected that the number of ESRD patients being treated will increase from ~2 million in 2005 to 2.5 million by 2010, worldwide (1). In 2001, Taiwan had the second highest national prevalence globally (1). The national prevalence rate of ESRD was more than 1,400 per million persons in 2001 (1, 2). Up to 95% of ESRD patients in Taiwan must resort to hemodialysis due to lack of organ donation. These compromised individuals must adapt to new dependen- cies on medical professionals and equipment, and withstand multiple physiological and psychological stresses (3). They have only 40%-50% of the maximal cardiopulmonary fitness and skeletal muscle strength of their age-matched controls (4). Even in ambulatory hemodialysis patients, maximal cardiovas- cular fitness was only 71% of that for their age-matched con- trols (5). Poor exercise tolerance and muscular weakness may lead to further deconditioning (6). These changes may lead to job losses and alteration of familial and social relationships. These patients are generally more depressed and less satisfied than their peers in the general population (7). These changes may result in reduced quality of life (QOL) (8). QOL is defined as an individual’s perceptions of his or her position in life, of culture and value systems, and relation to goals and expectations (9). It incorporates an individual’s physical health, psychological state, level of independence, social relationships, religious and personal beliefs (10). The rise of consumer-oriented medical care has led to QOL being used to embody the concern for patients as people and not just cases (11). The broad definition of health by WHO is that of “a state of complete physical, mental and social well-being and not merely the absence of disease” (12). This concept is particularly important for subjects who suffer from chronic Ru-Lan Hsieh 1 , Wen-Chung Lee 2 , Hsiao-Yuan Huang 2 , Chung-Hsin Chang 3,4 1 Department of Physical Medicine and Rehabilitation, Shin-Kong Wu Ho-Su Memorial Hospital, and Taipei Medical University, Taipei - Taiwan 2 Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei - Taiwan 3 Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei - Taiwan 4 Department of Medicine, School of Medicine, Fu Jen Catholic University, Taipei - Taiwan Quality of life and its correlates in ambulatory hemodialysis patients www.sin-italy.org/jnonline – www.jnephrol.com