Meaning of Quality of Life for ESRD Population

With maximum well-being and comfort being key factors for improved quality of life for individuals with end-stage renal disease (ESRD), the potential benefits of any health care provided must be weighed carefully against possible side effects or disadvantages. For those people living with the consequences of chronic disease, it must be understood that the types of medical treatment, availability of support networks and financial resources, environmental conditions, as well as personal attributes can each significantly affect quality of life.

Treatment

• A review of numerous studies shows that quality of life for individuals with ESRD improved more for those who had a kidney transplant in comparison to those who continued to receive dialysis. Although neither of these medical treatments is a cure, transplant patients seem to function more normally, whereas dialysis patients report more disability related to chronic disease. However, the fact remains that either treatment choice brings on significant lifestyle changes. Even those individuals who undergo successful kidney transplants are faced with potential rejection of the donor kidney in the future. The financial cost of the transplant, comprehensive follow-up care and the side effects of immunosuppressive drugs are other considerations that certainly affect a person's everyday life.

Responsibility

• Because chronic illness is a lifelong condition, individuals with ESRD need to make adjustments to their normal routines of daily living. In other words, individuals with chronic kidney disease must adapt their lives to a number of new conditions. Whether treatment is a kidney transplant or dialysis, these individuals remain at risk for all kinds of medical complications. In view of this, the person's primary responsibility is to strictly follow all treatment regimens. Positive outcomes can only be accomplished if an individual seeks out information, adopts healthy lifestyle behaviors, promptly reports symptoms and makes it a point to participate in wellness initiatives.

Communication

• Regular communication between the individual and his health care team is essential for successful disease management. ESRD patients must be able to distinguish between symptoms they can manage themselves and those that must be reported immediately to their health care providers. Although medical intervention will be necessary at times, improved quality of life requires that individuals take more proactive roles in their own health care. Effective communication involves a conscientious health care team guiding and supporting a patient who wants to contribute to her own care. While a number of other health care professionals may play a role in a treatment plan, the individual's treating physician is often seen as the most credible source for information. It is a partnership in which a patient must stay well informed to understand what could happen, and prepare in advance for how to deal with possible setbacks.

Emotional Impact

• A person usually tries to preserve quality of life by maintaining as normal a life as possible, the goal being to achieve the highest level of functioning while suffering the fewest number of side effects. But chronic illness can have a significant emotional impact on a person's life. It can also affect how a person continues to view life. The emotional adjustment is often preceded by feelings of denial and anger. But since the disease is not going to go away, an individual has only one choice and that is to learn how to cope with the changes that have disrupted his life. As unlikely as it may seem at first, most people become stronger individuals as they recover from each medical crisis that occurs.

Self-Care

• Self-care refers to any treatment regimen that a patient can self-administer at home. Although a person is required to measure fluid intake, take blood pressure readings, and follow dietary and fluid restrictions along with strict medication schedules, home dialysis offers dialysis patients more freedom and flexibility. According to "What limits the expansion of self-care dialysis at home," an article published in the July 2008 issue of Hemodialysis International, many individuals choose self-care dialysis because it is the less-expensive option, yet offers at least as good an outcome as dialysis treatment received in a clinical setting.

Future Considerations

• Medical treatment and disease management are expected to be ongoing challenges for both the health care industry and society in general as the population ages and those suffering from chronic diseases such as ESRD increase in numbers. Yet because of medical advances, individuals with ESRD are now living longer. While dialysis and kidney transplants are not cures, they can extend a person's life and improve the quality of that life. Even though dialysis treatments have the potential to cause complications, following a proper diet and taking medications exactly as prescribed can help prevent common side effects of treatment.