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The quality of life of older and younger people who receive renal replacement therapy

Published online by Cambridge University Press:  04 November 2005

KEVIN J. McKEE
Affiliation:
Sheffield Institute for Studies on Ageing, University of Sheffield, UK.
STUART G. PARKER
Affiliation:
Sheffield Institute for Studies on Ageing, University of Sheffield, UK.
JENNIFER ELVISH
Affiliation:
Department of Psychology, University of Sheffield, UK.
VINCE J. CLUBB
Affiliation:
Health Care for the Elderly, Northern General Hospital, Sheffield, UK.
MEGUID EL NAHAS
Affiliation:
Sheffield Kidney Institute, University of Sheffield and Northern General Hospital, Sheffield, UK.
DEBORAH KENDRAY
Affiliation:
Sheffield Kidney Institute, University of Sheffield and Northern General Hospital, Sheffield, UK.
NICOLA CREAMER
Affiliation:
Department of Psychology, University of Sheffield, UK.

Abstract

The use of age as a criterion for the allocation of medical resources has been extensively debated internationally. This paper describes a study of the significance of age for the quality of life (QoL) of older and younger people with end-stage renal failure (ESRF) and in receipt of renal replacement therapy (RRT). The study has two components: a structured literature review to characterise the QoL and health-status measurement instruments that have been developed for use with all or specifically older RRT patients; and a longitudinal survey of the QoL domains nominated by older RRT patients by their age and duration of treatment. The literature review found that no validated QoL instrument had been developed specifically for use with older RRT patients. Moreover, there was little correspondence between the QoL domains used in the instruments described in the published literature and those mentioned by the survey participants. Older and younger patients nominated different domains, and their nominations changed with the duration of treatment. No significant differences in QoL scores were found between older and younger patients, but the scores improved significantly between 6–12 and 18–24 months of treatment. The findings suggest that using older age as a criterion for refusing full access to healthcare resources in ESRF is a simplistic and potentially erroneous strategy.

Type
Research Article
Copyright
2005 Cambridge University Press

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