Peritoneal dialysis is the archetypal home-based therapy and is often favoured by patients. However, as patients with end-stage renal failure become more elderly, with more co-morbidity, their dependence on carers to provide physical, emotional and logistical support increases. The effect of this chronic burden has not been systematically studied. The study prospectively studied patients with end-stage renal failure starting peritoneal dialysis and their carers over a 1-year period.
The study selected a cohort of caregivers that are actively involved with the care of their partners’ dialysis. Quality of Life (QoL) assessed by SF-36 questionnaires showed the patients and carers had impairment of QoL at the start of dialysis. As expected, the baseline QoL Physical Component Scores highly correlated with co-morbidity and assessment of functional capacity. Scores of all QoL domains improved after 1 year and this reached statistical significance for social functioning for both patients and carers. When compared, carers of highly dependent patients (required to perform daily dialysis) with carers of less dependent patients, the former had a statistically significant worsening of their mental health but other parameters were not different.
The study shows that despite increasing the burden for caregivers, with careful selection, education and support, active involvement in their partners' dialysis did not adversely impact on the QoL of carers whilst there was some evidence of improvement, especially in social functioning. This gives reassurance that establishing dependent patients on PD is compatible with a holistic approach to the patients and their families.
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