Quality of life in chronic dialysis patients: a critical comparison of continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis.

Thirty-three matched pairs of chronic continuous ambulatory peritoneal dialysis (CAPD) and center hemodialysis (CHD) patients from three dialysis programs were studied cross-sectionally to assess their current medical, psychological, and social status. The CAPD and CHD groups were similar on matching and medical status variables. The CAPD subject group had a higher quality of life, lower illness and modality related stress scores, and nonsignificantly lower mood disturbance scores. The groups did not differ in self-esteem or health locus of control. CAPD subjects reported higher frequency of participation in community activities, better relationships with dialysis physicians and patients, and were more likely to be currently vocationally active. Dialysis modality likely exerts an independent effect on the quality of life of chronic dialysis patients, and CAPD is likely superior to CHD in this regard. Longitudinal studies are needed to determine the relative role of patient-selection and modality-related factors in determining the psychological and social adaptation (quality of life) of chronic dialysis patients.