Study of the quality of life of patients with proliferative diabetic retinopathy and end-stage chronic renal failure requiring hemodialysis: prospective cross-sectional study

At present, a sufficiently high efficiency of including the assessment of the quality of life (QOL) of patients in the complex of standard clinical and functional methods for examining the organ of vision of patients with various types of vitreoretinal pathology has been determined. The occurrence and/or progression of proliferative diabetic retinopathy (PDR) is accompanied by an increase in the prevalence of chronic kidney disease because of similar pathogenetic mechanisms associated with pathological abnormalities in the microvascular bed. However, the analysis of the literature indicates the special practical importance of the end-stage chronic renal failure (CRF), which requires continuous hemodialysis.

AIM: This study aimed to investigate the patient’s QOL with PDR and end-stage CRF requiring hemodialysis.

MATERIALS AND METHODS: A prospective cross-sectional study was conducted from November 2020 to March 2022. Two groups of equal age, gender, and severity of PDR («Severe», «Severe risks I and II») were under observation: the main group (MG, n=36, mean age 60.4±2.1 yr), in which the hemodialysis procedure and the control procedure (CG, n=32, mean age 61.8±2.2 yr) were regularly performed, in which stage IV CRF was diagnosed. The study of QOL was performed according to two questionnaires, tested in patients with vitreoretinal pathology: «general» («VFQ-25») and «special» («QOL-20»).

RESULTS: The results obtained indicate a pronounced, statistically significant increase in the level of QOL in the CG compared with the MG. In quantitative terms, the conducted comparative assessment is 12.7 (p <0.05) and 26.1% (p <0.01) for the «QOL-20» and «VFQ-25» questionnaires, respectively. According to the «VFQ-25» questionnaire, the most pronounced differences between the QОL of patients in the MG and the CG were noted on the scales of near visual function, distant visual function, social functioning, and mental health. It is especially important to note that in accordance with the methodological foundations of the «QOL-20» questionnaire, patients in the CG (according to the total scores) were diagnosed with the 3rd degree of severity of visual impairment, whereas in patients of the MG, it was already the 4th degree.

CONCLUSION: In practical terms, the results presented reflect the improvement of the technology of surgical intervention in patients with PDR who are on hemodialysis. The level of QОL in patients with PDR who are on hemodialysis is significantly lower than in patients with PDR with stage IV CRF.