Abstract
We analyzed the costs of artificial dialysis, the quality of life (QOL) in patients on dialysis and with type 2 diabetes, and factors affecting them. The direct cost per month in medical care of outpatients with dialysis (n=106) were ¥428,788±44,249 (Mean±SD) in the Matsushima clinic (2004). The sample of patients in the Matsushima clinic (n=70) were given questionnaires to assess QOL, and the score of KDQOL-SF in patients with dialysis were the following: without diabetes, 63.94±15.96 (mean±SD), and with diabetes, 47.32±17.39 (p=0.00001). The QOL scores of SF-36 in patients with diabetes in the Matsushima clinic (n=24) and the diabetes clinic of Kyoto University hospital (n=87) became lower as the number of complications increased (p<0.0256) as follows: without complications, 73.09±9.57 (mean±SD); with one complication, 67.71±8.33; with two complications, 60.17±8.61; with three complications, 37.94±9.24; with four complications, 36.42±14.52. We further gave questionnaires of KDQOL-SF to ascertain the impression of potential kidney disease in subjects without kidney disease. The scores in non-kidney patients were lower than patients with kidney disease. Multiple regression analysis expressed the factors that affect QOL. The negative factors of QOL for patients with dialysis were aging, living alone, morning dialysis, questionnaire at home, cardiovascular, cerebrovascular disease, and neuropathy. In contrast, the negative factors of QOL for patients without dialysis but with diabetes were gender and living alone. Because all QOL scores by KDQOL-SF were lower and medical cost per month is much more expensive in patients with dialysis and diabetes than patients with dialysis without diabetes (non-dialysis but with diabetes vs. dialysis with/without diabetes, ¥428,788 vs. ¥5,140,000/year), reducing medical cost is important and hence there should be provisions for secondary prevention of complications along with the primary prevention of disease.
