[Background] The Japanese Ministry of Health, Labor, and Welfare has issued updated guidelines for controlling renal disease, which emphasize the importance of the QOL of CKD patients, including dialysis patients. However, there is no unified method for evaluating dialysis patients’ QOL. We conducted a literature survey in order to clarify the current status of QOL studies of dialysis patients. [Methods] We searched the Japan Medical Abstracts Society database using the keywords hemodialysis, QOL, and quality of life, and then investigated QOL-related content and evaluation scales. [Results] Seventy-seven of 489 matching reports were selected for the survey. QOL studies were classified into two types, comprehensive QOL evaluations (n=53) and symptom-specific evaluations, such as evaluations of fatigue (n=4), pruritus (n=10), sleep disorders (n=9), and digestive symptoms (n=5), and psychological evaluations (n=13). In accordance with the focus of each study, 8 and 42 types of scales were used for the comprehensive and symptom-specific evaluations, respectively. [Conclusion] QOL studies involving Japanese dialysis patients have examined a diverse range of issues, and various types of QOL scales have been used for such studies. In order to allow inter-study comparisons, it will be necessary to standardize the evaluation tools that are used for such QOL studies.

A 69-year-old male had a history of a thoracic dissecting aortic aneurysm, which was conservatively monitored. He was started on dialysis due to nephrosclerosis in year X-2. However, it was difficult to create an arteriovenous fistula because of his bleeding tendency. Resurgery and hematoma removal were subsequently required. Conspicuous hemorrhagic symptoms were seen, even after the introduction of hemodialysis, and anticoagulants were not used during the hemodialysis due to the difficulty of achieving hemostasis after the shunt puncture. The patient visited a hospital in week X-5 because of a buccal mucosal hematoma, which had formed after an accidental bite. Despite outpatient treatment, the hematoma continued to grow. Therefore, he was hospitalized to undergo surgery under general anesthesia. The buccal mucosa was sutured, but the hematoma continued to grow. On the ninth day of his hospitalization, a giant subcutaneous hematoma formed on his back. Blood tests suggested that his chronic disseminated intravascular coagulation had been exacerbated by the dissecting aortic aneurysm and secondary factor XIII deficiency-related bleeding. However, since radical surgery was considered difficult, tranexamic acid and recombinant human thrombomodulin were administered in addition to a blood transfusion. Afterwards, all of the patient’s bleeding symptoms, including the buccal mucosal hematoma, were ameliorated, and hemostasis became easier to achieve during dialysis. Therefore, dialysis could be continued without performing radical surgery for the aortic aneurysm.