The impact of reusable dialyzer membrane on end-stage renal disease patients' Quality of life: A multicenter study in Jakarta, Indonesia

Data from 8th Report of the Indonesian Renal Registry in 2015 reported that there was an increase in the prevalence of hemodialysis (HD) patients in Indonesia. Measures had been taken to reduce the cost of HD such as utilizing reusable dialyzer membrane. However, little is known on the impact of reusable dialyzer membrane on patients' quality of life (QOL), and hence, this study was conducted. We conducted a multicenter study at Cipto Mangunkusumo Hospital, Koja District Hospital, and Cengkareng District Hospital with a total of 389 patients. Cipto Mangunkusumo Hospital represented single-use dialyzer group while, Koja and Cengkareng District Hospital represented reusable dialyzer group. Face-to-face interviews were conducted using Kidney Disease QOL-Short Form 36 questionnaires. Single-use dialyzer group's scores were significantly higher than reusable dialyzer group's scores in the following dimensions: kidney disease component summary (KDCS; 74.2 vs. 66.3; P <0.001), physical component summary (PCS; 70.6 vs. 55.2; P<0.001), mental component summary (MCS; 76.1 vs. 70.7; P= 0.023), and overall health rating (73.4 vs. 64.9; P <0.001). In the linear regression model, reusable dialyzer was still a strong predictor in KDCS (coefficient β = -9.3; P<0.001) and PCS (coefficient β = -17.2; P <0.001). Reusable dialyzer was associated significantly with patients' QOL impairment. Unemployment, age, and illiteracy also showed significant association with patients' QOL.