**3.2 Perception of health-related quality of life**

At the start of the study, the perception of HRQOL measured by the SF-36 showed no significant differences between the RPP and CT, except for MCS1 and role-emotional. However, the effect size (ES) was 0.08 and 0.13 respectively. The only domain exhibiting significant differences after one year was change in health, whose values favored the RPP with ES=0.11 (See Table 2).

As for the changes within each group after one year, the RPP patients showed a significant decrease only in physical functioning (p=0.038; ES=0.14), whereas CT patients showed a decrease in four domains: physical functioning (p=0.027; ES=0.14), general health (p=0.001; ES=0.29), social functioning (p=0.010; ES=0.22), and vitality (p=0.009; ES=0.22) and in MCS1 (p=0.044; ES=0.19).


RPP: Renal Protection Program. CT: Conventional treatment; PCS1: Physical health summary score. MCS1: Mental health summary score. SD: Standard deviation

Table 2. Distribution of HRQOL scores in patients with chronic renal failure in predialysis before and after an intervention. Medellín, 2007-2008.

Health-Related Quality of Life in Chronic Renal Predialysis

health (p=0.012 ES=0.09).

**3.3 Perception of health-related quality of life in terms of gender** 

**3.4 Perception of health-related quality of life in terms of age** 

health (p=0.001, ES=0.35) and vitality (p=0.044, ES=0.20) See Table 4.

general health (p=0.021, ES year=0.45). See Table 4.

diabetes, and dyslipidemia (See Table 5).

Patients Exposed to a Prevention Program – Medellín, 2007-2008 437

In both groups HRQOL was lower for women both in the initial measurement and in the final measurement after one year. At the start of the study, the female patients of the RPP showed significant differences in most domains, and CT female patients showed these only in a few domains. One year later, the HRQOL difference between men and women in the RPP group remained unchanged for PCS1 (ES=0.40) and MCS1 (ES=0.34), and for the following domains: physical functioning (ES=0.53), bodily pain (ES=0.37), mental health (ES=0.35) and vitality (ES=0.69). For the CT group, the only significant differences were in bodily pain (ES=0.61), role-emotional (ES=0.51) and change in health (ES=0.48). See Table 3. After one year, women within each group showed no changes in HRQOL measurements. Only the men following CT showed a significant decrease in general health (p=0.001 ES=0.33), social functioning (p=0.014 ES=0.15), vitality (p=0.007 ES=0.13), and change in

In both interventions, the physical component of HRQOL was more affected in patients older than 65 than in younger individuals. This was constant throughout the study. In the RPP group, these differences at the start of the study and one year later were statistically significant for PCS1 (p=0.001, ES start=0.08; p<0.001, ES year=0.06), for the physical functioning domain (p=0.001, ES start=0.30; p<0.001, ES year=0.03) and for bodily pain (p=0.009, ES start=0.02; p=0.025, ES year=0.10). In CT, however, the differences found between the age groups at the start were in PCS1 (p=0.025, ES start=0.44), in the physical functioning domain (p=0.001, ES start=0.61) and in role-physical (p=0.022, ES start=0.43). One year later, differences were found in physical functioning (p=0.022, ES year=0.57) and

After analyzing changes within each group and for each age group, it was observed that the RPP patients who were 65 and older showed significant changes in physical functioning (p=0.006, ES=0.30) after one year. Patients younger than 65 showed no changes after this time. In CT, patients younger than 65 showed significant changes in MCS1 (p=0.044, ES=0.34) and in the social functioning domain (p=0.003, ES=0.53). Patients who were 65 and older showed changes after one year in physical functioning (p=0.050, ES=0.15), general

**3.5 Health-related quality of life adjusted for previous measurements, age, and gender**  After adjusting the second measurement's raw HRQOL score (See Table 2) for the initial HRQOL score, significant differences were found between the RPP and the CT groups in the following domains: general health (a difference of 5.2 points favoring the RPP) and change in health (the difference of 5.9 points continues to favor the RPP). After adjusting it for gender, differences were found in PCS1 (a difference of 7.7 points favoring the RPP) and vitality (a difference of 6.9 points favoring the RPP). When the score was adjusted for age, differences were then found in physical functioning (a difference of 7.2 points favoring CT). No significant differences were found upon adjusting HRQOL for stage, hypertension,


RPP: Renal Protection Program. CT: Conventional treatment PCS1: Physical health summary score. MCS1: Mental health summary score. SD: Standard deviation

\*: Effect size =0.69 +: Effect size =0.61

Table 3. Distribution of HRQOL scores, by gender, in patients with chronic kidney disease in predialysis before and after an intervention. Medellín, 2007-2008.

Female Male t-Student Female Male t-Student Mean (SD) Mean (SD) P value Mean (SD) Mean (SD) P value

Initial 1 year

PCS1: 54.6 (27.7) 66.6 (28.0) 0.010 53.0 (26.4) 64.3 (27.8) 0.013 Physical Functioning 61.5 (27.4) 77.9 (25.1) <0.001 57.3 (30.8) 73.6 (28.3) 0.001 Role-Physical 53.2 (41.8) 70.1 (39.5) 0.012 62.0 (44.7) 70.5 (39.9) 0.224 Bodily Pain 61.3 (28.5) 71.7 (28.0) 0.026 59.4 (27.3) 70.2 (28.3) 0.021 General Health 52.4 (22.2) 64.7 (23.5) 0.001 53.8 (22.6) 61.1 (23.9) 0.059

MCS1: 59.4 (36.1) 74.3 (28.6) 0.006 64.4 (28.7) 74.0 (25.8) 0.034 Mental Health 62.5 (29.1) 76.2 (22.7) 0.002 63.5 (23.5) 72.3 (24.9) 0.028 Role-Emotional 52.0 (45.0) 76.5 (37.9) <0.001 64.5 (43.1) 77.0 (38.0) 0.065 Social Functioning 74.0 (29.7) 78.5 (28.6) 0.354 73.7 (28.4) 80.7 (24.6) 0.109 Vitality 59.6 (27.5) 74.6 (24.6) 0.001 56.1 (23.9) 73.0 (23.2) <0.001\*

HEALTH 65.1 (23.6) 67.0 (24.2) 0.622 66.2 (21.0) 70.6 (25.0) 0.245

PCS1: 51.3 (27.8) 60.1 (27.4) 0.142 47.6 (28.5) 55.7 (28.7) 0.198 Physical Functioning 61.5 (28.8) 70.2 (25.7) 0.130 55.6 (30.6) 66.3 (31.0) 0.112 Role-Physical 48.1 (43.0) 66.6 (42.3) 0.046 47.1 (44.9) 62.4 (45.3) 0.121 Bodily Pain 57.1 (29.0) 70.1 (26.6) 0.027 49.9 (25.7) 67.3 (29.0) 0.005+ General Health 61.9 (21.9) 60.0 (22.6) 0.700 59.6 (24.7) 51.7 (26.2) 0.162

MCS1: 65.9 (28.9) 77.1 (27.6) 0.065 61.4 (27.5) 71.5 (27.1) 0.086 Mental Health 61.5 (24.0) 75.8 (23.1) 0.005 64.5 (17.7) 70.9 (24.8) 0.213 Role-Emotional 66.6 (43.2) 78.0 (35.4) 0.216 52.5 (42.1) 74.0 (39.2) 0.013 Social Functioning 74.4 (30.2) 82.4 (26.2) 0.176 67.8 (21.5) 76.0 (29.7) 0.180 Vitality 58.5 (23.4) 69.8 (24.5) 0.033 56.9 (20.0) 62.9 (27.5) 0.292

HEALTH 60.8 (21.5) 67.1 (20.9) 0.169 71.5 (18.9) 60.7 (23.3) 0.028

RPP: Renal Protection Program. CT: Conventional treatment PCS1: Physical health summary score.

Table 3. Distribution of HRQOL scores, by gender, in patients with chronic kidney disease

Domains and Summary Scores

CHANGES IN

CHANGES IN

 CT: MCS1: Mental health summary score. SD: Standard deviation

in predialysis before and after an intervention. Medellín, 2007-2008.

\*: Effect size =0.69 +: Effect size =0.61

RPP
