End-Stage Renal Disease (ESRD): Transplantation, Dialysis, and Quality of Life in Michigan, 1984-1988

This study investigated survival rates, quality of life, and costs of four major treatments for end-stage renal disease (ESRD) patients in Michigan. The project began in 1984 and continued through 1988. The four treatments studied were in-center hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), transplantation from nonrelated, nonliving donors (cadaver transplants), and transplantation from related living donors (related transplants). A major advantage for the project in relation to other large-scale research studies on ESRD patients was access to comprehensive data bases maintained by the Michigan Kidney Registry (MKR) and the Organ Procurement Agency of Michigan (OPAM) to identify the sample and provide treatment and survival data. Records on medical expenditures for treatment were obtained from the United States' Health Care Financing Administration. Data on the quality of life during treatment were collected by personal interviews with patients over the four-year span needed to accumulate the desired number of cases. The personal interview schedule included measures of subjective well-being, such as mood states, satisfaction with various aspects of life, and other widely-used scales such as Activities of Daily Living, Sickness Impact Profile, and Bradburn Affect Balance Scale. Items on standard demographics, the clinical and symptomatic picture of the disease, and the respondents' social support systems were also included in the interview.