Abstract
BACKGROUND: Haemodialysis (HD) is the predominant kidney replacement therapy for end-stage kidney disease (ESKD) in Indonesia, whereas continuous ambulatory peritoneal dialysis (CAPD) is less frequently used. Hypertension is highly prevalent in this population and may impair health-related quality of life (HRQoL). This study aimed to compare HRQoL between HD and CAPD patients using the EQ-5D-5L instrument. METHODS: A prospective observational cohort study was conducted at Dr. Hasan Sadikin General Hospital, Bandung (September 2023-January 2024). Adults with ESKD and hypertension on HD or CAPD for ≥3 months were assessed at baseline, week 2 and week 4 using EQ-5D-5L and EQ-VAS. Socio-demographic and clinical data were obtained from medical records. Baseline differences were examined using χ(2)/Fisher's exact and Mann-Whitney U-tests. Longitudinal changes in EQ-5D-5L utility and EQ-VAS were analysed using linear mixed-effects models (LMMs) with random intercepts and fixed effects for time, dialysis modality, age and comorbidity; age×comorbidity and time×comorbidity interactions were explored. RESULTS: Ninety-one patients were included (58 HD, 33 CAPD). Compared with HD, CAPD patients were younger, more highly educated, more often insured through non-PBI schemes, and had greater comorbidity burden, more frequent use of ≥3 antihypertensive drugs and higher rehospitalisation rates. Mean EQ-5D-5L utility and EQ-VAS scores were similar between modalities at all time points. In LMMs, neither modality nor time showed significant main effects on EQ-5D-5L utility or EQ-VAS (all p>0.05). For utility, significant age×comorbidity (p=0.002) and time×comorbidity (p=0.032) interactions indicated less favourable trajectories among older, multimorbid patients. CONCLUSION: After accounting for repeated measurements and baseline confounding, short-term overall HRQoL appeared broadly comparable between HD and CAPD. Small numerical advantages for CAPD and the interaction patterns observed in LMMs should be considered hypothesis-generating and require confirmation in larger, methodologically robust studies.