Kidney Week

Abstract: TH-PO822

Limitations of the KDQoL for Assessing Quality of Life Among Patients with ESRD

Session Information

• Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular - I
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

• Lee, Andrew, DaVita Clinical Research, Minneapolis, Minnesota, United States

Andrew Lee,

• Cohen, Dena E., DaVita Clinical Research, Minneapolis, Minnesota, United States

Dena E. Cohen,

• Sibbel, Scott, DaVita Clinical Research, Minneapolis, Minnesota, United States

Scott Sibbel,

• Benner, Deborah A., DaVita, Inc, Denver, Colorado, United States

Deborah A. Benner,

• Brunelli, Steven M., DaVita Clinical Research, Minneapolis, Minnesota, United States

Steven M. Brunelli,

• Tentori, Francesca, DaVita Clinical Research, Minneapolis, Minnesota, United States

Francesca Tentori,

Background

Achieving the best possible quality of life (QoL) is a key goal for patients with end-stage renal disease (ESRD). The Centers for Medicaid and Medicare Services mandate regular assessment using the Kidney Disease Quality of Life (KDQoL) survey. Given concerns that the KDQoL may not adequately capture QoL among contemporary ESRD patients, we examined its construct validity.

Methods

We considered 282,895 KDQoL surveys completed by 175,826 adult patients receiving in-center hemodialysis at a large US dialysis organization (2014-2016). Correlations between item responses, domain scores, and interdialytic weight gain (IDWG) were calculated using Pearson correlations computed with pairwise complete observations.

Results

Patient perceptions of general health were not correlated (R<0.05) with any other question in the physical composite score (PCS) or the symptoms and problems subscale (SPS). Mean SPS (77.9 ± 16.9) exceeded mean PCS (36.3 ± 12.2); correlation between the two was modest (R=0.42). Many items in the SPS showed ceiling effects: for all 12 items, <10% of patients were “extremely bothered,” while >65% of patients reported being “not at all” or only “somewhat bothered;” for 3 items, >85% of patients gave these two responses. IDWG was not correlated with patient-reported shortness of breath, PCS, or SPS.

Conclusion

We identified possible limitations in the mandated tool that is used for assessment of QoL in ESRD patients. New measures of QoL that focus on factors that affect a considerable proportion of contemporary dialysis patients, particularly those that can be addressed by modifiable clinical practices, are needed.

Funding

• Commercial Support – DaVita, Inc