Abstract: FR-PO874

Association of Dialysis-Related Amyloidosis with Lower Quality of Life in Patients on Hemodialysis More Than 10 Years: The Kyushu Dialysis-Related Amyloidosis Study

Session Information

Category: Dialysis

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

Authors

  • Tsuruya, Kazuhiko, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Tsuji, Masayoshi, Fukuoka University, Fukuoka, Japan
  • Arima, Hisatomi, Fukuoka Uniuversity, Fukuoka, Japan
  • Iseki, Kunitoshi, Tomishiro Central Hospital, Tomigusuku, Japan
  • Hirakata, Hideki N., Fukuoka Renal Clinic, Fukuoka City, Japan

Group or Team Name

  • Kyushu Dialysis-Related Amyloidosis Study
Background

Dialysis-related amyloidosis (DRA) is one of the important critical issues in patients with long-term dialysis therapy. However, it remains unknown whether DRA is independently associated with patients’ quality of life (QOL) and outcomes. Thus, we conducted a multicenter prospective cohort study to examine the association between DRA and QOL using cross-sectional and longitudinal study designs.

Methods

The major inclusion criteria were patients on dialysis for more than 10 years. Diagnosis of DRA was based on the clinical diagnostic criteria of DRA in Japan. Briefly, patients having two or more of five DRA-related findings (polyarthralgia, carpal tunnel syndrome, trigger finger, dialysis-related spondyloarthropathy, or bone cysts) were diagnosed with DRA. QOL was evaluated using EQ-5D health state utility scores. Decline in QOL was defined as an absolute change in EQ-5D scores from baseline to two years of follow-up (ΔEQ-5D scores) less than 0.

Results


A total of 1,314 patients from 72 dialysis facilities were enrolled in this study. Among them, 277 (21%) were diagnosed with DRA. EQ-5D scores were significantly lower in patients with DRA compared to those without DRA [median (interquartile range): 0.649 (0.533–0.768) vs. 0.768 (0.693–1.000); P<0.001]. Among the all patients, 931 (71%) could be followed for two years and were divided into three groups according to baseline and follow-up DRA status: patients with DRA at baseline (G1, n=190), those who had not DRA at baseline, but developed DRA during the follow-up period (G2, n=44), and those without DRA both at baseline and after two years (G3, n=697). Although G3 had shorter dialysis vintage (15 years) compared to G1 (27 years) and G2 (23 years), age, sex, and previous history of cardiovascular diseases were comparable among three groups. Decline in QOL was observed in significantly greater proportion in G1 (45%, P<0.05) and G2 (66%, P<0.01) compared to G3 (35%). Multivariable-adjusted odds ratios (95% confidence intervals) for the decline in QOL in G1, G2, and G3 were 1.40 (0.84–2.31) and 2.26 (1.01–5.09), and 1.00 (reference), respectively. The ΔEQ-5D scores were significantly lower in G2 than G3.

Conclusion

DRA was associated with lower QOL in hemodialysis patients with long-term dialysis therapy.

Funding

  • Commercial Support