Abstract: FR-PO892

Extended Weekly Hemodialysis Hours Selectively Improves Kidney Disease-Specific Quality of Life: A Secondary Analysis of the ACTIVE Dialysis Trial

Session Information

Category: Dialysis

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

Authors

  • Smyth, Brendan, The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
  • Perkovic, Vlado, The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
  • van den Broek-Best, Oliver, University of Sydney , Sydney, New South Wales, Australia
  • Zuo, Li, Peking University People's Hospital, Beijing, China
  • Gray, Nicholas A., Sunshine Coast University Hospital, Birtinya, New South Wales, Australia
  • Chan, Christopher T., Toronto General Hospital, Toronto, Ontario, Canada
  • de Zoysa, Janak Rashme, Waitemata District Health Board, AUCKLAND, New Zealand
  • Howard, Kirsten, University of Sydney , Sydney, New South Wales, Australia
  • Rogers, Kris, The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
  • Jardine, Meg J., The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
Background

End-stage kidney disease is associated with high symptom burden and poor quality of life (QOL). The ACTIVE Dialysis trial randomized 200 hemodialysis (HD) patients to standard (median 12) or extended (median 24) weekly HD hours for 12 months. Extended hours HD did not affect EQ-5D utility-based QOL but had a small but significant effect on generic health-related QOL, measured by the SF-36. We aimed to determine the impact of extended hours HD on kidney disease-specific QOL.

Methods

QOL assessments were administered by blinded interviewers at 3-monthly intervals during the trial. The Kidney Disease Component Summary (KDCS) is a disease-specific summary measure ranging from 0-100 including disease-specific dimensions such as disease impact, dialysis delivery and symptoms. The average intervention effect on KDCS was determined using mixed linear regression adjusted for time and baseline score. Pre-specified subgroups were defined by residence in China or other, dialysis in an institution or at home and dialysing for more or less than 6 months.

Results

Mean baseline KDCS scores were similar in participants randomised to standard and extended weekly dialysis hours (66.6 [95% CI 64.1-69.1] and 66.0 [95%CI 63.2-68.7] respectively). Extended weekly HD hours improved mean KDCS by 3.48 points (95%CI 1.44-5.51, p=0.0009). Subgroup analysis demonstrated the improvement in KDCS was individually significant in those from China, dialysing in an institution or of dialysis vintage >6 months (4.54 [95%CI 2.04-7.05], 4.05 [95%CI 1.83-6.27] and 4.20 [95%CI 1.92-6.48] respectively, all p<0.001).

Conclusion

Extended hours HD is associated with improvement in kidney disease-specific QOL despite having no effect on overall EQ-5D measured QOL. The impact in defined patient populations warrants further investigation. NCT00649298

Funding

  • Commercial Support