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Abstract: FR-PO899

Impact of Extended Weekly Hemodialysis Hours on Diverse Health-Related Quality of Life Domains: A Secondary Analysis of the ACTIVE Dialysis Trial

Session Information

Category: Dialysis

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

Authors

  • van den Broek-Best, Oliver, University of Sydney , Lewisham, New South Wales, Australia
  • Smyth, Brendan, The George Institute for Global Health, UNSW, 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 , Lewisham, New South Wales, Australia
  • Rogers, Kris, 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
  • Jardine, Meg J., The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
Background

The SF-36 quality of life (QOL) tool has been validated in multiple populations and conditions. The ACTIVE Dialysis trial randomised 200 haemodialysis (HD) recipients to standard (median 12) or extended (median 24) weekly HD hours for 12 months with no impact on overall EQ-5D utility-based QOL. Extended hours led to small but significant improvements in both SF-36 physical (PCS) and mental (MCS) composite scores (PCS 2.30, 95%CI 0.52-4.07; MCS 2.54, 95%CI 0.42-4.65). We aimed to examine the impact of extended weekly dialysis hours on individual SF-36 domains.

Methods

Generic health-related QOL was assessed by blinded interviewers every 3 months with SF-36 which includes PCS, MCS and 8 domains. The average intervention effect was calculated using mixed linear regression adjusted for baseline score and time.

Results

ACTIVE dialysis participants had a mean age of 51.6±11.5 years, with 62% recruited from China and 75% dialysing in-center. Extended dialysis had a significant, positive effect on 4 of the 8 domains: General Health Perceptions (7.33, 95%CI 2.85-11.81, p=0.002), Social Functioning (6.70, 95%CI 1.14-12.25, p=0.02), Role Emotional (8.17, 95%CI 0.03-16.30, p=0.05) and Mental Health (3.30, 95%CI 0.15-6.45, p=0.04). Although not reaching statistical significance, point estimates in other domains were also in a consistent positive direction: Physical Functioning (3.54, 95%CI -0.67-7.74, p=0.1), Role Physical (6.67, 95%CI -0.95-14.28, p=0.1), Bodily Pain (4.92, 95%CI -0.24-10.08, p=0.06) and Vitality (3.46, 95%CI -0.93-7.84, p=0.12).

Conclusion

Predominantly in-center extended weekly HD hours may have a positive effect on SF-36 measures beyond purely physical domains. Dialysis delivery involves multiple dimensions including biochemical, haemodynamic, social and health service access. Better understandings of the mechanisms for its impact on QOL are needed. NCT00649298

Funding

  • Commercial Support