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Kidney Week

Abstract: FR-PO563

Health-Related Hope, Disease Stage, and Disease Self-Management over a Very Wide Range of CKD Severity

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Kurita, Noriaki, Department of Innovative Research and Education for Clinicians and Trainees, Fukushima Medical University Hospital, Fukushima, Japan
  • Wakita, Takafumi, Kansai University, Suita, Osaka-Fu, Japan
  • Ishibashi, Yoshitaka, Japanese Red Cross Medical Center, Tokyo, Japan
  • Suzuki, Tomo, Division of Nephrology and Hypertension, Department of Internal Medicine, St.Marianna University School of Medicine, Kawasaki, Japan
  • Kawarazaki, Hiroo, Inagi Municipal Hospital, Tokyo, Japan
  • Shibagaki, Yugo, Division of Nephrology and Hypertension, Department of Internal Medicine, St.Marianna University School of Medicine, Kawasaki, Japan
  • Yazawa, Masahiko, Division of Nephrology and Hypertension, Department of Internal Medicine, St.Marianna University School of Medicine, Kawasaki, Japan
Background

Disease experience varies at different stages of CKD. Patients who experience hope might more effectively adjust to their health condition. The aims of this study were to quantify the associations of health-related hope with disease stage, and with psychological and medical indices of CKD self-management.

Methods

Data were collected from 461 adult CKD patients in Japan. The range of disease severity was very wide: Included were patients at stage 2-3 who were not receiving dialysis (ND stage 2-3) and those at ND stages 4 and 5. Also included were patients receiving dialysis. Health-related hope (HR hope) was measured with a recently developed 18-item scale focusing on how people experience their health and how healthcare affects hope. General linear models were used to examine the associations of HR hope with CKD stage, blood pressure (BP), and serum levels of phosphorus and potassium. The burdens of water and diet restriction were measured with the Kidney Disease Quality of Life questionnaire. Generalized ordered logit models were used to examine the associations of HR hope with the likelihood of reporting that water or diet restriction was burdensome.

Results

Patients at ND stages 4 and 5 had lower levels of HR hope than those at ND stage 2-3 (Figure). With ND stage 2-3 as the reference, patients at all further stages had lower levels of HR-hope. The lowest level of HR-hope was among patients with disease at ND stage 5. Higher levels of HR hope were significantly associated with lower likelihoods of reporting that water and diet restrictions were burdensome (adjusted OR 0.53 and 0.57 for water restriction and diet restriction, respectively). Higher levels of HR hope were also significantly associated with lower systolic BP (adjusted mean difference -5.8 mmHg). HR hope levels were not associated with diastolic BP or with serum levels of phosphorus or potassium.

Conclusion

Among CKD patients, higher HR hope is associated with less-severe disease, lower systolic BP, and lower perceived burden of water restriction and diet restriction.