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Kidney Week

Abstract: TH-PO1084

Family Relationships and Self-Reported Outcomes in Patients with Moderate or Advanced CKD: Findings from the French CKD-Renal Epidemiology and Information Network (CKD-REIN) Study

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Speyer, Elodie, CESP Inserm U1018, VILLEJUIF Cedex, France
  • Montalescot, Lucile, Paris Descartes University, Boulogne Billancourt, France
  • Legrand, Karine, CHRU Nancy, Vandœuvre les Nancy, France
  • Ayav, Carole, University Hospital of Nancy, Vandoeuvre les Nancy, France
  • Combe, Christian, CHU de Bordeaux, Bordeaux, France
  • Stengel, Benedicte, CESP Inserm U1018, VILLEJUIF Cedex, France
  • Untas, Aurelie, Paris Descartes University, Boulogne Billancourt, France
Background

Social support is associated with higher well-being in chronic kidney disease (CKD), but has only been explored in ESRD patients. We describe family profiles and their associations with self-reported quality of life and depression in patients with moderate or advanced CKD.

Methods

Four questionnaires were administrated to 3,033 adult patients with CKD stage 3-5 under nephrology care: the 12-item Family Relationships Index (FRI) to assess family relationships through 3 subscales [family cohesion (degree of support within the family), family expressiveness (extent to which family members express feelings) and family conflict (amount of conflict among family members), the KDQoL scale to measure CKD effects, burden, and symptoms, the SF-12 to assess mental and physical composite scores (MCS, PCS), and the CES-D scale for depression symptoms. Comparisons between profiles were adjusted for age, sex, and living status.

Results

Based on 2,004 patients (median age 68, 68% men, 20% living alone, 56% stage 3 CKD) with complete data for the FRI, cluster analysis yielded 3 family profiles (Upper Figure). Patients with profile 3 (the highest family cohesion and expressiveness, and the lowest conflict) had the best patient-reported outcomes. In comparison, patients with profile 1 (the lowest family cohesion and expressiveness, and intermediate conflict) had significantly lower KDQoL and SF-12 scores (p<.001) (Lower Figure), and a higher prevalence of self-reported depression symptoms, 9% vs 6% (p<.001). Patients with profile 2 (high family cohesion, intermediate expressiveness, and highest conflict) did not differ significantly from those with profile 3.

Conclusion

Family environment plays a crucial role in patients’ adaptation to CKD. Accounting for it could allow health professionals to better assist their patients.