Kidney Week

Abstract: TH-PO387

Health-Related Quality of Life: Seeking Novel Targets for Effective Interventions

Session Information

• Dialysis: Peritoneal Dialysis - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 703 Dialysis: Peritoneal Dialysis

Authors

• Hemmett, Juliya, London Health Sciences Centre, London, Ontario, Canada

Juliya Hemmett,

• Colbran, Kiersten, Schulich School of Medicine & Dentristy, Sarnia, Ontario, Canada

Kiersten Colbran,

• Sanghera, Dilraj Singh, Schulich School of Medicine & Dentristy, Sarnia, Ontario, Canada

Dilraj Singh Sanghera,

• Chahine, Saad, Western University, London, Ontario, Canada

Saad Chahine,

• McIntyre, Christopher W., London Health Sciences Centre, London, Ontario, Canada

Christopher W. McIntyre,

Background

Understanding patients’ perceived quality of life (QOL) is important in order to provide quality care for chronic kidney disease (CKD) patients. QOL is shaped by several factors including patients’ beliefs, symptoms, and behaviours, and yet the interaction between these is not well studied. We studied the interaction between these factors using well-established instruments, to help identify priority targets to meaningfully improve patient care.

Methods

The sample of study were patients with CKD and end-stage renal disease (ESRD). This was a single-phase, cross-sectional survey-based study of adult patients from two centers in London, ON. Patients were recruited in three cohorts: in-center hemodialysis (cHD), CKD (eGFR <30 ml/min), and home dialysis (peritoneal (PD) and home hemodialysis (HHD)). Each set of surveys included the KDQOL-36SF, Illness Intrusiveness Scale (IIS), Dialysis Recovery Time (DRT), Grit Scale, Physical and Emotional Symptom (PES) Questionnaire, BMQ, and PHQ-9. Demographic information was also collected. Surveys were individually scored results from the three cohorts were compared and analyzed using correlation and regression techniques.

Results

Seventy two patients (24 cHD, 24 home dialysis (19 PD, 5 HHD), and 24 CKD) completed the survey package. The cohorts were well balanced with respect to age and comorbidities. There was no difference between the cohorts with respect to any of the surveys except for DRT (cHD=384.63 mins, SD 411.13 versus home dialysis= 142.75 mins, SD 404.46). Physical QOL (pQOL) and mental QOL (mQOL) were not significantly related (R²=0.045). IIS was significantly associated with decreased pQOL (R²=0.27, p<0.001). The linear combination of depression, PES, and grit were significantly associated with mQOL (R²=0.54, p<0.001). While depression (b=-0.31) and PES (b=-0.31) were negatively associated with mQOL, grit (b=0.34) was found to be partially protective.

Conclusion

Using a rigorous series of validated questionnaires, we did not find a significant difference between CKD and ESRD patients on home and in-center dialysis modalities with regards to pQOL or mQOL. We have identified several targets for potential patient education and engagement strategies. Further studies are required to identify how to best integrate this knowledge into practice.