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Abstract: TH-PO295

The Impact of Race and Ethnicity upon Health-Related Quality of Life and Mortality in Dialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kalantar, Sara S., University of California Irvine, Huntington Beach, California, United States
  • You, Amy Seung, University of California, Irvine, Orange, California, United States
  • Novoa, Alejandra, UC Irvine Health, Orange, California, United States
  • Juarez, Kimberly Michelle, University of California Irvine, Huntington Beach, California, United States
  • Nakata, Tracy, UC Irvine, Orange, California, United States
  • Rhee, Connie, University of California Irvine, Huntington Beach, California, United States
Background

While health-related quality of life (HRQOL) has been increasingly recognized as a strong predictor of mortality among hemodialysis (HD) patients, differences in these associations across diverse racial/ethnic groups have not been thoroughly investigated.

Methods

We examined the relationship between HRQOL and mortality among a prospective cohort of racially/ethnically diverse HD patients recruited across 18 dialysis units over 2011-16. Using Short Form 36 (SF36) surveys administered every 6 months, HRQOL was ascertained by 36 questions summarized as 2 physical and mental health dimension and 8 subscale scores. Associations of time-varying SF36 scores with all-cause mortality were estimated using multivariable Cox models in the overall cohort and within racial/ethnic subgroups.

Results

Among 753 HD patients who met eligibility criteria, the lowest quartiles (Q) of physical and mental health dimension scores were associated with higher mortality in the overall cohort (ref: highest Q): HRs (95% CIs): 2.18 (1.43-3.32) and 1.56 (1.06-2.28), respectively. In analyses stratified by race/ethnicity, among Blacks and Hispanics the lowest Q of physical health dimension scores was significantly associated with higher mortality, whereas in Non-Hispanic Whites and Asian/Pacific Islanders point estimates of the lowest Q suggested higher death risk but did not reach statistical significance. The lowest Q of physical functioning, energy/fatigue, and pain subscale scores were associated with higher mortality in the overall cohort, and were particularly pronounced in Blacks and Hispanics.

Conclusion

Lower self-reported HRQOL scores, particularly related to impaired physical health dimension and subscales, were associated with higher mortality in HD patients, including those of minority background. Further studies are needed to determine whether interventions that augment physical function improve the survival of these diverse populations.

Funding

  • NIDDK Support