Kidney Week

Abstract: SA-OR070

Subgroup Analysis of Impact of Extended Hours Dialysis on Quality of Life in the Active Dialysis Trial

Session Information

• Improving Dialysis Delivery and Patient Outcomes
  October 27, 2018 | Location: 2, San Diego Convention Center
  Abstract Time: 04:54 PM - 05:06 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Smyth, Brendan, The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia

Brendan Smyth, MBBS

Dr Smyth is a practicing nephrologist and researcher based at The George Institute for Global Health in Sydney, Australia. He completed his training in 2015 and is undertaking a PhD investigating impact of dialysis practice changes on patient outcomes. His interests include randomized trial methodology and cardiovascular and quality of life outcomes in hemodialysis.

• van den Broek-Best, Oliver, University of Sydney, Sydney, New South Wales, Australia

Oliver van den Broek-Best,

• Howard, Kirsten, University of Sydney, Sydney, New South Wales, Australia

Kirsten Howard,

• Rogers, Kris, The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia

Kris Rogers,

• Gray, Nicholas A., Sunshine Coast University Hospital , Birtinya, Queensland, Australia

Nicholas A. Gray,

• de Zoysa, Janak Rashme, Waitemata District Health Board, Auckland, New Zealand

Janak Rashme de Zoysa,

• Chan, Christopher T., Toronto General Hospital, Toronto, Ontario, Canada

Christopher T. Chan,

• Cass, Alan, Menzies School of Health Research, Darwin, Northern Territory, Australia

Alan Cass,

• Gallagher, Martin P., The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia

Martin P. Gallagher,

• Perkovic, Vlado, The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia

Vlado Perkovic,

• Jardine, Meg J., The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia

Meg J. Jardine,

Background

The ACTIVE Dialysis trial of extended hours (≥24 hours per week) versus standard hours (≤18 hours per week) haemodialysis demonstrated a significant improvement in QOL as measured by Short Form-36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS). We aimed to determine if the effect of extended hours dialysis on quality of life (QOL) in the ACTIVE Dialysis trial differed according to pre-specified subgroups.

Methods

The ACTIVE Dialysis trial was an open-label randomised, blinded endpoint assessment trial. Two hundred participants were enrolled from four countries and randomised to 12 months of standard or extended hours dialysis. The SF-36 was administered by a blinded interviewer at 3-month intervals. Mean difference between extended and standard arms was assessed by mixed linear regression. The overall effect sizes (Cohen’s d: where 0.2-0.5 is a small effect, 0.5-0.8 a moderate effect and >0.8 a large effect) were calculated as the ratio of mean difference to standard deviation. Subgroup variables were added to the regression model with an interaction with treatment group to test for effect modification.

Results

Extended hours dialysis was associated with significant improvement in PCS (2.30 [95% CI 0.55-4.06]; p=0.010) and MCS (2.54 [95% CI 0.48-4.60]; p=0.016). The effect size on both measures was small (PCS 0.24 [95%CI 0.06-0.42; p=0.010], MCS 0.24 [95%CI 0.04-0.43; p=0.016]). The effect of extended hours dialysis did not vary significantly by baseline score, region (China vs Australia, Canada, New Zealand), dialysis location (home vs in-centre/satellite) or dialysis vintage (≤6 months vs >6 months).

Conclusion

Extended hours dialysis leads to a small improvement in physical and mental QOL. These effects did not differ significantly between key demographic and clinical subgroups.

Funding

• Commercial Support –