Abstract: TH-PO231
Patient-Reported Quality of Life in Dialysis Compared with Non-Dialysis CKD Patients with Hyperkalemia in the United States and European Union 5: Results from the KDQOL
Session Information
- Hemodialysis and Frequent Dialysis - II
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Tafesse, Eskinder, AstraZeneca, Gaithersburg, Maryland, United States
- Jackson, James, Adelphi Real World, Macclesfield, United Kingdom
- Moon, Rebecca, Adelphi Real World, Macclesfield, United Kingdom
- Milligan, Gary R., Adelphi Real World, Macclesfield, United Kingdom
- Kim, Jennifer, AstraZeneca, Gaithersburg, Maryland, United States
Background
Patients with chronic kidney disease (CKD) have an increased risk of hyperkalemia (HK), which increases with CKD progression. Patients on hemodialysis report negative impact to quality of life (QoL), though evidence is limited. The increased risk of HK and associated morbidity and mortality may further add to patient burden.
Methods
Data from the 2015 and 2018 Adelphi CKD Disease Specific Programmes were pooled to create a cross-sectional dataset of patients, including data from physicians and their CKD patients across France, Germany, Italy, Spain, the UK and USA. Patients completed the KDQOL, a measure targeted at specific concerns of individuals with CKD. A multiple linear regression was performed, for each of the 5 KDQOL domains, to study the association between non-dialysis dependent (NDD) patients with HK (K+ >5.0 mmol/L), DD patients without HK (K+ 3.5-5.0 mmol/L) and DD patients with HK to a reference group of NDD patients without HK (and their interaction), adjusting for age, sex, eGFR level, and presence of heart failure and diabetes.
Results
Results from 1,242 patients showed an incremental decrease in QoL across each patient group for 2 of the 5 KDQOL domains. When compared to the reference group, NDD patients with HK experienced significantly poorer QoL across all 5 of the KDQOL domains. However, DD patients with HK experienced an additional significant deterioration in QoL across 4 of the 5 domains, compared with NDD patients without HK (Table 1).
Conclusion
This study highlights the negative impact that HK contributes to CKD patients, leading to further decrements in QoL, particularly among DD CKD patients. Innovative HK treatment approaches should be an important consideration by physicians to contribute to improved QoL in this patient population.
Table 1: KDQOL values vs. CKD and Hyperkalemia Status
| KDQOL domains, mean (n) | NDD without HK | NDD with HK | DD without HK | DD with HK |
| Burden of kidney disease | 62.44 (774) | 57.61 (178); p=0.030 | 44.78 (190); p=<0.001 | 46.96 (100); p=<0.001 |
| Symptoms/problems | 83.67 (760) | 80.03 (177); p=0.012 | 78.60 (188); p=0.005 | 76.77 (101); p=0.002 |
| Effect of kidney disease | 78.42 (759) | 69.68 (174); p=<0.001 | 68.29 (186); p=<0.001 | 61.26 (100); p=<0.001 |
| SF-12 physical summary score | 41.81 (741) | 39.37 (171); p=0.002 | 38.30 (178); p=<0.001 | 38.39 (98); p=0.005 |
| SF-12 mental summary score | 47.42 (741) | 45.53 (171); p=0.025 | 45.33 (178); p=0.050 | 45.85 (98); p=0.020 |
lower scores represent poorer quality of life; p-values show the comparison to the reference group
Funding
- Commercial Support –