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Abstract: PO1292

Burden of Dialysis, Health-Related Quality of Life, and Employment Comparisons Between Peritoneal Dialysis and In-Center Hemodialysis: Findings from the DOPPS Program

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Brown, Edwina A., Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, United Kingdom
  • Zhao, Junhui, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • McCullough, Keith, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Fuller, Douglas S., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Figueiredo, Ana Elizabeth, School of Health Sciences and Life, Nursing School, Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil
  • Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Finkelstein, Fredric O., Yale University, New Haven, Connecticut, United States
  • Shen, Jenny I., Division of Nephrology and Hypertension, LaBiomed at Harbor–UCLA Medical Center, Torrance, California, United States
  • Kanjanabuch, Talerngsak, Deparment of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Kawanishi, Hideki, Tsuchiya General Hospital, Nakaku, Hiroshima, Japan
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Perl, Jeffrey, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada

Group or Team Name

  • PDOPPS patient support working group
Background

The Dialysis Outcomes and Practice Patterns Study (DOPPS) and the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) collect information annually about quality of life, including employment and functional status. Differences in these domains by dialysis modality (PD vs. centre-based hemodialysis) may inform individuals in choosing a dialysis modality.

Methods

PD and HD patients with comparable characteristics were analyzed. For baseline patient questionnaire, we used logistic regression to analyze binary outcomes employment (full- or part-time versus unemployed), depression (CES-D ≥10 vs. <10), and functional status (≥11 vs. <11) , and used linear mixed models to analyze continuous outcomes (PCS, MCS, and burden of kidney disease score). Change of outcomes were described descriptively.

Results

There were 3227 PD and 4544 HD patients at baseline. Burden of kidney disease scores were better for PD compared to HD (overall 9-point adjusted difference, [95%CI: 7-11]) with a higher proportion of patients on PD in the lowest burden range (10%-37%) compared to 8%-24% on HD, depending on country. PD patients also had better PCS and MCS, though these were less marked (overall adjusted difference of 0.9 [0.2-1.6] for PCS, 1.0 [0.2-1.9] for MCS). HD patients had worse functional status scores (adjusted OR HD vs. PD 0.6, [0.5, 0.8] for score ≥ 11); were less likely employed (OR=0.6, [0.5, 0.8]); and had worse CES-D scores (OR=0.8, [0.7, 1.0] for CES-D < 10). In Australia/New Zealand, HD patients had better MCS and CES-D scores and a higher proportion being employed than PD patients.
174 PD patients and 254 HD patients died within one year; 614 PD patients and 535 HD patients left the study between questionnaires. Changes over time in the continuous measures were small. Trends in employment, CES-D score, and functional status were small and not statistically significant.

Conclusion

Compared to HD patients, PD patients reported a lower burden of kidney disease score and among survivors, remains stable on either PD or HD over 12 months. This information, when shared with patients choosing a dialysis modality, could result in an increased uptake of PD.

Funding

  • Commercial Support –