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Kidney Week

Abstract: PO2139

Assessing Social Difficulties in Patients Treated with Kidney Replacement Therapy (Dialysis or Kidney Transplant)

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical


  • Wasim, Aghna, University Health Network, Toronto, Ontario, Canada
  • Sun, Yingji, University Health Network, Toronto, Ontario, Canada
  • Yang, Mengxi, University Health Network, Toronto, Ontario, Canada
  • Alhabbal, Hiba, University Health Network, Toronto, Ontario, Canada
  • Gyatso, Karma S., University Health Network, Toronto, Ontario, Canada
  • Ahmadzadeh, Ghazaleh, University Health Network, Toronto, Ontario, Canada
  • Afzal, Aysha, University Health Network, Toronto, Ontario, Canada
  • Li, Madeline, Princess Margaret Hospital Cancer Centre Department of Supportive Care, Toronto, Ontario, Canada
  • Howell, Doris, Princess Margaret Cancer Centre, Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
  • Mucsi, Istvan, University Health Network, Toronto, Ontario, Canada

The Social Difficulties Inventory (SDI) is used in the clinical management of patients with cancer in the UK. We examine the construct validity of the SDI in patients with kidney replacement therapy (KRT: dialysis or kidney transplant [KT]).


This is a secondary analysis of data collected in multicenter, cross-sectional studies. Adults receiving KRT completed the SDI and other patient reported outcome measures. Clinical and sociodemographic characteristics were also collected. For SDI, the degree of difficulty is rated: no difficulty, a little, quite a bit or very much. 16 items form the SD16 and three subscales: “Everyday Living”, “Money Matters” and “Self and Others.” We used Cronbach’s alpha to assess reliability. We assessed the correlation of SD16 and its subscales with variables that measure similar constructs. Further, we compared scores between groups that are expected to have different degree of difficulties.


788 participants (mean[SD] age 57[15] years) completed the SDI. 61% of them were male and 58% were on dialysis.
Internal consistency was good for all scales: α=0.87, 0.82, 0.75, 0.88, for “Everyday Living”, “Money Matters”, “Self and Others” subscales and the SD16, respectively.
The “Everyday Living” subscale was moderately correlated depression (Rho=0.61, p<0.001) and physical functioning (Rho=0.72, p<0.001). The Self and Other” subscale was moderately correlated with depression (Rho=0.56, p<0.001).
SD16 scores were higher for patients on dialysis vs KT (median[interquartile range – IQR] 7[3,13] vs 3[1,8]p<0.001). “Everyday Living” scores were higher in patients with Charlson Comorbidity Index of ≥4 ([3[0,6.5] vs 1[0,3.5]p<0.001). “Money Matters” scores were higher in individuals facing high vs low material deprivation (1[0,4] vs 0[0,3]p<0.008). “Self and Other” scores were higher in participants that are uncomfortable or reluctant in relationships vs those that find it easy (3[1,7] vs 1[0,3]p<0.002).


These results suggests that the SD-16 and its subscales have good reliability and structural validity. Further research is required to explore the potential clinical benefits of using the SD16 in patients with kidney failure.