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Abstract: FR-PO513

Changes in Health-Related Quality of Life and Home Dialysis Modality Selection in Predialysis

Session Information

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis


  • Pichette, Maude, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada
  • Morin, Catherine, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada
  • Elftouh, Naoual, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada
  • Imbeault, Benoit, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada
  • Laurin, Louis-Philippe, Hopital Maisonneuve-Rosemont Centre de Recherche, Montreal, Quebec, Canada
  • Goupil, Remi, Hopital du Sacre-Coeur de Montreal Centre de Recherche, Montreal, Quebec, Canada
  • Nadeau-Fredette, Annie-Claire, Hopital Maisonneuve-Rosemont Centre de Recherche, Montreal, Quebec, Canada

Patients with advanced chronic kidney disease (CKD) have lower health-related quality of life (HRQOL) than the general population. There are still few data on patterns and predictors of HRQOL changes before dialysis initiation. We aimed to characterize HRQOL trajectory and assess its association with selected dialysis modality in advanced CKD.


In this prospective study, adult with an eGFR ≤15ml/min/1.73m2 completed Kidney Disease Quality of Life-Short Form at baseline and every 6-month until dialysis initiation. Planned dialysis modality, our main exposure, was based on patient's choice, with home dialysis defined as selection of peritoneal dialysis or home hemodialysis. Predictors of changes in KDQOL components, including Physical Component scores (PCS), Mental Component scores (MCS) and Symptoms/Problems of kidney disease (SPKD) were modelled using mixed effect multivariable linear regressions to account for within-patient changes over time.


One hundred nine patients were included. Patients selecting home dialysis (n=41) were younger (61±15 vs. 76±11 yrs) and had less cardiovascular disease (34% vs 60%). At baseline, crude PCS (45±10 vs. 39±8) was significantly higher in patients choosing home dialysis, while MCS and SPKD were similar in both groups. (Figure) After adjustment for demographics, comorbidities and psychosocial characteristics, patients choosing home dialysis had an 8-point higher MSC for each year of follow-up (B 8.1 per year, p=0.002) compared to those selecting in-center HD or undecided. Similarly, the decrease in SPKD score through time was attenuate (i.e. lower burden) for patients selecting home dialysis compared to others (B 12.4 per year, p<0.001). These differences were clinically significant considering the minimal important difference of 3-point for this instrument.


Patients choosing home dialysis had improved HRQOL scores in predialysis compared to those not selecting home dialysis. More work is needed to determine if differences in process of care (e.g. enhanced multidisciplinary team support) or unmeasured patient characteristics modulate this association.