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Kidney Week

Abstract: SA-PO655

Association Between Age, Frailty, and Change in Health-Related Quality of Life After Dialysis Initiation?

Session Information

  • Home Dialysis - II
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Pichette, Maude, Hopital Maisonneuve-Rosemont Centre de Recherche, 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
  • Elftouh, Naoual, Hopital Maisonneuve-Rosemont Centre de Recherche, Montreal, Quebec, Canada
  • Nadeau-Fredette, Annie-Claire, Hopital Maisonneuve-Rosemont Centre de Recherche, Montreal, Quebec, Canada
Background

Despite its key importance, changes in health-related quality of life (HRQOL) after dialysis start are still poorly understood. This study aimed to assess the association between age, frailty and changes in HRQOL during the transition to home dialysis and in-center hemodialysis (ICHD).

Methods

HRQOL was measured using the KDQOL-SF questionnaire. Frailty was evaluated at study baseline using the Clinical Frailty Scale. Changes in physical component summary (PCS), mental component summary (MCS), and kidney-specific domains (burden, symptoms/problems and effects of kidney disease) were assessed in linear regressions comparing scores 6-months before and 6-months after dialysis start, with adjustment for age, frailty, dialysis modality and gender.

Results

Among a cohort of 121 CKD patients, 59 patients initiated dialysis (68 ±13 years, 61% ICHD and 39% home dialysis). HRQOL trajectories, stratified by age and frailty are illustrated in Figure 1. After adjustment, there were no statistically significant predictors associated with score changes at six months. There was however a nearly significant interaction between age and frailty (p=0.052) for MCS whereby frailty was associated with a trend towards decreased MCS for patients <65 years (B -18.1, 95% CI -37.4; 1.2, p=0.06), without a significant change in older patients. We also observed a trend towards improved score in the Problems/Symptoms in patients >65 years (vs. <65 years) after dialysis start (B 10.7, -0.3; 21.7, p=0.055).

Conclusion

This small prospective study showed that age and frailty may be associated with HRQOL after dialysis start, although we did not identify statistically significant associations. It demonstrates the importance of individualizing the choice of kidney replacement therapy, avoiding generalizing the expected evolution of patients on the basis of isolated characteristics such as age or frailty.