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Kidney Week

Abstract: FR-PO412

One-Year Quality of Life Trend in a Large Population of Incident Hemodialysis Patients

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Santos Araujo, Carla Alexandra R., Diaverum AB, Hyllie, Sweden
  • Silva, Eliana, Diaverum AB, Hyllie, Malmo, Sweden
  • Silva, Israel Pereira, Diaverum AB, Hyllie, Malmo, Sweden
  • Haarhaus, Mathias, Diaverum AB, Hyllie, Malmo, Sweden
  • Lucas, Carlos, Diaverum AB, Hyllie, Malmo, Sweden
  • Pearce, Suzanne H., Diaverum AB, Hyllie, Malmo, Sweden
  • Macario, Fernando Jose Gordinho Rocha Maio, Diaverum AB, Hyllie, Malmo, Sweden
Background

Health-related quality of life (QoL) is an important outcome in prevalent hemodialysis (HD) patients, but the evolution in the first months of treatment is still to be explored. We aimed to evaluate the 1-year changes in QoL in incident patients in a large, multinational HD population.

Methods

This was a multicenter prospective observational study. All adult patients with less than 3 months on HD that voluntarily responded to KDQOL-36 in 2021 were selected and included after the response to the 2022 survey. Mental (MCS) and Physical Composite Scales (PCS) were analyzed. At the time of the first survey, demographic (age, gender) and clinical data (diabetes, comorbidity index - CI, vascular access) were collected. T-test, z-test and multivariate logistic regression were used for statistical analysis.

Results

1 401 HD patients with valid responses to both KDQOL-36 were included. QoL reported on HD admission was low: PCS=36.73±9.05 and MCS=44.07±10.29. In multivariate analysis, female gender and CI were independently associated with a poorer QoL at baseline, whereas diabetes was positively correlated with MCS but not with PCS. In the second survey, a significant increase in QoL was documented: PCS=38.75±9.77, p<0.01 and MCS=46.09±10.20, p<0.01. Increase in both scales after 1-year was observed in 234 patients (16.7% of surveys) and a decrease in 112 (8.0%) with the remaining presenting mixed results. The group with improvement in QoL was significantly younger, had a higher percentage of fistulas and lower prevalence of diabetes, when compared to the group with a decrease in both scales. In multivariate analysis, diabetic status was associated with PCS improvement after 1-year, whereas male gender was an independent predictor of PCS decrease.

Conclusion

In our incident HD patients, QoL was poor at baseline, but increased during the first months on dialysis. Diabetes was associated with QoL improvement, despite the low baseline values normally reported by this population, suggesting that HD may positively impact on QoL of diabetic patients with advanced renal disease. Despite the higher scores at baseline, male patients were more prone to QoL decrease during the first year, alerting for the importance of following QoL through time after the beginning of HD.