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Kidney Week

Abstract: FR-PO472

Association Between Vascular Access Type and Health-Related Quality of Life

Session Information

  • Dialysis: Vascular Access
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 803 Dialysis: Vascular Access

Authors

  • Ion Titapiccolo, Jasmine, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
  • Bellocchio, Francesco, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
  • Stuard, Stefano, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
  • Usvyat, Len A., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Neri, Luca, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
Background

The use of arteriovenous fistula (AVF), arteriovenous graft (AVG), or central venous catheter (CC) may differently affect patients’ quality of life (QOL). We assessed the association between vascular access (VA) type and Kidney Disease Quality of Life Short Form (KDQOL-36) in a large, multinational sample of dialysis patients.

Methods

We enrolled 10148 European dialysis patients participating in the ePROM improvement program initiated in 8 European countries since September 2021. We assessed the association between the active vascular access type and KDQOL-36 subscales with generalized linear regression. All models were adjusted for potential confounders. We accounted for the multicenter design by including a random-intercept denoting patients’ referral center.

Results

Catheter use was associated with statistically significant quality of life penalty in all KDQOL-36 subscales. However, the difference in score was very mild and did not reach clinical significance based on minimal clinically important difference estimation for all scales but the physical composite score (PCS12). Specifically, AVF was associated with 2-point better PCS12 scores, a small effect size difference.

Conclusion

Improving HRQOL of dialysis patients has been an elusive task as it may be associated with a multitude of factors which may require a multifaceted management approach. We found a small PCS12 advantage for AVF users which may be barely perceived as clinical important. Expanding AVF use may contribute to HRQOL improvement in combination with optimization of others modifiable clinical parameters.

QOL scoreCatheter (N=2596)Fistula (N=6379)Graft (N=220)p-value
BKD37.8 (35.3-40.3)40.3 (37.9-42.7)37.7 (33.5-41.9)<0.001
EKD65.9 (63.9-67.9)67.8 (65.9-69.7)66.4 (63.2-69.7)<0.001
MCS12
44.1 (43.0-45.3)44.9 (43.7-46.0)45.0 (43.2-46.7)<0.05
PCS1233.6 (31.1-36.0)
35.5 (33.0-38.0)34.0 (31.2-36.8)<.0001
SKD76.2 (73.9-78.5)77.4 (75.1-79.6)75.6 (72.7-78.6)<0.01