Abstract: FR-PO0396
Association of Heart Failure Symptoms and Subsequent Heart Failure Hospitalizations and Mortality Among Incident Dialysis Patients
Session Information
- Dialysis: Measuring and Managing Symptoms and Syndromes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Assefa, Mahlet, University of Washington, Seattle, Washington, United States
- Zelnick, Leila R., University of Washington, Seattle, Washington, United States
- Bansal, Nisha, University of Washington, Seattle, Washington, United States
Background
Diagnosing heart failure (HF) in dialysis patients is challenging due to overlapping symptoms of volume overload. The Kansas City Cardiomyopathy Questionnaire Score (KCCQ) is a health status questionnaire measuring HF related symptoms and functional limitations, with lower scores indicating greater burden. KCCQ is also an FDA-validated clinical endpoint. We assessed the association between KCCQ and subsequent HF hospitalization and all-mortality in incident dialysis patients.
Methods
We studied 625 Chronic Renal Insufficiency Cohort study (CRIC) participants who developed end-stage kidney disease (ESKD), had KCCQ scores post-ESKD diagnosis and had first dialysis modality of either hemodialysis (HD) or peritoneal dialysis (PD). The primary outcomes were rates of HF hospitalization, 30-day HF readmission and all-cause mortality. KCCQ was modeled dichotomously (<75 vs ≥75) and continuously (per 5-point decrement). Poisson regression with robust standard errors was used to test the association of KCCQ score with each outcome.
Results
Among 625 participants (mean age 59 years; 60% male; 87% on HD), median follow-up was 6.8 (IQR 3.2-12.0) years. Those with KCCQ <75 had nearly twice the rate of HF hospitalizations (15.4 vs 8.4/100 person-years) and 30-day readmissions (3.7 vs 1.6/100 person-years) compared to KCCQ ≥75 (Table 1). Each 5-point decrement in KCCQ was associated with 9% higher HF hospitalization risk (aRR 1.09, p=0.0003), 13% higher 30-day HF readmission risk (aRR 1.13, p=0.003), and 6% higher all-cause mortality (aRR 1.06; p<0.0001) (Table 1). Stratified by HF subtype, patients with HFrEF and KCCQ<75 had 81% higher HF hospitalization risk vs those with KCCQ ≥75 (p=0.02).
Conclusion
The findings suggest that higher burden of early HF symptoms and functional limitations are associated with subsequent HF hospitalizations, 30-day HF readmissions and mortality. The KCCQ symptom score may be a useful tool to help prognosticate risk of poor clinical outcomes in dialysis patients.
Funding
- Other NIH Support