Kidney Week

Abstract: FR-PO0275

Quality of Life and Treatment Preferences for Conservative Kidney Management or Kidney Replacement: Baseline Data from a Prospective Multicenter Cohort Study of Patients with ESKD in Japan

Session Information

• CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Wei, Tianyi, Tokyo Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Bunkyo, Tokyo, Japan

Tianyi Wei, MPH

• Sasaki, Yuji, Koritsu Showa Byoin, Kodaira, Tokyo, Japan

Yuji Sasaki, MD

• Miyakawa, Hiroshi, Koritsu Showa Byoin, Kodaira, Tokyo, Japan

Hiroshi Miyakawa, MD

• Honda, Tomoko, Chofu Byoin, Chofu, Tokyo, Japan

Tomoko Honda

• Komatsu, Shuuhei, Hachioji Sanno Byoin, Hachioji, Tokyo, Japan

Shuuhei Komatsu

• Matsuyama, Yutaka, Tokyo Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Bunkyo, Tokyo, Japan

Yutaka Matsuyama, PhD

• Yoshida, Yui, Tokyo Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Bunkyo, Tokyo, Japan

Yui Yoshida, MD, PhD

Background

There is limited information on quality of life (QOL), treatment preferences, and reasons for choosing conservative kidney management (CKM) or renal replacement therapy (RRT) among patients with ESRD before treatment initiation. We report the baseline characteristics, including QOL and treatment preferences (CKM vs RRT), in patients with ESRD from a multicenter cohort study in Japan.

Methods

We enrolled 81 adults with ESRD, defined as eGFR≤15 mL/min/1.73 m², who had not started RRT at enrollment. Patients were recruited from three hospitals in the western Tokyo area from July 2024 to March 2026. The baseline data included clinical characteristics, QOL measured by SF-36v2, and patient-reported treatment preferences with reasons. The cohort is designed to follow same questionnaires every 6 months for up to 3 years until July 2027.

Results

The mean age was 70.7 (SD 13.3) years, 27.2% were female, and mean eGFR was 10.8 (SD 3.2) mL/min/1.73 m². Eastern Cooperative Oncology Group performance status (PS) score was 0–1 in 77.8%, and no patients had a PS score of 4. Diabetic nephropathy (34.6%) and nephrosclerosis (29.6%) were the leading causes of ESRD. Regarding comorbidities, 96.3% of patients had hypertension and 38.3% had diabetes. Using norm-based scores, baseline SF-36 showed lower scores of physical functioning [mean (SD), 40.9 (15.0)], general health [44.9 (8.6)], and physical component summary [42.4 (11.2)] than national normative values of 50, while mental health [52.9 (10.3)] and mental component summary [51.8 (11.7)] were similar to or above national normative values. At enrollment, 38 patients preferred RRT (35 hemodialysis, 1 peritoneal dialysis, and 2 kidney transplantation), 11 preferred CKM, and 32 remained undecided. The most common reasons for choosing treatment were recommendations by clinicians (25.9%) and patients’ physical conditions (18.5%).

Conclusion

The characteristics of predialysis patients in our research were similar to those of Japanese patients newly initiating maintenance dialysis in the Japanese nationwide registry. The high proportion of patients who remained undecided regarding treatment choice suggests that many patients may require additional time to make this decision. Further follow-up will evaluate changes in treatment choices and QOL trajectories over time.

Funding

• Commercial Support – Pfizer Health Research Foundation