Ramon Paniagua1, Dante Amato, Edward Vonesh, Amy Guo, Salim Mujais. 1. Unidad de Investigacion Médica en Enfermedades Nefrolgicas, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Abstract
BACKGROUND: We hypothesized that increasing small solute clearance in peritoneal dialysis (PD) would lead to improvements in patient health-related quality of life (HRQOL). METHODS: Patients were randomized to a control group [standard 4 x 2 L continuous ambulatory peritoneal dialysis (CAPD)] and an intervention group (CAPD with a target creatinine clearance >/=60 L/week/1.73 m(2)). The Kidney Disease Quality of Life Short Form was obtained at baseline and at 6, 12, and 24 months. Physical (PCS), mental (MCS), andkidney disease component summary (KDCS) scores were computed. RESULTS: The two groups were comparable at baseline with respect to HRQOL. Baseline variables highly predictive of better QOL included absence of diabetes, younger age, higher starting GFR, and serum albumin. Baseline values of QOL were highly predictive of survival and hospitalizations. An unadjusted comparison revealed that patients in the intervention group had significantly higher PCS and KDCS scores at six months. However, there were no significant differences between the intervention and control patients at 12 or 24 months. When similar analyses were carried out adjusting for different patterns of patient dropout, there were no significant differences between the two groups at any time point in terms of PCS, MCS, and KDCS scores. CONCLUSION: We found no evidence of a long-term benefit in HRQOL of CAPD patients by increasing peritoneal small-solute clearances when HRQOL parameters were adjusted for patient dropout. Measures of HRQOL have a significant predictive value for patient survival and hospitalizations.
RCT Entities:
BACKGROUND: We hypothesized that increasing small solute clearance in peritoneal dialysis (PD) would lead to improvements in patient health-related quality of life (HRQOL). METHODS:Patients were randomized to a control group [standard 4 x 2 L continuous ambulatory peritoneal dialysis (CAPD)] and an intervention group (CAPD with a target creatinine clearance >/=60 L/week/1.73 m(2)). The Kidney Disease Quality of Life Short Form was obtained at baseline and at 6, 12, and 24 months. Physical (PCS), mental (MCS), and kidney disease component summary (KDCS) scores were computed. RESULTS: The two groups were comparable at baseline with respect to HRQOL. Baseline variables highly predictive of better QOL included absence of diabetes, younger age, higher starting GFR, and serum albumin. Baseline values of QOL were highly predictive of survival and hospitalizations. An unadjusted comparison revealed that patients in the intervention group had significantly higher PCS and KDCS scores at six months. However, there were no significant differences between the intervention and control patients at 12 or 24 months. When similar analyses were carried out adjusting for different patterns of patient dropout, there were no significant differences between the two groups at any time point in terms of PCS, MCS, and KDCS scores. CONCLUSION: We found no evidence of a long-term benefit in HRQOL of CAPD patients by increasing peritoneal small-solute clearances when HRQOL parameters were adjusted for patient dropout. Measures of HRQOL have a significant predictive value for patient survival and hospitalizations.
Authors: Vassilis Liakopoulos; Ioannis Stefanidis; Theodoros Eleftheriadis; Carlos G Musso; Iraklis Ioannidis; Dimitrios G Oreopoulos Journal: Int Urol Nephrol Date: 2006 Impact factor: 2.370
Authors: Karine E Manera; David W Johnson; Jonathan C Craig; Jenny I Shen; Lorena Ruiz; Angela Yee-Moon Wang; Terence Yip; Samuel K S Fung; Matthew Tong; Achilles Lee; Yeoungjee Cho; Andrea K Viecelli; Benedicte Sautenet; Armando Teixeira-Pinto; Edwina Anne Brown; Gillian Brunier; Jie Dong; Tony Dunning; Rajnish Mehrotra; Saraladevi Naicker; Roberto Pecoits-Filho; Jeffrey Perl; Martin Wilkie; Allison Tong Journal: Clin J Am Soc Nephrol Date: 2018-12-20 Impact factor: 8.237
Authors: Jeffrey Perl; Laura M Dember; Joanne M Bargman; Teri Browne; David M Charytan; Jennifer E Flythe; LaTonya J Hickson; Adriana M Hung; Michel Jadoul; Timmy Chang Lee; Klemens B Meyer; Hamid Moradi; Tariq Shafi; Isaac Teitelbaum; Leslie P Wong; Christopher T Chan Journal: Clin J Am Soc Nephrol Date: 2017-03-17 Impact factor: 8.237
Authors: Debbie S Gipson; Howard Trachtman; Frederick J Kaskel; Milena K Radeva; Jennifer Gassman; Tom H Greene; Marva M Moxey-Mims; Ronald J Hogg; Sandra L Watkins; Richard N Fine; John P Middleton; V M Vehaskari; Susan L Hogan; Suzzane Vento; Patti A Flynn; Leslie M Powell; June L McMahan; Norman Siegel; Aaron L Friedman Journal: Kidney Int Date: 2010-12-22 Impact factor: 10.612
Authors: Fredric O Finkelstein; Kelli L Arsenault; Ana Taveras; Kwabena Awuah; Susan H Finkelstein Journal: Nat Rev Nephrol Date: 2012-10-23 Impact factor: 28.314
Authors: Huseyin Atalay; Yalcin Solak; Murat Biyik; Zeynep Biyik; Mehdi Yeksan; Faruk Uguz; Ibrahim Guney; Halil Zeki Tonbul; Suleyman Turk Journal: Int Urol Nephrol Date: 2009-12-02 Impact factor: 2.370
Authors: Karen L Saban; Fred B Bryant; Domenic J Reda; Kevin T Stroupe; Denise M Hynes Journal: Health Qual Life Outcomes Date: 2010-10-25 Impact factor: 3.186