Edwina A Brown1, Junhui Zhao2, Keith McCullough2, Douglas S Fuller2, Ana E Figueiredo3, Brian Bieber2, Frederic O Finkelstein4, Jenny Shen5, Talerngsak Kanjanabuch6, Hideki Kawanishi7, Ronald L Pisoni2, Jeffrey Perl8. 1. Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK. 2. Arbor Research Collaborative for Health, Ann Arbor, MI, USA. 3. School of Health Sciences and Life, Nursing School, Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil. 4. Yale University, New Haven, CT, USA. 5. Division of Nephrology and Hypertension, LaBiomed at Harbor-UCLA Medical Center, Torrance, CA, USA. 6. Center of Excellence in Kidney Metabolic Disorders and Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 7. Tsuchiya General Hospital, Nakaku, Hiroshima, Japan. 8. St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. Electronic address: jeff.perl@utoronto.ca.
Abstract
RATIONALE & OBJECTIVE: Individuals faced with decisions regarding kidney replacement therapy options need information on how dialysis treatments might affect daily activities and quality of life, and what factors might influence the evolution over time of the impact of dialysis on daily activities and quality of life. STUDY DESIGN: Observational cohort study. SETTING & PARTICIPANTS: 7,771 HD and PD participants from 6 countries participating in the Peritoneal and Dialysis Outcomes and Practice Patterns Studies (PDOPPS/DOPPS). PREDICTORS: Patient-reported functional status (based on daily living activities), country, demographic and clinical characteristics, and comorbidities. OUTCOMES: Employment status and patient-reported outcomes (PROs) including Kidney Disease Quality of Life (KDQOL) instrument physical and mental component summary scores [PCS, MCS], kidney disease burden score, and depression symptoms (CES-D score >10). ANALYTICAL APPROACH: Linear regression (PCS, MCS, kidney disease burden score); Logistic regression (depression symptoms); adjusted for predictors plus 12 additional comorbidities. RESULTS: In both dialysis modalities, Japan had the highest PCS and employment [HD (55%); PD (68%)], whereas the US had the highest MCS score, lowest kidney disease burden, and lowest employment [HD (20%); PD (42%)]. After covariate adjustment, the association of age, sex, vintage, diabetes, and functional status with PROs was similar in both modalities, with females having lower PCS and kidney disease burden scores. Lower functional status (score <11) was strongly associated with lower PCS and MCS scores, a much greater burden of kidney disease, and greater likelihood of depression symptoms (CES-D>10). The median change in KDQOL-based PROs was negligible over 1 year in participants completing at least two annual questionnaires. LIMITATIONS: Selection bias due to incomplete survey responses. Generalizability was limited to dialysis populations of included countries. CONCLUSIONS: Variation exists in quality of life, burden of kidney disease, and depression across countries but did not appreciably change over time. Functional status remained one of the strongest predictors of all PROs. Routine assessment of functional status may provide valuable insights for patients and providers in anticipating outcomes and support needs for patients receiving either PD or HD.
RATIONALE & OBJECTIVE: Individuals faced with decisions regarding kidney replacement therapy options need information on how dialysis treatments might affect daily activities and quality of life, and what factors might influence the evolution over time of the impact of dialysis on daily activities and quality of life. STUDY DESIGN: Observational cohort study. SETTING & PARTICIPANTS: 7,771 HD and PDparticipants from 6 countries participating in the Peritoneal and Dialysis Outcomes and Practice Patterns Studies (PDOPPS/DOPPS). PREDICTORS: Patient-reported functional status (based on daily living activities), country, demographic and clinical characteristics, and comorbidities. OUTCOMES: Employment status and patient-reported outcomes (PROs) including Kidney Disease Quality of Life (KDQOL) instrument physical and mental component summary scores [PCS, MCS], kidney disease burden score, and depression symptoms (CES-D score >10). ANALYTICAL APPROACH: Linear regression (PCS, MCS, kidney disease burden score); Logistic regression (depression symptoms); adjusted for predictors plus 12 additional comorbidities. RESULTS: In both dialysis modalities, Japan had the highest PCS and employment [HD (55%); PD (68%)], whereas the US had the highest MCS score, lowest kidney disease burden, and lowest employment [HD (20%); PD (42%)]. After covariate adjustment, the association of age, sex, vintage, diabetes, and functional status with PROs was similar in both modalities, with females having lower PCS and kidney disease burden scores. Lower functional status (score <11) was strongly associated with lower PCS and MCS scores, a much greater burden of kidney disease, and greater likelihood of depression symptoms (CES-D>10). The median change in KDQOL-based PROs was negligible over 1 year in participants completing at least two annual questionnaires. LIMITATIONS: Selection bias due to incomplete survey responses. Generalizability was limited to dialysis populations of included countries. CONCLUSIONS: Variation exists in quality of life, burden of kidney disease, and depression across countries but did not appreciably change over time. Functional status remained one of the strongest predictors of all PROs. Routine assessment of functional status may provide valuable insights for patients and providers in anticipating outcomes and support needs for patients receiving either PD or HD.
Authors: Mark Lambie; Junhui Zhao; Keith McCullough; Simon J Davies; Hideki Kawanishi; David W Johnson; James A Sloand; Mauricio Sanabria; Talerngsak Kanjanabuch; Yong-Lim Kim; Jenny I Shen; Ronald L Pisoni; Bruce M Robinson; Jeffrey Perl Journal: Clin J Am Soc Nephrol Date: 2022-06 Impact factor: 10.614
Authors: Andrea Galassi; Eliana Maria Fasulo; Paola Ciceri; Roberta Casazza; Fabrizio Bonelli; Claudia Zierold; Mariella Calleri; Frank A Blocki; Maria Assunta Palmieri; Claudio Mastronardo; Mario G Cozzolino Journal: Front Med (Lausanne) Date: 2022-03-02
Authors: Aminu K Bello; Ikechi G Okpechi; Mohamed A Osman; Yeoungjee Cho; Brett Cullis; Htay Htay; Vivekanand Jha; Muhammad A Makusidi; Mignon McCulloch; Nikhil Shah; Marina Wainstein; David W Johnson Journal: Nat Rev Nephrol Date: 2022-09-16 Impact factor: 42.439