Assisted peritoneal dialysis was associated with higher physical component scores (Exp B 1.20; 95% CI 1.00-1.45; P<0.05) and lower symptom scores compared with conservative kidney management.
Observational (n=84)
Does assisted peritoneal dialysis or haemodialysis improve quality of life in older patients with ESKD compared to conservative kidney management?
In older patients with ESKD, dialysis (both aPD and HD) improved some quality of life measures compared to conservative kidney management, though frailty was associated with worse outcomes regardless of modality.
Effect estimate: Exp B 1.20 (95% CI 1.00-1.45)
p-value: p=<0.05
BACKGROUND: (i.e. individuals with ESKD otherwise likely to be managed with dialysis). METHODS: CKM patients were propensity matched to HD and aPD patients by age, gender, ethnicity, diabetes status and index of deprivation. QoL outcomes measured were Short Form-12 (SF12), Hospital Anxiety and Depression Scale depression score, symptom score, Illness Intrusiveness Rating Scale (IIRS) and Renal Treatment Satisfaction Questionnaire. Frailty was assessed using the Clinical Frailty Scale. Generalized linear modelling was used to assess the impact of treatment modality on QoL outcomes, adjusting for baseline characteristics. RESULTS: In total, 84 (28 CKM, 28 HD and 28 PD) patients were included. Median age for the cohort was 82 (79-88) years. Compared with CKM, aPD was associated with higher SF12 physical component score (PCS) Exp B (95% confidence interval) = 1.20 (1.00-1.45), P < 0.05 and lower symptom score Exp B = 0.62 (0.43-0.90), P = 0.01; depression score was lower in HD compared with CKM Exp B = 0.70 (0.52-0.92), P = 0.01. Worsening frailty was associated with higher depression scores Exp B = 2.59 (1.45-4.62), P < 0.01, IIRS Exp B = 1.20 (1.12-1.28), P < 0.01 and lower SF12 PCS Exp B = 0.87 (0.83-0.93), P < 0.01. CONCLUSION: Treatment by dialysis, both with aPD and HD, improved some QoL measures. Overall, aPD was equal to or slightly better than the other modalities in this elderly population. However, as in the primary FEPOD study, frailty was associated with worse QoL measures irrespective of CKD modality. These findings highlight the need for an individualized approach to the management of ESKD in older people.
Iyasere et al. (Tue,) conducted a observational in End-Stage Kidney Disease (ESKD) (n=84). Assisted peritoneal dialysis (aPD) and haemodialysis (HD) vs. Conservative kidney management (CKM) was evaluated on SF12 physical component score (PCS) (Exp B 1.20, 95% CI 1.00-1.45, p=<0.05). Assisted peritoneal dialysis was associated with higher physical component scores (Exp B 1.20; 95% CI 1.00-1.45; P<0.05) and lower symptom scores compared with conservative kidney management.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: