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Abstract: TH-PO870

Characteristics and Patient-Reported Outcomes of Advanced CKD Patients Treated With Conservative Management vs. Dialysis: Findings From the Prospective NIH OPTIMAL Cohort

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Rhee, Connie, University of California Irvine, Irvine, California, United States
  • Yoon, Ji Hoon, University of California Irvine, Irvine, California, United States
  • Otobe, Yuhei, University of California Irvine, Irvine, California, United States
  • Crowley, Susan T., Yale University, New Haven, Connecticut, United States
  • Kovesdy, Csaba P., The University of Tennessee Health Science Center VolShop Memphis, Memphis, Tennessee, United States
  • Mukamel, Dana B., University of California Irvine, Irvine, California, United States
  • Narasaki, Yoko, University of California Irvine, Irvine, California, United States
  • Novoa-Vargas, Alejandra, University of California Irvine, Irvine, California, United States
  • Torres Rivera, Silvina, University of California Irvine, Irvine, California, United States
  • You, Amy Seung, University of California Irvine, Irvine, California, United States
  • Nguyen, Danh V., University of California Irvine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
Background

Dialysis is linked with high early mortality, frequent hospitalizations, and high withdrawal in certain groups, catalyzing interest in conservative management (CM) as an alternative treatment option for advanced CKD. We conducted an interim analysis of the prospective NIH OPTIMAL cohort examining patient-centered outcomes in advanced CKD patients treated with CM vs. dialysis.

Methods

We conducted an interim analysis of the prospective NIH OPTIMAL cohort comparing CM vs. dialysis preparation on the longitudinal trajectory of HRQOL, physical function, symptom burden, and nutrition in advanced CKD patients. We examined clinical characteristics and patient-reported outcomes (PROs) among the 1st 18 enrolled patients undergoing comprehensive, holistic CM vs. dialysis preparation encompassing commensurate education, nutrition guidance, symptom management, and social support.

Results

Baseline Short Form 36 HRQOL assessments showed low (worse) physical/mental component summary scores, as well as lower subscale scores (Table 1). Human Activity Profile surveys showed high prevalence of low/moderate self-reported activity levels, and Short Physical Performance Battery assessments showed relatively low physical performance. While the Dialysis Symptom Index showed high symptom burden in the cohort, Malnutrition Inflammation Score surveys showed preserved nutritional status.

Conclusion

The next phases in the OPTIMAL study will compare hard and patient-centered outcomes among patients receiving CM vs. dialysis preparation, and will identify which patients will most benefit from these advanced CKD management strategies.

Funding

  • NIDDK Support