ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2024 and some content may be unavailable. To unlock all content for 2024, please visit the archives.

Abstract: TH-PO257

Dynamic Patient-Reported Outcome Measures Evaluate Durability of Expanded Hemodialysis on Health-Related Quality of Life (HR-QoL) and Symptom Variability

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Penny, Jarrin D., London Health Sciences Centre, London, Ontario, Canada
  • McIntyre, Christopher W., London Health Sciences Centre, London, Ontario, Canada
Background

Current hemodialysis (HD) utilizing high-flux dialyzers, is handicapped by clearance limitations contributing to poor health-related quality-of-life (HR-QoL) and symptom-burden. Recent international guideline-setting efforts have prioritized identification and management of symptoms and subjective experience. This study aimed to utilize dynamic patient-reported-outcome-measurement tool (PROM), London Evaluation of Illness (LEVIL), to iteratively interrogate patient-experience and benefits of the use of expanded hemodialysis (HDx) on HR-QoL and symptom burden, including durability-of-effects, variability of symptoms and impact of HDx withdrawal.

Methods

Multi-centre interventional study in 47 patients established on conventional thrice weekly centre-based HD in Ontario, Canada. Study was 15-months with five phases 1) one-month observation (high-flux-HD), 2) three-months HDx 3) two-month wash-out (high-flux-HD), 4) six-months HDx, 5) three-month wash-out (high-flux-HD). HR-QoL and symptom-burden were evaluated using LEVIL throughout study.

Results

HDx-therapy improved HR-QoL p 0.0006 (19% ) and a variety of symptoms including general wellbeing p 0.005 (23%), energy p 0.004 (33%), sleep-quality p 0.001 (33%), pruritus 0.003 (30%), pain p 0.01 (19%), restless leg syndrome p 0.0006 (15%), mood p 0.02 (12%), appetite p 0.03 (9%), breathlessness p 0.001 (9%), and HD-recovery p 0.004 (26%). Response was more pronounced in those with poorer HR-QoL and higher symptom-burden. Improvements were durable over time with less symptom-variability. Improvements diminished with return to high-flux-HD. Drivers of poor HR-QoL were general-wellbeing, energy, sleep-quality, pruritus, and bodily pain.

Conclusion

Dynamic PROM effectively evaluates HR-QoL and impact of therapy. HDx improved subjective outcomes that are durable and associated with less variation in important symptomx than patients experience with conventional high-flux-HD.

Allow Cookies?
www.asn-online.org is attempting to set a cookie to store a user preference.

Cookie Name = page_modal_8
Value = hide

To allow this operation and to opt-in to cookie usage for this website, in accordance with our Privacy Policy, please click the 'Allow' button below.
Allow
Do Not Allow