Abstract: SA-PO451
Impact of Peritoneal Dialysis Modality on Quality of Life in Hypervolemic Patients
Session Information
- Home Dialysis - 2
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Sritippayawan, Suchai, Division of Nephrology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Chaikledkaew, Usa, Mahidol University Faculty of Pharmacy, Bangkok, Thailand
- Chuengsaman, Piyatida, Banphaeo General Hospital, Samut Sakhon, Thailand
- Thavorncharoensap, Montarat, Mahidol University Faculty of Pharmacy, Bangkok, Thailand
- Aiyasanon, Nipa, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
- Tongsai, Sasima, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
Group or Team Name
- APDICO Project Group.
Background
Hypervolemia significantly affects outcomes and quality of life (QOL) in peritoneal dialysis (PD) patients. Limited data compare the QOL across the PD modalities. Our study aims to study the QOL in hypervolemic patients treated with Continuous Ambulatory Peritoneal Dialysis (CAPD), CAPD with 1 cycle of icodextrin (ICO) and nighttime Automated Peritoneal Dialysis (APD).
Methods
180 CAPD patients with systolic blood pressure (BP) >140 mmHg, diastolic BP >90 mmHg, edema from volume excess or a history of heart failure within the past year from 16 hospitals were randomized into 3 groups of 60 each: CAPD, ICO and APD. Hypertonic solutions, antihypertensive drugs and daily dialysate volume were adjusted based on patients' BP, symptoms and total weekly Kt/Vurea. QOL was assessed using the EQ-5D-5L and KDQOL-36 questionnaires at week 0, 24, 48, 104 and 156. The relationship between the treatment groups and the QOL scores was analyzed using Generalized Estimating Equations in linear regression. The model coefficients determined the intensity and direction of these correlations.
Results
At enrollment, the groups showed no significant differences in age, urine volume, PD duration, Charlson Comorbidity Index (CCI) score, blood pressure, serum albumin, previous peritonitis rate, total weekly Kt/Vurea, or QOL scores. By week 156, 20, 21, and 11 patients remained in the study, while 30, 19, and 32 had died in the CAPD, ICO, and APD groups, respectively. Two patients each withdrew from the CAPD and ICO groups. Patients on ICO and APD showed significantly better utility and VAS scores on EQ-5D-5L compared to those on CAPD (p<0.05). KDQOL-36 also revealed higher scores in all domains for the ICO group compared to the CAPD group (significant or trending). The APD group achieved higher KDQOL-36 scores in the Effects and Burden of Kidney Disease and SF-12 Physical Component Summary domains compared to the CAPD group. There were no differences between APD and ICO groups in any domain.
Conclusion
In hypervolemic patients, treatment with ICO offered better QOL than CAPD alone, but was similar to APD. APD offered advantages in specific aspects of QOL compared to CAPD. The ICO group also had a higher survival rate than the CAPD and APD groups. This suggests ICO may improve QOL for PD patients.
Funding
- Government Support – Non-U.S.