Kidney Week

Abstract: TH-PO1006

Patient-Centered Outcomes of Advanced CKD Treated with Conservative Management vs. Dialysis: A Substudy of the Prospective NIH OPTIMAL Cohort

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• You, Amy Seungsook, University of California Los Angeles, Los Angeles, California, United States

Amy Seungsook You, MS

• Narasaki, Yoko, University of California Los Angeles, Los Angeles, California, United States

Yoko Narasaki, MS, PhD

• Novoa Vargas, Alejandra, University of California Los Angeles, Los Angeles, California, United States

Alejandra Novoa Vargas, MPH

• Le, Lisa, University of California Los Angeles, Los Angeles, California, United States

Lisa Le

• Nguyen, Danh V., University of California Irvine, Irvine, California, United States

Danh V. Nguyen, PhD

• Kalantar-Zadeh, Kamyar, Harbor-UCLA Medical Center, Torrance, California, United States

Kamyar Kalantar-Zadeh, MD, DrMed, PhD, MPH, FASN

• Rhee, Connie, University of California Los Angeles, Los Angeles, California, United States

Connie Rhee, MD, MS

Background

While dialysis has been the treatment paradigm among advanced CKD patients ineligible for/unlikely to receive transplantation, it may not improve HRQOL among certain subgroups (elderly, multi-morbid), which has motivated interest in conservative management (CM) as an alternative patient-centered treatment option.

Methods

In a subcohort of 53 participants from the ongoing multicenter prospective NIH OPTIMAL study comparing CM vs. dialysis preparation on the longitudinal trajectory of HRQOL, physical performance/activity, symptom burden, and nutrition in stage 4-5 CKD patients, we examined baseline patient-centered outcomes data collected using validated instruments.

Results

Short Form 36 data showed low (worse) PCS (median [IQR] 41 [28, 52]) and MCS (median [IQR] 56 [47, 59]) scores. Short Physical Performance Battery data showed relatively low physical performance (median [IQR] 9 [7, 11]). Human Activity Profile data showed low self-reported activity (50% with low Adjusted Activity Score <53). Dialysis Symptom Index data showed high symptom burden (median [IQR] 25 [15, 30]). The most prevalent symptoms included feeling tired/lack of energy (60%), dry skin (60%), and trouble staying asleep (51%).

Conclusion

Baseline data from the NIH OPTIMAL cohort showed low HRQOL, low physical performance/activity, and high symptom burden in advanced CKD patients undergoing CM vs. dialysis preparation.

Funding

• NIDDK Support