University of Hertfordshire

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Quality of life with conservative care compared with assisted peritoneal dialysis and haemodialysis

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Quality of life with conservative care compared with assisted peritoneal dialysis and haemodialysis. / Iyasere, Osasuyi; Brown, Edwina A; Johansson, Lina; Davenport, Andrew; Farrington, Ken; Maxwell, Alexander P; Collinson, Helen; Fan, Stanley; Habib, Ann-Marie; Stoves, John; Woodrow, Graham.

In: Clinical Kidney Journal, Vol. 12, No. 2, sfy059, 01.04.2019, p. 262-268.

Research output: Contribution to journalArticlepeer-review

Harvard

Iyasere, O, Brown, EA, Johansson, L, Davenport, A, Farrington, K, Maxwell, AP, Collinson, H, Fan, S, Habib, A-M, Stoves, J & Woodrow, G 2019, 'Quality of life with conservative care compared with assisted peritoneal dialysis and haemodialysis', Clinical Kidney Journal, vol. 12, no. 2, sfy059, pp. 262-268. https://doi.org/10.1093/ckj/sfy059

APA

Iyasere, O., Brown, E. A., Johansson, L., Davenport, A., Farrington, K., Maxwell, A. P., Collinson, H., Fan, S., Habib, A-M., Stoves, J., & Woodrow, G. (2019). Quality of life with conservative care compared with assisted peritoneal dialysis and haemodialysis. Clinical Kidney Journal, 12(2), 262-268. [sfy059]. https://doi.org/10.1093/ckj/sfy059

Vancouver

Author

Iyasere, Osasuyi ; Brown, Edwina A ; Johansson, Lina ; Davenport, Andrew ; Farrington, Ken ; Maxwell, Alexander P ; Collinson, Helen ; Fan, Stanley ; Habib, Ann-Marie ; Stoves, John ; Woodrow, Graham. / Quality of life with conservative care compared with assisted peritoneal dialysis and haemodialysis. In: Clinical Kidney Journal. 2019 ; Vol. 12, No. 2. pp. 262-268.

Bibtex

@article{3ccc8859a2fa430da21894cddb492ec6,
title = "Quality of life with conservative care compared with assisted peritoneal dialysis and haemodialysis",
abstract = "Background. There is little information about quality of life (QoL) for patients with end-stage kidney disease (ESKD) choosing conservative kidney management (CKM). The Frail and Elderly Patients on Dialysis (FEPOD) study demonstrated that frailty was associated with poorer QoL outcomes with little difference between dialysis modalities [assisted peritoneal dialysis (aPD) or haemodialysis (HD)]. We therefore extended the FEPOD study to include CKM patients with estimated glomerular filtration rate ⌉10 mL/min/1.73m2 (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.",
keywords = "Conservative care, Dialysis, End-stage kidney disease, Frailty, Quality of life",
author = "Osasuyi Iyasere and Brown, {Edwina A} and Lina Johansson and Andrew Davenport and Ken Farrington and Maxwell, {Alexander P} and Helen Collinson and Stanley Fan and Ann-Marie Habib and John Stoves and Graham Woodrow",
year = "2019",
month = apr,
day = "1",
doi = "10.1093/ckj/sfy059",
language = "English",
volume = "12",
pages = "262--268",
journal = "Clinical Kidney Journal",
issn = "2048-8505",
publisher = "Oxford University Press",
number = "2",

}

RIS

TY - JOUR

T1 - Quality of life with conservative care compared with assisted peritoneal dialysis and haemodialysis

AU - Iyasere, Osasuyi

AU - Brown, Edwina A

AU - Johansson, Lina

AU - Davenport, Andrew

AU - Farrington, Ken

AU - Maxwell, Alexander P

AU - Collinson, Helen

AU - Fan, Stanley

AU - Habib, Ann-Marie

AU - Stoves, John

AU - Woodrow, Graham

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Background. There is little information about quality of life (QoL) for patients with end-stage kidney disease (ESKD) choosing conservative kidney management (CKM). The Frail and Elderly Patients on Dialysis (FEPOD) study demonstrated that frailty was associated with poorer QoL outcomes with little difference between dialysis modalities [assisted peritoneal dialysis (aPD) or haemodialysis (HD)]. We therefore extended the FEPOD study to include CKM patients with estimated glomerular filtration rate ⌉10 mL/min/1.73m2 (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.

AB - Background. There is little information about quality of life (QoL) for patients with end-stage kidney disease (ESKD) choosing conservative kidney management (CKM). The Frail and Elderly Patients on Dialysis (FEPOD) study demonstrated that frailty was associated with poorer QoL outcomes with little difference between dialysis modalities [assisted peritoneal dialysis (aPD) or haemodialysis (HD)]. We therefore extended the FEPOD study to include CKM patients with estimated glomerular filtration rate ⌉10 mL/min/1.73m2 (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.

KW - Conservative care

KW - Dialysis

KW - End-stage kidney disease

KW - Frailty

KW - Quality of life

UR - http://www.scopus.com/inward/record.url?scp=85068561236&partnerID=8YFLogxK

U2 - 10.1093/ckj/sfy059

DO - 10.1093/ckj/sfy059

M3 - Article

C2 - 30976407

VL - 12

SP - 262

EP - 268

JO - Clinical Kidney Journal

JF - Clinical Kidney Journal

SN - 2048-8505

IS - 2

M1 - sfy059

ER -