P1212PREDICTORS OF QUALITY OF LIFE IN PERITONEAL DIALYSIS: A SINGLE-CENTER EXPERIENCE
Authors: Figueiredo Carolina , Maia Pedro , Mendes Teresa , Pinto Helena , Lança Alice , Sá Helena , Alves Rui 
Published: June 2020

Abstract

Background and Aims
Quality of life (QoL) is an important indicator of quality of healthcare. Measuring QoL and its correlates for peritoneal dialysis (PD) patients is very important for intervention and clinical decision-making. Being a technique performed by the patients themselves, their perspective of health related QoL is extremely important. The EuroQol questionnaire evaluates 5 QoL dimensions (mobility, self-care, usual activities, pain/ discomfort and anxiety/ depression) and includes a visual analogue scale (VAS) rated 0-100% that provides a quantitative measure of the patients’ perception of their overall health.

Method
Data from 69 patients on peritoneal dialysis at our center were collected using EQ-5D-5L EuroQol questionnaire. Health state index (HSI) scores were calculated from individual health profiles using the Spanish value set (maximum score 1). Additional clinical and laboratory data was collected from the patient’s medical files.

Results
Mean age of the population studied was 55,2 ± 14,0 years, and 66,7% (n=46) were male. Most patients were on PD &gt; 1 year (62,3%, n=43) and performing automated peritoneal dialysis (APD) (52,2%, n=36). Mean HSI was 0,88 ± 0,15 and mean VAS score was 75,1 ± 18,7.
Patients with weekly Kt/V ≥ 1,7 scored on average 0,09 points higher on the HSI (p=0,070) and 13,34 points higher in VAS (p=0,019), compared to patients with weekly Kt/V &lt; 1,7. Patients on PD &gt; 1 year scored on average 0,09 points lower on the HSI (p=0,017), mainly due to higher levels of anxiety/depression, and 11,9 points lower in VAS (p=0,005) than those &lt; 1 year.
Age did not significantly influence QoL, even when comparing patients &gt; 70 years with those &lt; 70 years old (HSI 73.0 ± 15.5 vs 75.4 ± 19.3, p=0.710 / VAS 0.82 ± 0.3 vs 0.89 ± 0.1, p=0.175). Likewise, when comparing continuous ambulatory peritoneal dialysis (CAPD) to APD, there was no significant difference in the scores of QoL. Gender, diabetes mellitus, arterial hypertension, cancer and infectious events related to PD in the last year did not influence QoL. Residual diuresis as an isolated factor did not significantly influence QoL scores. However, as it is a fundamental contributor to Kt/V, it may be indirectly associated with better QoL. A more detailed analysis was not possible as the number of patients with Kt/V ≥ 1.7 and no residual diuresis was, as expected, very low (n=4).

Conclusion
Perceived QoL in the elderly when compared to younger patients in PD was not inferior in our study, showing this option should be discussed individually with each patient.
Our results revealed time in PD negatively influences patients’ perception of their own health, which may be due to patient’s burden and exhaustion, and eventually lead to technique related complications.
Kt/V ≥ 1,7 was related to better QoL, either because higher dialysis adequacy leads to better QoL, or because patients who feel better have less tendency to neglect the technique.
Finally, we also found type of PD (CAPD vs APD) to have no significant influence on QoL, reinforcing the idea that it should be discussed and adapted to each individual patient.