MO394: Health Related Quality of Life in Patients With End-Stage Renal Disease Before and After Starting Dialysis During Pandemic Covid-19

Abstract

Abstract BACKGROUND AND AIMS Patients with end-stage renal disease (ESRD) have complex functional and social changes that affect their quality of life (QoL), leading to an increased cardiovascular risk, mortality and overall morbidity. Several studies showed that general QoL worsened after dialysis initiation but improved by 12 weeks. The influence of coronavirus (COVID-19) among pre-dialysis CKD patients starting dialysis during pandemic COVID-19 is challenging and still largely unexplored. To evaluate the quality of life in patients with ESRD before and after initiating dialysis during pandemic COVID-19, in Constanta County, a south-eastern Romanian region. METHOD We assessed 59 patients (mean age = 61.65year ± 11.36, Male : Female = 3:1, 13.79% employee) with ESRD before and after dialysis started (T1–12 weeks and T2–24 weeks), using KDQOL–36™, in the interval of time of 1 year (May 2020–May 2021). RESULTS QoL was severely affected in patients with diabetes and hypertension, especially because of diet restrictions (58.6%, P < 0.01), fatigue (67.5%, P < 0.01), concerns about the kidney disease (72.4%, P < 0.05) and permanent need for medical services (48.6%, P = NS). Most of the patients required acute initiation of haemodialysis on CVC (66.1%) due to uraemic manifestations and late referral, 34.4% started planned haemodialysis on AV fistula and 8.47% started planned peritoneal dialysis. An overall improvement of QoL was seen both in patients with urgent and planned dialysis initiation, in women group less than in males (P < 0.05). Among dialysis patients at T2, we have found significantly lower levels for mean Mental Component Summary (MCS), calculated as 45.9 ± 14.1, about 3.1 points less than the majority of other studies. The following mental health-related symptoms were claimed during the COVID-19 pandemic ‘second and third waves’: feeling sad, worrying, feeling nervous and trouble falling asleep, even though dialysis patients seemed less impacted by social distancing measures. CONCLUSION The initiation of dialysis was an important factor in improving the QoL in our ESRD patients and the type of dialysis and planned initiation contribute substantially to the patient's perception of the disease and influence the main psycho-social parameters of QoL. COVID-19 pandemic affected the QoL of patients that started dialysis in the established interval of time, especially the mean MCS score, probably associated with the high morbidity and mortality of Romanian ESRD and dialysis patients.