P1150BURDEN OF SYMPTOMS EVALUATION AND DETERMINANTS IN PERITONEAL DIALYSIS PATIENTS USING ESAS-R AND IPOS RENAL SCORE

Abstract

Abstract Background and Aims CKD patients are known to have a substantial burden of symptoms. Effort towards treatment modifications aiming to improve the quality of life in ESRD patients is growing among clinicians. ESAS-r and IPOS renal score are well known among conservative and palliative care physicians, used to evaluate the burden of symptoms in their renal patients. However, there are few studies including patients in chronic peritoneal dialysis. Using these tools, we aim to evaluate the symptoms and determine patient and treatment-related conditions associated with their burden in a PD population. Method We have conducted 73 phone interviews to the prevalent PD population in our centre. ESAS-r and IPOS renal (3-days patient version) questionnaires were answered by each patient/family caregiver. The population was then characterized according to gender, race, age, PD technique and duration, number of daily exchanges, patient autonomy, diabetes mellitus and cancer status, Charlson score and number of cardiac events and hospitalizations since PD beginning. Statistical analysis of data was carried out using SPSS®. Results We obtained a total of 63 answers to both questionnaires. Three were answered by a family caregiver. 60.3% of the patients were male, mean age 53 (±14.9) years. 15.9% were on automated PD, with mean number of daily exchanges of 3.45 (±0.7) and mean PD duration of 25.7 (±33.5) months. 38,1% were diabetic, six (9.5%) patients had cancer and mean Charlson score was 4.24 (±1.8). Only 3 patients were caregiver dependent for treatment. 31.3% had at least one hospitalization since PD beginning. Each patient reported a mean 3.1 (±2) number of symptoms on ESASr: renal. Mean IPOS-renal score was 9.5 (±6.4). In univariate analysis (t-student test), greater IPOS-renal score was associated with female gender only (p = 0.056; CI -0.07-6.1). In multivariate analysis (linear regression) the number of symptoms reported by each patient on ESASr renal was associated with number of hospitalizations during PD time (B = 0.46; CI(95%) 0.18-0.75; p = 0.02) in model adjusted to time of PD. Conclusion The majority of variables analysed do not have an association with IPOS renal score. The number of hospitalizations was associated with greater burden of symptoms, adjusted to PD time. Oddly, Charlson score, diabetes mellitus and cancer status had no relation to the symptoms reported or IPOS renal score. More modifiable patient and treatment-related variables can be studied to better characterize which interventions may ease the burden of symptoms in PD patients. Patients can answer these questionnaires periodically to help clinicians understand weather treatment modifications have a positive impact on their well-being.