PC092. Patient-Reported Outcomes in Patients With End-Stage Renal Disease: Is Quality of Life Affected When Catheters Are Used for Hemodialysis versus Arteriovenous Fistulas?

Abstract

Patients with end-stage renal disease (ESRD) often require tunneled dialysis catheters (TDC) for hemodialysis, but the impact of TDCs on patient quality of life is unclear. The purpose of this study was to evaluate patient-reported outcome (PRO) measures for depression and physical function among patients with ESRD undergoing TDC as compared with arteriovenous fistulas (AVF). We retrospectively analyzed all patients with ESRD presenting to the University of Utah Vascular Surgery clinic for dialysis access from January 2016 to February 2017. During this period, PROMIS PRO measures for depression and physical function were obtained at clinic visits. We evaluated PRO measures for depression and physical function among patients who received dialysis only via AVF versus those who required a TDC using mixed effects regression models and t tests for preprocedure and postprocedure comparisons A total of 174 patients with ESRD were identified, including 70 (40%) who received only AVF for dialysis and 104 (60%) who received a TDC for dialysis when AVF options did not exist or while waiting for AVF to mature. There was no significant difference in age, gender, 30-day readmission, or mortality between patients with ESRD receiving AVF versus TDC. Moreover, there was no significant difference in PRO depression (−1.72; 95% confidence interval [CI], −4.59 to 1.16; P = .24) or physical function scores (0.61; 95% CI, −1.68 to 2.90; P = .60) among patients using AVFs as compared with a TDC. Among patients with PRO assessment preprocedure and postprocedure, there was no difference in mean PRO score change over time for depression (AVF, 2.4 vs TDC, 1.9; P = .85) and physical function (AVF, −0.7 vs TDC, −0.9; P = .93). Our study demonstrates that patients with ESRD using TDCs for hemodialysis did not suffer worse PRO measures for depression and physical function than patients dialyzed using AVF. These data suggest that selective use of TDC for dialysis does not adversely impact quality of life.