PS-C18-1: SLEEP SCORE AMONG HEALTH-RELATED QUALITY OF LIFE SUBSCALES PREDICTS TECHNIQUE SURVIVAL IN PATIENTS WITH PERITONEAL DIALYSIS

Abstract

Purpose: There is sufficient evidence that peritoneal dialysis (PD) is superior to hemodialysis in terms of health-related quality of life (HRQOL), and higher HRQOL scores are associated with better clinical outcomes in patients with PD, however, the specific HRQOL subscales that predict prognosis remain uncertain. Design and method: In addition to various PD-related parameters and exercise capacity, HRQOL of outpatients with PD were assessed using Kidney Disease Quality of Life-Short Form Japanese version 1.3 from March 2017 to March 2018, and the association of HRQOL items with technique survival was prospectively analyzed until June 2021. Result: Among the 50 recruited PD outpatients, age and PD vintage were 63.8 ± 9.6 and 3.8 ± 2.8 years, respectively, and 21 patients discontinued PD and transferred to hemodialysis during the study period. In a univariate Cox proportional hazards model, higher scores (per 10) for symptoms, sleep, and vitality among HRQOL subscales were significantly associated with lower technique failure rate (Hazard Ratio(HR) 0.66, P = 0.002; HR 0.70, P = 0.006; and HR 0.80, P = 0.04, respectively). In multivariate analysis adjusted for Charlson comorbidity index, incremental shuttle walk test distance, and baseline PD vintage, only higher sleep score was significantly associated with lower technique failure rate (HR 0.68 per 10, P = 0.003). Among PD-related parameters, serum potassium level was significantly inversely correlated with sleep score (r = -0.34, P = 0.01). Discussion and Conclusion: Our results suggest that sleep score among HRQOL subscales is particularly useful as a predictor of technique survival in patients with PD. Improvement in sleep quality may improve technique survival in prevalent PD patients.