#3104 Determinants of quality of life in chronic kidney disease patients on conservative management and on dialysis

Abstract Background and Aims CKDis one of the leading causes of mortality worldwide. WHO has defined Quality of life (QOL) as “an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns”. Health related quality of life (HRQL0, reflects the impact of health on an individual's ability to lead a fulfilling life. For patients with chronic medical conditions, HRQL also considers the effects of disease progression, treatment on disability and daily functioning and patient centered outcome questionnaires are used. The aim was to evaluate the quality of life in patients with kidney failure managed conservatively and with dialysis using the euroqol visual analogue scale (EQVAS). Method The study was a cross sectional study, conducted over 3-months, at dialysis centre, Nephrology at Sri Ramachandra Institute of Higher Education and Research, Chennai, India. Sample size was 200, in which 80 patients were on maintenance hemodialysis,120 patients on conservative management. Euroqol visual analogue scale (EQVAS), IPOS renal surveys,EQ-5D-5L scale were used to evaluate quality of life, sleep level, baseline symptoms and functional data. Results Of the participants, 0.5% were below 20 years, 15.5% were 21–40 years, 39% were 41–60 years, and 45% were above 60 years. Males made up 59.5%, and females 40.5%. Among them, 120 were conservatively managed ESRD patients, and 80 were on maintenance hemodialysis. The sleep scale average was 8.3 for conservative patients and 5.6 for hemodialysis patients. The EQ VA scale average was 82.9 and 53.5, respectively. Severe poor appetite was seen in 5% of conservative and 16.3% of hemodialysis patients (P = 0.029). Severe tiredness (9.2% vs. 23.8%, P = 0.001), sleep difficulty (6.7% vs. 32.5%, P < 0.001), muscle cramps (3.3% vs. 16.3%, P < 0.001), stress (1.7% vs. 18.8%, P < 0.001), mobility issues (3.3% vs. 12.5%, P = 0.009), and pain (0.8% vs. 15%, P < 0.001) were more common in hemodialysis patients. Kidney disease interfered with social activities (5.8% vs. 30%, P < 0.001) and daily life (21.7% vs. 87.5%, P < 0.001). Fluid (0.8% vs. 52.5%, P < 0.001) and dietary restrictions (3.3% vs. 23.8%, P < 0.001) were major concerns. Frustration (20% vs. 78.8%, P < 0.001), reduced work output (35% vs. 75%, P < 0.001), and activity limitations (31.7% vs. 75%, P < 0.001) were significantly higher in hemodialysis patients. Conclusion This study identified several significants associated with quality of life in patients with kidney failure both managed conservatively and with dialysis. Symptoms like pain, tiredness, difficulty in sleeping, muscle cramps, factors affecting mental health are stress, worries and anxiety, life style changes like fluid restriction, functional impairment associated with mobility, selfcare and usual activities, factors like frustration, lesser work accomplishment and limitations in activities have emotional impact on patients. Addressing these factors is essential to enhance the quality of life for patients with kidney failure.