THE ASSOCIATION BETWEEN PATIENT-REPORTED OUTCOMES (PROMS) AND TRADITIONAL DIALYSIS ADEQUACY MEASURES IN PERITONEAL DIALYSIS (PD) PATIENTS
Dr Aruni Malaweera1, Dr Louis Huang1, Professor Lawrence McMahon1
1Department of Renal Medicine, Eastern Health, Box Hill, Australia
Aim: To assess the association between patient-reported outcomes (PROMs) and traditional dialysis adequacy measures in peritoneal dialysis (PD) patients.
Background: Traditionally, PD adequacy has been defined according to Kt/V and CCr, which reflect the elimination of water-soluble uraemic toxins, urea and creatinine. However, these measures correlate poorly with both patient symptoms and outcomes, and residual real function (RRF) remains the better determinant of each. Largely in response to these findings, guidelines now recommend focussing on PROMs rather than these traditional numerical targets, although it is unknown if PROMs relate either to the traditional measures of adequacy or to renal symptom scores (POS-S).
Method: We performed a retrospective study on PD patients from 2018 to 2022, who had at least one POS-S renal symptom questionnaire score within 2 weeks of their PET-adequacy test. We also tested the association between POS-S renal scores and traditional adequacy measures, and if POS-S renal symptom scores predicted patient outcomes.
Results: There were 216 POS-S time-relevant questionnaires performed in 107 PD patients. Patient distribution was 64% male, and diabetes the cause of ESKD in 32%. There was no correlation between total, RRF- or membrane-related Kt/V/CCr with the total POS-S renal scores or with individual symptom elements. However, albumin correlated closely with the total POS-S score and remained a predictor of patient symptoms after accounting for age, gender, co-morbidities, dialysis adequacy, and nutritional markers (p<0.001). The total POS-S renal score did not predict technique failure or death.
Summary & Conclusions: There was no correlation between traditional markers of dialysis adequacy and POS-S renal scores. The POS-S renal score also did not predict patient outcomes. Conversely, albumin is a valuable determinant of both.
Biography:
Aruni is a PhD fellow at Eastern health doing a PhD in PD.