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Abstract

Background and Aims

In recent years, there has been a growing interest in the use and relevance of Patient-Reported Outcomes Measures (PROMs) and Patient-Reported Experience Measures (PREMs). The main objective of the study is to analyze scores in quality of life, anxiety, depression, and functional capacity using tests that assess PREMs and PROMs in patients at different stages of chronic kidney disease (CKD).

Method

Multicenter, cross-sectional, observational, non-interventional study with 281 patients (84 on hemodialysis, 48 on peritoneal dialysis, 50 with kidney transplant, 50 with advanced CKD, and 49 patients with CKD stages 1-2). Two professionals conducted interviews for data collection from all patients. Collected data: For PROMs: PFS (Piper Fatigue Scale), HADS (Hospital Anxiety and Depression Scale), FACIT-F (Functional Assessment of Chronic Illness Therapy-Fatigue Scale), SF-36, VAS (Visual Analogue Scale). For PREMs - PACIC test (Patients' Assessment of Chronic Illness Care), in addition to other comorbidity indices and laboratory analyses. ANOVA statistical analysis was used for group comparison.

Results

Although patients showed significant differences in age and comorbidities, our analysis shows that the most PROMs do not discriminate between different stages of CKD. The PROMs that most discriminate between different stages of CKD are those related to the Piper Fatigue Scale test. PREMs, analyzed using the PACIC scale, do achieve said discrimination (Table 1).

PDHDACKDKTFG>60All groupsWithout eGFR>60
Age70737460580,0010,001
Karnofsky72697281790,0010,001
Charlson6,06,56,03,32,2<0,0010,001
VAS17312927240,1170,075
HADS anxiety scale5,55,56,05,46,20,840,91
HADS depression scale6,45,96,04,35,00,080,067
FACIT numeric2228252537<0,0010,116
SF36- physical Functioning45394665700,0010,001
SF36- role-Physical36274146630,0010,064
SF36- general Health44374254450,0010,001
SF36- vitality12131315150,0590,089
SF36- social Functioning44494757560,0440,089
SF36- role-Emotional65636469790,6360,543
SF36- mental Health70616471700,6360,932
SF36- body Pain62515361620,0960,105
PFS numeric3,73,02,81,82,10,0060,009
PFS behavioral3,22,82,71,82,00,600,083
PFS affective4,23,33,01,72,30,0010,002
PFS sensory4,33,43,21,82,10,0010,001
PFS cognitive4,23,31,72,32,90,0530,111
PACIC (PREMs)3,52,92,83,72,8<0,0010,001
PDHDACKDKTFG>60All groupsWithout eGFR>60
Age70737460580,0010,001
Karnofsky72697281790,0010,001
Charlson6,06,56,03,32,2<0,0010,001
VAS17312927240,1170,075
HADS anxiety scale5,55,56,05,46,20,840,91
HADS depression scale6,45,96,04,35,00,080,067
FACIT numeric2228252537<0,0010,116
SF36- physical Functioning45394665700,0010,001
SF36- role-Physical36274146630,0010,064
SF36- general Health44374254450,0010,001
SF36- vitality12131315150,0590,089
SF36- social Functioning44494757560,0440,089
SF36- role-Emotional65636469790,6360,543
SF36- mental Health70616471700,6360,932
SF36- body Pain62515361620,0960,105
PFS numeric3,73,02,81,82,10,0060,009
PFS behavioral3,22,82,71,82,00,600,083
PFS affective4,23,33,01,72,30,0010,002
PFS sensory4,33,43,21,82,10,0010,001
PFS cognitive4,23,31,72,32,90,0530,111
PACIC (PREMs)3,52,92,83,72,8<0,0010,001

PD: Peritoneal Dialysis; HD: Hemodialysis; ACKD: Advanced CKD; KT: Kidney Transplant; eGFR>60: CKD stages 1-2 All: Comparison of means among the 5 groups. Without eGFR>60: Comparison of all groups except stages 1-2.

PDHDACKDKTFG>60All groupsWithout eGFR>60
Age70737460580,0010,001
Karnofsky72697281790,0010,001
Charlson6,06,56,03,32,2<0,0010,001
VAS17312927240,1170,075
HADS anxiety scale5,55,56,05,46,20,840,91
HADS depression scale6,45,96,04,35,00,080,067
FACIT numeric2228252537<0,0010,116
SF36- physical Functioning45394665700,0010,001
SF36- role-Physical36274146630,0010,064
SF36- general Health44374254450,0010,001
SF36- vitality12131315150,0590,089
SF36- social Functioning44494757560,0440,089
SF36- role-Emotional65636469790,6360,543
SF36- mental Health70616471700,6360,932
SF36- body Pain62515361620,0960,105
PFS numeric3,73,02,81,82,10,0060,009
PFS behavioral3,22,82,71,82,00,600,083
PFS affective4,23,33,01,72,30,0010,002
PFS sensory4,33,43,21,82,10,0010,001
PFS cognitive4,23,31,72,32,90,0530,111
PACIC (PREMs)3,52,92,83,72,8<0,0010,001
PDHDACKDKTFG>60All groupsWithout eGFR>60
Age70737460580,0010,001
Karnofsky72697281790,0010,001
Charlson6,06,56,03,32,2<0,0010,001
VAS17312927240,1170,075
HADS anxiety scale5,55,56,05,46,20,840,91
HADS depression scale6,45,96,04,35,00,080,067
FACIT numeric2228252537<0,0010,116
SF36- physical Functioning45394665700,0010,001
SF36- role-Physical36274146630,0010,064
SF36- general Health44374254450,0010,001
SF36- vitality12131315150,0590,089
SF36- social Functioning44494757560,0440,089
SF36- role-Emotional65636469790,6360,543
SF36- mental Health70616471700,6360,932
SF36- body Pain62515361620,0960,105
PFS numeric3,73,02,81,82,10,0060,009
PFS behavioral3,22,82,71,82,00,600,083
PFS affective4,23,33,01,72,30,0010,002
PFS sensory4,33,43,21,82,10,0010,001
PFS cognitive4,23,31,72,32,90,0530,111
PACIC (PREMs)3,52,92,83,72,8<0,0010,001

PD: Peritoneal Dialysis; HD: Hemodialysis; ACKD: Advanced CKD; KT: Kidney Transplant; eGFR>60: CKD stages 1-2 All: Comparison of means among the 5 groups. Without eGFR>60: Comparison of all groups except stages 1-2.

Conclusion

The analysis of PROMs and PREMs show the significant impact that CKD has on health-related quality of life. Some PROMs can discriminate between different stages of CKD, but the most effective ones are PREMs, which are an indirect indicator of the quality of care received, contributing to patient involvement in decision-making and empowerment.

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© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://dbpia.nl.go.kr/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
Topic:
Issue Section:
C4 - CO-MORBIDITIES (ANAEMIA, CARDIOVASCULAR, CKD-MBD, ETC.)
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