HEALTH-RELATED QUALITY OF LIFE AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE DURING NURSE-LED FLUID VOLUME AND BLOOD PRESSURE MANAGEMENT

 

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https://storage.unitedwebnetwork.com/files/1099/f5fcc24f70885c0f0a219d14a18d7f43.pdf
HEALTH-RELATED QUALITY OF LIFE AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE DURING NURSE-LED FLUID VOLUME AND BLOOD PRESSURE MANAGEMENT

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Ruojun
Ding
Zhihua Huang huang.zhihua@sgh.com.sg Singapore General Hospital Specialty Nursing Singapore Singapore -
Li Choo Ng ng.li.choo@sgh.com.sg Singapore General Hospital Specialty Nursing Singapore Singapore -
Fiona Yeo Hui Ing fiona.yeo.h.i@sgh.com.sg Singapore General Hospital Pharmacy Singapore Singapore -
Chieh Suai Tan tan.chieh.suai@singhealth.com.sg Singapore General Hospital Renal Medicine Singapore Singapore -
Cynthia Lim Ciwei cynthia.lim.c.w@singhealth.com.sg Singapore General Hospital Renal Medicine Singapore Singapore -
Ruojun Ding dingruojun1993@gmail.com Singapore General Hospital Renal Medicine Singapore Singapore *
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Fluid overload is common in chronic kidney disease (CKD) and may significantly impact patients’ perceived health status. We examined patient-reported outcome measures (PROMs) including health-related quality of life (HrQOL) among individuals who had chronic kidney disease and managed at a nurse-led clinic for patients with CKD and fluid overload.

Post-hoc analysis of a single-center prospective implementation study of adults in the Nurse-led Optimization of Volume and blood pressure – Enabling at multi-Levels using TechnologY (NOVELTY) program between August 2022 and April 2024. These patients had CKD not requiring dialysis and had fluid overload and/or systolic blood pressure (BP) >160 mmHg or diastolic BP >100 mmHg. HrQOL was assessed by the EuroQOL-5 Dimension [EQ5D5L] survey at the first visit and compared with patients’ sociodemographic and clinical characteristics including the 5-item SARC-F sarcopenia screen and PROM for chronic disease self-management (Partner in Health [PIH] questionnaire).

We included 65 participants who attended the first visit and completed the EQ5D5L survey. The median age was 67.4 (interquartile range [IQR]: 57.9, 76.5) years and the Charlson Comorbidity Index was 4 (IQR 3, 5). The median EQ5D5L score was 5 (IQR: 5, 7). The EQ5D5L score was significantly higher in older age (r = 0.35, p=0.004), female sex (median 6 [IQR: 5, 9] vs 5 [IQR: 5, 6] in male, p=0.02), not employed (median 6 [IQR: 5, 8] versus 5 [IQR: 5, 6] in employed), p=0.004), monthly income <$2000 (median 6 [IQR: 5, 8] versus 5 [IQR: 5, 5], p=0.01), higher CCI (r = 0.32, p=0.008), higher SARC-F score (r = 0.61, p<0.001), higher serum creatinine (r = 0.30, p=0.02), and two or more fluid overload-related symptoms in the past month (median 8 [IQR: 5, 11] versus 5 [IQR: 5, 6], p=0.02). EQ5D5L scores were lower with higher eGFR (r = -0.36, p=0.004) and RAS blocker treatment (median 5 [IQR: 5, 6] versus 6 [IQR: 5, 8] without treatment, p=0.046). The EQ5D5L score was not significantly associated with number of healthcare visits in the past 6 months, BP, weight, overhydration volume, or levels of serum calcium, phosphate, albumin, hemoglobin, HbA1c, lipids, NT-proBNP and UPCR in our cohort.

HrQOL is associated with clinical and socioeconomic determinants of health status among patients with CKD and fluid overload.

Kewords