Yeungnam Univ J Med.  2021 Apr;38(2):127-135. 10.12701/yujm.2020.00346.

The relationship between disability and clinical outcomes in maintenance dialysis patients

• Kang SH
• Do JY
• Kim JC

• KMID: 2515186
• DOI: http://doi.org/10.12701/yujm.2020.00346

Abstract

Background
Dialysis patients are prone to having disabilities. We aimed to evaluate the association between disability and various clinical outcomes in Korean dialysis patients.
Methods
This study consisted of 1,615 dialysis patients from 27 centers. We evaluated disability by using four questions on the activities of daily living (ADLs) concerning whether help was needed for feeding, dressing/undressing, getting in/out of bed, or taking a bath/shower. We divided the patients into three groups: no disability (Non-D, none of the four ADL domains required help; n=1,312), mild disability (Mild-D, one ADL domain required some/full help; n=163), or moderate to severe disability (MS-D, two or more ADL domains required some/full help; n=140). We evaluated falls, frailty, health-related quality of life (HRQoL), mortality, and hospitalization.
Results
The numbers of participants with a fall during the last 1 year were 199 (15.2%), 42 (25.8%), and 44 (31.4%) in the Non-D, Mild-D, and MS-D groups, respectively (p<0.001). The numbers of participants with frailty in the Non-D, Mild-D, and MS-D groups were 381 (29.0%), 84 (51.5%), and 93 (66.4%), respectively (p<0.001). In both univariate and multivariate analyses, the physical component scale and mental component scale scores decreased as the grade of disability increased (p<0.001 for both scores). Hospitalization-free survival rate at 500 days was 64.2%, 56.7%, and 51.1% in the Non-D, Mild-D, and MS-D, respectively (p=0.001 for trend). Patient survival rate at 500 days was 95.3%, 89.5%, and 92.3% in the Non-D, Mild-D, and MS-D, respectively (p=0.005 for trend).
Conclusion
Disability was associated with falls, frailty, HRQoL scales, and survival trends in Korean dialysis patients.

Keyword

Treatment outcome; Disabled persons; Dialysis; Quality of life

Figure

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  Fig. 1. Study flow chart.

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  Fig. 2. Kaplan-Meier curves of hospitalization-free survival and patient survival. (A) Hospitalization-free survival rate at 500 days (Non-D, 64.2%; Mild-D, 56.7%; MS-D, 51.1%; p=0.001 for trends, p=0.023 for Non-D vs. Mild-D, p=0.001 for Non-D vs. MS-D, and p=0.445 for Mild-D vs. MS-D). (B) Patient survival rate at 500 days (Non-D, 95.3%; Mild-D, 89.5%; MS-D, 92.3%; p=0.005 for trends, p=0.003 for Non-D vs. Mild-D, p=0.088 for Non-D vs. MS-D, and p=0.434 for Mild-D vs. MS-D). Non-D, non-disabled group; Mild-D, mildly disabled group; MS-D, moderate to severely disabled group.

Reference

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