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Lower HRQoL scores linked to increased mortality in minority patients on dialysis
Lower health-related quality of life scores were associated with higher mortality in black and Hispanic patients who received hemodialysis, according to a published study.
“While numerous health care disparities have been documented among minority dialysis patients, population-based studies have shown that African American and Hispanic ESRD patients have a paradoxically lower mortality risk compared to non-Hispanic whites,” Sara S. Kalantar, of the Harold Simmons Center for Kidney Disease Research and Epidemiology at the University of California Irvine School of Medicine, and colleagues wrote. “Despite the diversity of the U.S. hemodialysis population and growing recognition of the importance of patient-reported outcomes in research and clinical practice, there remain substantial knowledge gaps regarding the impact of HRQoL upon the health and survival of hemodialysis patients of varying racial and ethnic backgrounds.”
Researchers conducted an observational cohort study of 753 patients recruited from dialysis centers between 2011 and 2016 (49% were Hispanic; 32% were black; 19% were other; 10% were white). SF-36 surveys were administered every 6 months to measure HRQoL, calculated by two main summary scores (physical and mental component) and eight subscales (physical functioning, role limitations due to physical health or emotional problems, energy/fatigue, emotional well-being, social functioning, pain and general health). The association between scores and all-cause mortality was then evaluated.
Researchers found that, in the overall cohort, physical (adjusted HR = 2.30) and mental (aHR = 1.54) component scores were associated with higher mortality.
After stratifying by race/ethnicity, they observed that the lowest quartile of physical component scores was significantly associated with higher mortality for Hispanic (aHR = 2.64), black (aHR = 1.84) and other (aHR = 3.18) patients.
In addition, while the lowest quartile of subscale scores for time-varying physical functioning, role limitations due to physical health, role limitations due to emotional problems, social functioning and pain were associated with higher mortality in the overall cohort, the association was most pronounced for Hispanic and black patients.
Researchers concluded that: “Further studies are needed to identify interventions that can effectively improve the health-related quality of life and downstream survival of the diverse U.S. hemodialysis population.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.