Impact of dialysis modality conversion on the health-related quality of life of peritoneal dialysis patients: a retrospective cohort study in China

Background. To analyze the health-related quality of life associated with the conversion of dialysis modality among end-stage renal disease patients in China. Methods. Patients were recruited from hospitals and a dialysis center in Kunshan, China. Patients converting from continuous ambulatory peritoneal dialysis to automated peritoneal dialysis were recruited as the observation group (n=64), and patients continuing with continuous ambulatory peritoneal dialysis treatment were included in the control group (n = 64) after matching in this retrospective cohort study. Their health-related quality of life was measured using the kidney disease quality of life instrument in 2019 and 2020, respectively. Baseline socio-demographic characteristics and clinical data were collected in 2019. The before-and-after cross-group comparisons of subscale scores of two groups were conducted using a Student`s t-test. Multiple linear regression models were fitted to identify the factors associated with the change of each scale. Results. The health-related quality of life scores of the two groups was comparable in baseline, while the observation group had higher scores in Physical Component Summary (51.92 +/- 7.50), Kidney Disease Component Summary (81.21 +/- 8.41), Symptoms (90.76 +/- 6.30), Effects (82.86 +/- 11.42), and Burden (69.04 +/- 15.69) subscales after one year. In multivariate regression analysis, the change of Physical Component Summary was significantly associated with conversion to APD (beta =11:54, 95% CI [7.26-15.82]); the change of Mental Component Summary with higher education (beta = 95% CI [ and CCI (>2) (beta = 5:39, 95% CI [1.05-9.73]); the change of Kidney Disease Component Summary with conversion to APD (beta= 15:95, 95% CI [10.19-21.7]) and age (>60 years) (beta = 95% CI [the change of Symptoms with CCI (>2) (beta = 7:96, 95% CI [1.49- 14.44]); the change of Effects with conversion to APD (beta = 19:23, 95% CI [11.57- 26.88]); and the change of Burden with conversion to APD (beta = 22:40, 95% CI [13.46- 31.34]), age (>60 years) (beta = 95% CI [-22.59-1.65]), and higher education (beta = 95% CI [ -19.79-0.98]) Conclusions. The conversion of dialysis modality had a significant impact on the scores of most subscales. Patients converting from continuous ambulatory peritoneal dialysis