Impact of phosphate binders on quality of life in dialysis patients: Results from the prospective Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes study
Colombijn, Julia M T; Vonk, Sanne; Cornelis, Tom; Boorsma, Siska; Krekels, Marielle M E; Abrahams, Alferso C; van Jaarsveld, Brigit C
(2022) Nephrology (Carlton, Vic.), volume 27, issue 10, pp. 834 - 844
(Article)
Abstract
BACKGROUND: Phosphate binders cause high pill burden for dialysis patients, complicate medication regimens, and have unpleasant taste and large size which may affect patients' quality of life. This study explores the association between phosphate binder pill burden and health-related quality of life (HRQoL) in dialysis patients. METHODS: We conducted a
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cross-sectional multi-centre cohort study in 21 Dutch dialysis centres. Phosphate binder pill burden was extracted from electronic patient records. Primary outcome was HRQoL measured with the Short Form 12 physical and mental component summary scores (PCS and MCS). Secondary endpoints were severity of gastro-intestinal symptoms, itching, dry mouth, and mental health symptoms, measured with the Dialysis Symptom Index. RESULTS: Of 388 included patients, aged 62 ± 16 years, 77% underwent haemodialysis. PCS scores were comparable for patients with and without phosphate binders. Patients using 1-3 pills reported lower scores for decreased appetite (β -0.5; 95%CI -0.9 to -0.2), implying better appetite, than patients without phosphate binders. Patients using 4-6 pills also reported lower scores for decreased appetite (β -0.5; 95%CI -0.8 to -0.1) and for itching (β -0.5; 95%CI -0.9 to -0.1). Patients using >6 pills reported lower MCS (β -2.9; 95%CI -6.2-0.4) and higher scores for feeling nervous (β 0.6; 95%CI 0.1-1.1) and feeling sad (β 0.4; 95%CI 0.0-0.9). CONCLUSION: Phosphate binder pill burden is not associated with physical quality of life. A higher pill burden is associated with better appetite and less itching. Patients using >6 pills per day report lower mental quality of life and felt nervous and sad more often.
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Keywords: Cohort Studies, Cross-Sectional Studies, Hemodialysis, Home, Humans, Kidney Failure, Chronic/diagnosis, Phosphates, Prospective Studies, Pruritus, Quality of Life/psychology, Renal Dialysis/adverse effects, dialysis, phosphate binders, phosphate binding agents, quality of life, polypharmacy, Nephrology, Journal Article
ISSN: 1320-5358
Publisher: Wiley-Blackwell
Note: Funding Information: The Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes is funded by grants of ZonMw (grant number: 843004116), Fresenius Medical Care Deutschland GmbH, Baxter Netherlands BV, AstraZeneca and Dirinco. The grant of ZonMw is provided from the ‘Health care efficiency research’ program. ZonMw has independently peer reviewed the study protocol. The sponsors had no role in the design, the conduct of the study and the writing the manuscript. Julia Colombijn received a personal grant from the Dutch Kidney Foundation for this project (project code 20OSR004). Publisher Copyright: © 2022 The Authors. Nephrology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Nephrology.
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