P-51 Characteristics of end-stage kidney disease patients enrolled for conservative management in a renal supportive care clinic

Abstract

BackgroundWorldwide epidemics of type 2 DM, hypertension and obesity, along with population ageing are rapidly increasing the number of End-Stage Kidney Disease patients. Auckland, New Zealand is particularly affected because of our vulnerable populations of Maori and Pacific Island people. Counties-Manukau Health has 618 dialysis patients increasing at 5.5% annually. In 2014 we started a Supportive Care Clinic offering conservative treatment for ESKD patients unsuited or unwilling to enter our dialysis programme.AimTo describe the demographic, symptom and psychological profile of ESKD patients choosing conservative treatment.MethodsDemographics are drawn from patient records and clinic patients complete measures of symptoms (POS-S Renal), emotional functioning (DASS-21) and QoL (SF-36).ResultsCurrently 32 patients: (PI 17, European 7, Maori 4, Asian 4) M/F 46%–54%. Average age 76 (range 44–92), (PI 72, European 85, Maori 72, Asian 75).Prevalence DM 59% (PI 88%, European 0%, Maori 50%).The most reported symptoms were weakness (85%), shortness of breath and poor mobility (78%), itching (74%). The least reported were diarrhoea (18%) and vomiting (22%). Mean depression score was 4.5 (SD = 4.5), anxiety, 5.4 (SD = 4.87), and stress was 5.4 (SD = 5).DiscussionCompared to our incident dialysis population these preliminary results show this conservative group is markedly older with a higher percentage of males, PI people with DM, and Europeans. Symptoms reported are similar to other groups of ESKD patients internationally. Despite their symptom load their average mood and stress levels were in the non-symptomatic range, while anxiety was in the moderate range.