Introduction
Materials and Methods
Study population and data source
Outcomes
Statistical analysis
Results
Patient characteristics
Variables | All (n=5114) | In-center (n=4234) | Home (n=880) | p-value |
---|---|---|---|---|
Mean age, years | 60.3 ±14 | 60.9 ±14 | 57.3 ± 15 | <0.01 |
Male | 2864 (56) | 2371 (56) | 475 (54) | 0.25 |
Hispanic ethnicity | 563 (11) | 466 (11) | 70 (8) | <0.01 |
Black race | 1176 (23) | 931 (22) | 220 (25) | 0.07 |
Mean annual household income, dollars/year | 50888 ± 19073 | 50901 ±19098 | 50828 ± 18960 | 0.92 |
Education (bachelors and higher) | 2762 (54) | 2286 (54) | 493 (56) | <0.01 |
Married | 2148 (42) | 1778 (42) | 396 (45) | 0.10 |
Mean number of comorbidities | 16 ± 9 | 17 ± 9 | 15 ± 10 | <0.01 |
Cancer | 276 (5) | 243 (6) | 33 (4) | 0.01 |
Diabetes | 3158 (62) | 2711 (64) | 447 (51) | <0.01 |
Arrhythmias | 487 (10) | 421 (10) | 66 (8) | 0.01 |
Congestive heart failure | 1030 (20) | 903 (21) | 127 (14) | <0.01 |
Cerebrovascular disease | 290 (6) | 240 (6) | 50 (6) | 0.99 |
Ischemic heart disease (without myocardial infarction) | 1066 (21) | 946 (22) | 120 (14) | <0.01 |
Myocardial infarction | 518 (10) | 446 (11) | 72 (8) | 0.02 |
Chronic obstructive pulmonary disease | 440 (9) | 387 (9) | 53 (6) | <0.01 |
Drug/alcohol dependence | 127 (2) | 110 (3) | 17 (2) | 0.20 |
Gastrointestinal bleeding | 30 (1) | 28 (1) | 2 (0) | 0.03 |
Hepatitis | 225 (4) | 210 (5) | 15 (2) | <0.01 |
Pneumonia | 104 (2) | 80 (2) | 24 (3) | 0.15 |
Other infection | 852 (17) | 752 (18) | 100 (11) | <0.01 |
Hyperparathyroidism | 348 (7) | 273 (6) | 75 (9) | 0.04 |
Peripheral artery disease/vascular disease | 580 (11) | 491 (12) | 89 (10) | 0.19 |
Catheter access use | 3068 (60) | 2244 (53) | 836 (95) | <0.01 |
Presence of any residual renal function | 4551 (89) | 3726 (88) | 783 (89) | 0.71 |
Mean serum sodium (mmol/L) | 138.8 ± 2.8 | 138.5 ± 2.7 | 139.9 ± 2.9 | <0.01 |
Mean albumin (g/dL) | 3.7 ± 0.4 | 3.7 ± 0.4 | 3.7 ± 0.4 | 0.33 |
Mean hemoglobin (g/dL) | 10.7 ± 0.9 | 10.7 ± 0.8 | 11 ± 1.2 | <0.01 |
Mean systolic blood pressure (mmHg) | 142.4 ± 15.9 | 142.5 ± 15.6 | 141.3 ± 22 | 0.48 |
Mean body mass index (kg/m2) | 30.4 ± 9.1 | 30.4 ± 9.2 | 30 ± 6.3 | 0.34 |
Mean physical composite summary score (PCS) | 38.6 ± 10.4 | 38 ± 10.3 | 41.1 ± 10.5 | <0.01 |
Mean mental composite summary score (MCS) | 51.7 ± 10 | 51.8 ± 10 | 51.4 ± 9.7 | 0.27 |
Mean symptom problem score (SPS) | 81 ± 14.1 | 80.7 ± 14.3 | 82.7 ± 13.4 | <0.01 |
Mean burden of kidney disease score (BKD) | 54 ± 28 | 53.2 ± 28 | 58 ± 27.6 | <0.01 |
Mean effects of kidney disease score (EKD) | 77.2 ± 19.8 | 76.6 ± 20.1 | 79.7 ± 17.7 | <0.01 |
Changes in HrQOL over time
Variables | In-center to in-center (n=4179) | Home to home (n=814) | In-center to home (n=55) | Home to in-center (n=66) |
---|---|---|---|---|
Mean age, years | 61.0 ±13.9 | 57.2 ±14.4 | 53.0 ±14.5 | 57.6 ±15.4 |
Male | 2340 (56) | 440 (54) | 25 (45) | 38 (58) |
Hispanic ethnicity | 460 (11) | 65 (8) | 3 (5) | 5 (8) |
Black race | 919 (22) | 195 (24) | 11 (20) | 23 (35) |
Mean annual household income, dollars/year | 50888 ± 19080 | 51101 ±19064 | 51864 ± 20602 | 47460 ±17413 |
Education (bachelors and higher) | 2257 (54) | 456 (56) | 30 (55) | 36 (54) |
Married | 1755 (42) | 374 (46) | 23 (42) | 21 (32) |
Mean number of comorbidities | 17 ± 9 | 14 ±10 | 18 ±10 | 20 ±12 |
Cancer | 251 (6) | 33 (4) | 4 (7) | 1 (2) |
Diabetes | 2675 (64) | 415 (51) | 30 (55) | 33 (50) |
Arrhythmias | 418 (10) | 57 (7) | 8 (15) | 6 (9) |
Congestive heart failure | 878 (21) | 122 (15) | 12 (22) | 7 (11) |
Cerebrovascular disease | 251 (6) | 49 (6) | 4 (7) | 5 (8) |
Ischemic heart disease (without myocardial infarction) | 919 (22) | 106 (13) | 9 (16) | 15 (23) |
Myocardial infarction | 460 (11) | 65 (8) | 5 (9) | 5 (8) |
Chronic obstructive pulmonary disease | 376 (9) | 49 (6) | 4 (7) | 5 (8) |
Drug/alcohol dependence | 125 (3) | 16 (2) | 0 | 2 (3) |
Gastrointestinal bleeding | 42 (1) | 0 | 1 (2) | 1 (2) |
Hepatitis | 209 (5) | 8 (1) | 4 (7) | 3 (5) |
Pneumonia | 84 (2) | 25 (3) | 2 (4) | 3 (5) |
Other infection | 752 (18) | 90 (11) | 14 (25) | 11 (17) |
Hyperparathyroidism | 251 (6) | 73 (9) | 2 (4) | 5 (8) |
Peripheral artery disease/vascular disease | 460 (11) | 81 (10) | 12 (22) | 9 (14) |
Catheter access use | 2215 (53) | 773 (95) | 38 (69) | 63 (95) |
Presence of any residual renal function | 3678 (88) | 724 (89) | 48 (87) | 58 (88) |
Mean serum sodium (mmol/L) | 138.5 ± 2.7 | 139.9 ± 2.9 | 139.1 ± 2.7 | 139.4 ± 3.0 |
Mean albumin (g/dL) | 3.7 ± 0.4 | 3.7 ± 0.4 | 3.7 ± 0.5 | 3.5 ± 0.4 |
Mean hemoglobin (g/dL) | 10.7 ±0.8 | 11.1 ±1.2 | 10.7 ± 0.7 | 10.8 ±1.4 |
Mean systolic blood pressure (mmHg) | 142.4 ± 15.5 | 140.6 ± 21.8 | 144.5 ± 16.6 | 154.4 ± 22.3 |
Mean body mass index (kg/m2) | 30.4 ± 9.3 | 29.8 ± 6.2 | 30.7 ± 7.3 | 32.8 ± 6.9 |
Mean physical composite summary score (PCS) | 38.0 ± 10.3 | 41.1 ± 10.5 | 38.5 ± 9.9 | 41.7 ± 10.4 |
Mean mental composite summary score (MCS) | 1.8 ± 10.0 | 51.5 ± 9.7 | 51.1 ± 9.9 | 50.4 ± 10.2 |
Mean symptom problem score (SPS) | 80.7 ± 14.2 | 82.8 ± 13.2 | 78.4 ± 15.0 | 81.3 ± 15.4 |
Mean burden of kidney disease score (BKD) | 53.3 ± 28.0 | 58.0 ± 27.7 | 49.2 ± 30.9 | 57.1 ± 26.7 |
Mean effects of kidney disease score (EKD) | 76.7 ± 20.1 | 79.9 ± 17.6 | 71.4 ± 22.8 | 76.9 ±19.2 |
All (n = 5114) | In-center to in-cente (n=4179) | Home to home(n=814) | In-center to home(n=55) | Home to in-center(n=66) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
KDQOL subscales | Period 1 | Period 2 | 95% CI | Period 1 | Period 2 | 95% CI | Period 1 | Period 2 | 95% CI | Period 1 | Period 2 | 95% CI | Period 1 | Period 2 | 95% CI |
PCS | 38.6 (10.4) | 38.7 (10.7) | (-0.6, 0.3) | 38 (10.3) | 38.4 (10.7) | (-0.9, 0.0) | 41.1 (10.5) | 40.2 (10.6) | (-0.1, 1.9) | 38.5 (9.9) | 38.5 (10.1) | (-3.8, 3.7) | 41.7** (10.4) | 38** (10.6) | (0.1, 7.3) |
MCS | 51.7 (10) | 52 (9.9) | (-0.6, 0.1) | 51.8 (10) | 52 (9.9) | (-0.6, 0.2) | 51.5 (9.7) | 52.1 (9.8) | (-1.6, 0.3) | 51.1 (9.9) | 49.1 (9.8) | (-1.7, 5.7) | 50.4 (10.2) | 50.8 (9.9) | (-3.9, 3.1) |
SPS | 81.3 (14.1) | 80.7 (14.3) | (-0.2, 0.9) | 80.7 (14.2) | 80.4 (14.4) | (-0.4, 0.9) | 82.8 (13.2) | 81.6 (13.8) | (-0.2, 2.5) | 78.4 (15) | 80.2 (12.7) | (-7.0, 3.5) | 81.3 (15.4) | 82.6 (13.3) | (-6.2, 3.7) |
BKD | 54 (28) | 54.6 (28.5) | (-1.6, 0.6) | 53.3 (28) | 53.8 (28.6) | (-1.7, 0.7) | 58 (27.7) | 58.4 (27.8) | (-3.1, 2.3) | 49.2 (30.9) | 56.1 (29.1) | (-18.3, 4.4) | 57.1 (26.7) | 53.5 (27.6) | (-5.8, 13.0) |
EKD | 77.2 (19.8) | 77.6 (19.8) | (-1.1, 0.4) | 76.7 (20.1) | 77.2 (20.1) | (-1.3, 0.4) | 79.9 (17.6) | 79.8 (17.8) | (-1.6, 1.8) | 71.4 (22.8) | 76.9 (19.6) | (-13.6, 2.4) | 76.9 (19.2) | 77.9 (19) | (-7.6, 5.6) |