Effect of clinical factors on trajectory of functional performance in patients undergoing hemodialysis

Jin-Bor Chen; Lung-Chih Li; Wen-Chin Lee; Sin-Hua Moi; Cheng-Hong Yang

doi:10.1080/0886022X.2020.1852090

Effect of clinical factors on trajectory of functional performance in patients undergoing hemodialysis

Ren Fail. 2021 Dec;43(1):90-96. doi: 10.1080/0886022X.2020.1852090.

Authors

Jin-Bor Chen¹, Lung-Chih Li¹, Wen-Chin Lee¹, Sin-Hua Moi², Cheng-Hong Yang³

Affiliations

¹ Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
² Center of Cancer Program Development, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.
³ Department of Electronic Engineering, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan.

Abstract

Purpose: This study aimed to investigate the association between clinical factors and temporary changes in functional performance in patients undergoing hemodialysis.

Methods: This was a retrospective, longitudinal observational study conducted from 2015 to 2017. Eight-two patients undergoing hemodialysis in the outpatient clinic were enrolled. Functional performance was measured using the Karnofsky Performance Status (KPS) scale. Collected data for analysis included demographics, laboratory parameters, and KPS scale scores. All participants were grouped into a high KPS cluster and a low KPS cluster based on dynamic changes in KPS scales from 2015 to 2017.

Results: Participants in the high KPS cluster demonstrated an approximate trend, and those in the low KPS cluster demonstrated a low pattern. By stepwise selection model analysis, age (OR 1.12, 95% CI 1.03-1.23, p = 0.011), serum BUN (OR 1.08, 95% CI 1.02-1.16, p = 0.015), calcium levels (OR 3.24, 95% CI 1.2-8.73, p = 0.02), and beta-2-microglobulin (OR > 1.0, CI >1.00-<1.01, p = 0.031) showed risk for the low KPS cluster. Male sex (OR 0.20, 95% CI 0.04-0.96, p = 0.045) and albumin level (OR 0.02, 95% CI 0-0.4, p = 0.009) showed a low risk for the low KPS cluster.

Conclusions: A different trajectory pattern was observed between the high and low KPS clusters in a 3-year period. Risk factors for the low KPS cluster were age, serum BUN, calcium, and beta-2-microglobulin levels. Male sex and serum albumin levels reduced the risk for the low KPS cluster.

Keywords: Age; Karnofsky scale; albumin; hemodialysis.

Publication types

Observational Study

MeSH terms

Aged
Female
Humans
Karnofsky Performance Status*
Kidney Failure, Chronic / therapy
Logistic Models
Longitudinal Studies
Male
Middle Aged
Multivariate Analysis
Renal Dialysis*
Retrospective Studies
Risk Factors
Taiwan

Grants and funding

Authors would like to express their sincere gratitude to Kaohsiung Chang Gung Memorial Hospital in Taiwan for the grant support (contract number CMRPG8E0531, CMRPG8E0532, CMRPG8E0533).