FP762THE ROLE OF SOCIAL SUPPORT IN HEMODIALYSIS PATIENTS

Abstract

Introduction and Aims: A number of patients with End-Stage Renal Disease (ESRD) have significant impairment in social support. Especially, the limited function of patients with hemodialysis (HD) prevents them from social activities and even makes them social withdrawal. Clinical problems such as nutritional status and HD adequacy, and psychosocial problems such as quality of life, anxiety and depression are associated with increased morbidity and mortality in HD patients. However, there are few studies of the factors affecting the social support in HD patients. The aim of the current study was to identify the clinical and psychosocial factors including quality of life related to impaired social support in HD patients. Methods: The 101 participants (55 males with mean age 57.1+/-12.1 years) on HD from the Daegu Catholic University Medical Center were assessed from September in 2013 to September in 2014. Patients on HD for acute kidney injury were excluded from this study. Multidimensional Scale of Perceived Social support(MSPSS) was used for evaluating patients' social support. Psychosocial factors were evaluated using Euro Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D), Hospital Anxiety and Depression Scale, Montreal Cognitive Assessment, Pittsburgh Sleep Quality Index. Laboratory and clinical information including hemoglobin, vitamin D (25(OH)D, 1,25 (OH)2D3), albumin, Kt/V (a marker of dialysis adequacy), normalized protein catabolic rate (nPCR), ferritin, bone mass index (BMI), duration of HD were assessed. Stepwise multivariate logistic regression with backward selection was performed. Results: The mean of MSPSS (social support) score was 36.8+/-9.3. In subgroups of social support, the MSPSS-family, MSPSS-friend, and MSPSS-medical team scores were 14.79+/-4.28, 10.44+/-4.76, and 10.74+/-4.39, respectively. The variables showed significant association with social support were quality of life (r=0.332, p=0.001), depression (r=-0.290, p=0.003), anxiety (r=-0.372, p<0.001), and serum creatinine (r=-0.270, p=0.007). Multiple regression showed that quality of life (95% CI; 0.615~19.799, p=0.037) and serum creatinine (95% CI; -1.543~-0.319, p=0.003) were independent predictors of impaired social support. Conclusions: This study explored the determinants of high susceptibility to the impaired social support in HD patients. We found that the impaired social support is associated with the quality of life and serum creatinine. Further study will be needed because of the possibility of different results depending on culture and ethnicity. As well as, we should consider the psychosocial interventions to improve the impaired social support.