A comparison of health-related quality of life between continuous ambulatory peritoneal dialysis and automated peritoneal dialysis in children with stage 5 chronic kidney disease in Thailand: a randomized controlled trial

Abstract

Background: Improving health-related quality of life (HRQoL) is one of the main goals in managing stage 5 chronic kidney disease (CKD). However, limited evidence compares HRQoL between continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) in children. This open-label randomized controlled trial (RCT) aimed to compare HRQoL in pediatric patients with stage 5 CKD receiving CAPD vs. APD in Thailand. Methods: Children with stage 5 CKD were randomized 1:1 to receive APD or CAPD. The primary outcome was HRQoL, measured by EQ-5D-5L, EQ-5D-3L, and PedsQL at baseline, week 16 and week 48. Outcomes were analyzed using linear mixed models. Results: A total of 60 patients were recruited: 30 with CAPD and 30 with APD. General characteristics, utility scores measured by EQ-5D and HRQoL score measured by PedsQL were comparable between both groups at baseline. During follow-up, no significant differences in terms of utility and HRQoL scores could be identified at week 16 and week 48. Although the children in the APD group seemed to have more favorable changes in some PedsQL domains of PedsQL (school and social domain), as compared to the CAPD group, it was not found that the improvement from baseline was significantly different between both groups. Conclusions: No significant benefit of APD was found over CAPD in terms of HRQoL improvement. However, larger studies are warranted along with qualitative studies to examine the complete impacts of APD on HRQoL among pediatric patients with stage 5 CKD and their families.