Association of social support with outcomes in incident dialysis patients

Laura C. Plantinga, Nancy E. Fink, Rachel Harrington-Levey, Frederic O. Finkelstein, Nasser Hebah, Neil R. Powe, Bernard Jaar

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Abstract

Background and objectives: The association of social support with outcomes in ESRD, overall and by peritoneal dialysis (PD) versus hemodialysis (HD), remains understudied. Design, setting, participants, & measurements: In an incident cohort of 949 dialysis patients from 77 US clinics, we examined functional social support scores (scaled 0 to 100 and categorized by tertile) both overall and in emotional, tangible, affectionate, and social interaction subdomains. Outcomes included 1-year patient satisfaction and quality of life (QOL), dialysis modality switching, and hospitalizations and mortality (through December 2004). Associations were examined using overall and modality-stratified multivariable logistic, Poisson, and Cox proportional hazards models. Results: We found that mean social support scores in this population were higher in PD versus HD patients (overall 80.5 versus 76.1; P <0.01). After adjustment, highest versus lowest overall support predicted greater 1-year satisfaction and QOL in all patients (odds ratio 2.47 [95% confidence interval (CI) 1.18 to 5.15] and 2.06 [95% CI 1.31 to 3.22] for recommendation of center and higher mental component summary score, respectively). In addition, patients were less likely to be hospitalized (incidence rate ratio 0.86; 95% CI 0.77 to 0.98). Results were similar with subdomain scores. Modality switching and mortality did not differ by social support in these patients, and associations of social support with outcomes did not generally differ by dialysis modality. Conclusions: Social support is important for both HD and PD patients in terms of greater satisfaction and QOL and fewer hospitalizations. Intervention studies to possibly improve these outcomes are warranted.

Original languageEnglish (US)
Pages (from-to)1480-1488
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Volume5
Issue number8
DOIs
StatePublished - Aug 1 2010

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ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Plantinga, L. C., Fink, N. E., Harrington-Levey, R., Finkelstein, F. O., Hebah, N., Powe, N. R., & Jaar, B. (2010). Association of social support with outcomes in incident dialysis patients. Clinical Journal of the American Society of Nephrology, 5(8), 1480-1488. https://doi.org/10.2215/CJN.01240210