This research will focus on the impact of psychosocial factors on health outcomes in the presence of a shared chronic health condition requiring standardized therapy, and how this impact may vary by gender, race, and age. The study population will consist of older adults receiving dialysis treatment because of chronic kidney failure, and a matched control group of older adults who do not share this health condition. The first objective of the study is to prospectively investigate contributors to survival of 350 older black and older white persons who were receiving maintenance kidney dialysis when they were interviewed in 1988. The analysis will investigate the contributions of psychosocial variables to survival, over and above the contributions of the variables gender, race, age, primary cause of kidney failure, number of comorbid conditions, and hospitalization history that have been identified as predictive in other studies of dialysis patient survival. The analysis will also investigate whether the relation of psychosocial variables to survival of older dialysis patients varies significantly by gender/race category. The relation of psychosocial variables to survival among older black dialysis patients has not been investigated. The Cox proportional hazards model with time dependent covariates (the psychosocial variables) will be used; assumptions will be tested. The second objective of this study is to reinterview those persons from the sample of 350 older dialysis patients interviewed in 1988 who are still alive and living in Georgia in 1991 and to reinterview persons from a sample of 340 matched community respondents (control group) who were interviewed in 1988 and are still alive and living in Georgia in 1991. Subjects' reinterview date will be three years after the date of the initial interview. The purpose of the followup is to investigate (1) stability/change in subjects' psychological and social functioning over time, (2) whether these patterns differ significantly between the dialysis and control samples, and (3) how gender, race and age may be related to observed patterns of psychological and social functioning. The general linear model or categorical data analysis (Grizzle-Starmer-Koch) will be used, with main effect terms of gender, race and age and their interaction terms testing the hypotheses of interest.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK042949-03
Application #
3244169
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1990-04-01
Project End
1994-03-31
Budget Start
1992-04-01
Budget End
1994-03-31
Support Year
3
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Emory University
Department
Type
Schools of Medicine
DUNS #
042250712
City
Atlanta
State
GA
Country
United States
Zip Code
30322
Kutner, Nancy G (2017) Comment on: Quality of Life, Perceptions, and Health Satisfaction of Older Adults with End-Stage Renal Disease. J Am Geriatr Soc 65:2330-2331
Kutner, Nancy G; Zhang, Rebecca (2017) Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics. Healthcare (Basel) 5:
Kutner, Nancy G; Zhang, Rebecca; Huang, Yijian et al. (2012) Racial differences in restless legs symptoms and serum ferritin in an incident dialysis patient cohort. Int Urol Nephrol 44:1825-31
Kutner, Nancy G; Bliwise, Donald L; Zhang, Rebecca (2004) Linking race and well-being within a biopsychosocial framework: variation in subjective sleep quality in two racially diverse older adult samples. J Health Soc Behav 45:99-113
Kutner, Nancy G; Clow, Patricia Ward; Zhang, Rebecca et al. (2002) Association of fish intake and survival in a cohort of incident dialysis patients. Am J Kidney Dis 39:1018-24
Kutner, Nancy G; Zhang, Rebecca; McClellan, William M et al. (2002) Psychosocial predictors of non-compliance in haemodialysis and peritoneal dialysis patients. Nephrol Dial Transplant 17:93-9
Kutner, N G; Zhang, R (2001) Body mass index as a predictor of continued survival in older chronic dialysis patients. Int Urol Nephrol 32:441-8
Bliwise, D L; Kutner, N G; Zhang, R et al. (2001) Survival by time of day of hemodialysis in an elderly cohort. JAMA 286:2690-4
Kutner, N G; Bliwise, D L; Brogan, D et al. (2001) Race and restless sleep complaint in older chronic dialysis patients and nondialysis community controls. J Gerontol B Psychol Sci Soc Sci 56:P170-5
Kutner, N G; Zhang, R; McClellan, W M (2000) Patient-reported quality of life early in dialysis treatment: effects associated with usual exercise activity. Nephrol Nurs J 27:357-67; discussion 368, 424

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