A CHAMBERLAIN 1, N COOK 1
1Department of Nephrology, Austin Health, Heidelberg, Australia
Aim: To determine the prevalence of comorbidities which can impact driving fitness among dialysis patients who drive.
Background: The Assessing Fitness to Drive guidelines for health professionals are a national consensus document, yet they do not address end-stage kidney disease (ESKD) or dialysis. Despite the high prevalence of comorbidities affecting driving fitness among patients with ESKD and the physical impacts of dialysis, there is a paucity of literature worldwide regarding their risk of driving impairment.
Methods:A single-centre cross-sectional study was conducted at Austin Health, Melbourne. Inclusion criteria were chronic dialysis requirement and currently driving. Data was extracted from the medical records of eligible patients with respect to dialysis modality, demographics and comorbidities that may affect driving. Statistical significance was defined as p-value <0.05.
Results:98 patients were identified with a mean age of 61.07 years. The median number of comorbidities of interest was four (IQR 4, range 0-10). The most prevalent comorbidities were hypertension, diabetes, and coronary artery disease. There was a trend towards fewer comorbidities among home haemodialysis patients (median 2.5, IQR 2) compared with peritoneal dialysis (median 3, IQR 4) and in-centre haemodialysis (median 4, IQR 5), but this was not statistically significant. Whilst there was a weak positive correlation between age and number of comorbidities (r=0.257, p=0.011), there was significant multimorbidity among all age brackets excepting those younger than 40.
Conclusion:Significant multimorbidity was demonstrated among dialysis patients who drive at Austin Health, which was not confined to a specific dialysis modality or age group. This supports the need to develop driving fitness assessment guidelines for dialysis patients and for clinicians to routinely consider driving fitness when caring for these patients.
Dr Chamberlain is an Advanced Trainee in Nephrology and General and Acute Care Medicine, currently working at Austin Health, Melbourne. Her professional interests include home therapies, supportive care and rural health. She completed her MBBS(Hons) at Monash University in 2015 and is now undertaking a Master of Public Health. Upon completion of her training, she hopes to work in a regional area practicing both general medicine and nephrology.