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Patients with CKD rate their physical QoL lower than general population
Published findings suggest patients with different stages of chronic kidney disease — ranging from moderate to advanced and on dialysis — perceive their physical quality of life as lower than do those in the general population. However, for the mental score, only patients on dialysis had lower ratings.
Karine Legrand, PhD, of the University of Lorraine in France, and colleagues argued that health-related quality of life is an important way to measure more than morbidity and mortality; instead, it measures “how the disease affects the physical, mental, emotional and social dimensions of [the patient’s] well-being,” making it useful for patient-centered care.
“The strong impact of kidney failure and dialysis on QoL and its improvement after transplantation have long been documented, but less is known about patients with CKD not on kidney replacement therapy (KRT),” they wrote.
To evaluate the association between different stages of CKD and the physical and mental health domains of HRQoL, researchers selected patients from the national Renal Epidemiology and Information Network registry. These patients — who had moderate to advanced CKD, a functioning kidney transplant or who were on maintenance dialysis — responded to the medical outcomes study 36-item short form health survey or the kidney disease quality of life 36 scale. Responses were compared to those from the general population (participants identified through the French Decennial Health Survey).
Researchers found 27% of patients with moderate CKD, greater than 40% of those with advanced CKD or receiving dialysis and 12% with a functioning transplant perceived their health status as fair or poor compared with 3% of the general population.
In addition, after adjusting for age, sex, education, obesity and diabetes, researchers determined HRQoL physical scores were significantly lower in patients with any CKD stage (2.2 points lower than general population for moderate CKD). For patients on dialysis, the score was 10.2 points lower.
Regarding the mental score, only patients on dialysis had a score that was different from the general population (6.8 points lower).
Researchers suggested these results lead to two important conclusions: physical health is lower for patients with all stages of CKD, regardless of kidney failure and there is a “major difference in the effect and burden of kidney disease between patients with non-KRT-requiring CKD and those receiving dialysis.”
“Our study shows that the effect and burden of kidney disease on QoL in dialysis patients is substantial,” they wrote. “In light of the findings of a systematic review that patients are less concerned about longevity than QoL, health care professionals should understand that some patients might reasonably prefer to decline dialysis despite its survival benefits.” – by Melissa J. Webb
Disclosures: Legrand reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.