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PLoS One. 2014 Mar 10;9(3):e91176. doi: 10.1371/journal.pone.0091176. eCollection 2014.

Physical, cognitive and emotional factors contributing to quality of life, functional health and participation in community dwelling in chronic kidney disease.

Author information

1
Department of Neurology, University Hospital Essen, Essen, Germany.
2
Department of Nephrology, University Hospital Essen, Essen, Germany.

Abstract

BACKGROUND:

Quality of life (QoL) impairment is a well-known consequence of chronic kidney disease (CKD). The factors influencing QoL and late life functional health are poorly examined.

METHODS:

Using questionnaires combined with neuropsychological examinations, we prospectively evaluated physical, cognitive, and emotional factors influencing QoL, functional health and participation in community dwelling in 119 patients with CKD stages 3-5 including hemodialysis (61.5±15.7years; 63% men) and 54 control patients of the same age without CKD but with similar cardiovascular risk profile.

RESULTS:

Compared with control patients, CKD patients showed impairment of the physical component of QoL and overall function, assessed by the SF-36 and LLFDI, whereas disability, assessed by LLFDI, was selectively impaired in CKD patients on hemodialysis. Multivariable linear regressions (forced entry) confirmed earlier findings that CKD stage (β = -0.24; p = 0.012) and depression (β = -0.30; p = 0.009) predicted the QoL physical component. Hitherto unknown, CKD stage (β = -0.23; p = 0.007), cognition (β = 0.20; p = 0.018), and depression (β = -0.51; <0.001) predicted disability assessed by the LLFDI, while age (β = -0.20; p = 0.023), male gender (B = 5.01; p = 0.004), CKD stage (β = -0.23; p = 0.005), stroke history (B = -9.00; p = 0.034), and depression (β = -0.41; p<0.001) predicted overall function. Interestingly, functional health deficits, cognitive disturbances, depression, and anxiety were evident almost only in CKD patients with coronary heart disease (found in 34.2% of CKD patients). The physical component of QoL and functional health decreased with age and depressive symptoms, and increased with cognitive abilities.

CONCLUSIONS:

In CKD, QoL, functional health, and participation in community dwelling are influenced by physical, cognitive, and emotional factors, most prominently in coronary heart disease patients.

PMID:
24614180
PMCID:
PMC3948783
DOI:
10.1371/journal.pone.0091176
[Indexed for MEDLINE]
Free PMC Article

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