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Clin J Am Soc Nephrol. 2016 Jul 7;11(7):1154-62. doi: 10.2215/CJN.09990915. Epub 2016 May 31.

Predictors and Outcomes of Health-Related Quality of Life in Adults with CKD.

Author information

  • 1Due to the number of contributing authors, the affiliations are provided in the Supplemental Material. aporte3@uic.edu.
  • 2Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.

Abstract

BACKGROUND AND OBJECTIVES:

Low health-related quality of life is associated with increased mortality in patients with ESRD. However, little is known about demographic and clinical factors associated with health-related quality of life or its effect on outcomes in adults with CKD.

DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS:

Data from 3837 adult participants with mild to severe CKD enrolled in the prospective observational Chronic Renal Insufficiency Cohort and Hispanic Chronic Renal Insufficiency Cohort Studies were analyzed. Health-related quality of life was assessed at baseline with the Kidney Disease Quality of Life-36 and its five subscales: mental component summary, physical component summary, burden of kidney disease (burden), effects of kidney disease (effects), and symptoms and problems of kidney disease (symptoms). Low health-related quality of life was defined as baseline score >1 SD below the mean. Using Cox proportional hazards analysis, the relationships between low health-related quality of life and the following outcomes were examined: (1) CKD progression (50% eGFR loss or incident ESRD), (2) incident cardiovascular events, and (3) all-cause death.

RESULTS:

Younger age, women, low education, diabetes, vascular disease, congestive heart failure, obesity, and lower eGFR were associated with low baseline health-related quality of life (P<0.05). During a median follow-up of 6.2 years, there were 1055 CKD progression events, 841 cardiovascular events, and 694 deaths. Significantly higher crude rates of CKD progression, incident cardiovascular events, and all-cause death were observed among participants with low health-related quality of life in all subscales (P<0.05). In fully adjusted models, low physical component summary, effects, and symptoms subscales were independently associated with a higher risk of incident cardiovascular events and death, whereas low mental component summary was independently associated with a higher risk of death (P<0.05). Low health-related quality of life was not associated with CKD progression.

CONCLUSIONS:

Low health-related quality of life across several subscales was independently associated with a higher risk of incident cardiovascular events and death but not associated with CKD progression.

KEYWORDS:

Cohort Studies; Disease Progression; Humans; Kidney Failure, Chronic; Prospective Studies; chronic kidney disease; mortality risk; obesity; quality of life

PMID:
27246012
PMCID:
PMC4934840
[Available on 2017-07-07]
DOI:
10.2215/CJN.09990915
[PubMed - in process]
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