Health-related Quality of Life in People with Mild-Moderate Chronic Kidney Disease

Dawn O'Shea

August 11, 2020

The majority of patients in the UK with mild-moderate chronic kidney disease (CKD) experience deteriorations in at least one health-related quality of life (HRQoL) domain, according to a study published in BMJ Open.

The cross-sectional analysis was conducted at five-year follow-up in a prospective cohort recruited from 32 GP surgeries in England.

A total of 1008 participants with CKD stage III who survived to five years and had complete follow-up data for HRQoL and functional status (FS) were included.

The proportions reporting some problems in 5-level EQ-5D (EQ-5D-5L) domains were 57.7 per cent for mobility, 16.5 per cent for self-care, 46.2 per cent for usual activities, 70.6 for pain/discomfort and 31.6 for anxiety/depression.

Overall, 23.2 per cent had functional impairment. HRQoL index values showed greater variation among those with lower FS. Only 191 (18.9%) reported no problems in any domain.

In multivariable analysis, functional impairment was independently associated with experiencing problems for all EQ-5D-5L domains:

  • Mobility: OR, 16.87; 95% CI, 8.70-32.79; P<.001.

  • Self-care: OR, 13.08; 95% CI, 8.46-20.22; P<.001.

  • Usual activities: OR, 8.27; 95% CI, 5.43-12.58; P<.001.

  • Pain/discomfort: OR, 2.94; 95% CI, 1.86-4.67; P<.001.

  • Anxiety/depression: OR, 3.08; 95% CI, 2.23-4.27; P<.001.

Higher comorbidity count and obesity were independently associated with problems in mobility, self-care, usual activities and pain/discomfort. Female sex, lower FS and lower educational attainment were independently associated with anxiety/depression.

Older age, more comorbidity, albuminuria, lower educational attainment and obesity were independently associated with functional impairment.

Fraser SD, Barker J, Roderick PJ, Yuen HM, Shardlow A, Morris JE, McIntyre NJ, Fluck RJ, McIntyre CW, Taal MW. Health-related quality of life, functional impairment and comorbidity in people with mild-to-moderate chronic kidney disease: a cross-sectional study. BMJ Open. 2020;10(8):e040286. doi: 10.1136/bmjopen-2020-040286. PMID: 32764092 Full text.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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