Health-related quality of life and symptoms of conservative care versus dialysis in patients with end-stage kidney disease: a systematic review

2020 ◽  
Author(s):  
Wouter R Verberne ◽  
Iris D van den Wittenboer ◽  
Carlijn G N Voorend ◽  
Alferso C Abrahams ◽  
Marjolijn van Buren ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Older Patients ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Conservative Care ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
End Stage

Abstract Background Non-dialytic conservative care (CC) has been proposed as a viable alternative to maintenance dialysis for selected older patients to treat end-stage kidney disease (ESKD). This systematic review compares both treatment pathways on health-related quality of life (HRQoL) and symptoms, which are major outcomes for patients and clinicians when deciding on preferred treatment. Methods We searched PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus and PsycINFO from inception to 1 October 2019 for studies comparing patient-reported HRQoL outcomes or symptoms between patients who chose either CC or dialysis for ESKD. Results Eleven observational cohort studies were identified comprising 1718 patients overall. There were no randomized controlled trials. Studies were susceptible to selection bias and confounding. In most studies, patients who chose CC were older and had more comorbidities and worse functional status than patients who chose dialysis. Results were broadly consistent across studies, despite considerable clinical and methodological heterogeneity. Patient-reported physical health outcomes and symptoms appeared to be worse in patients who chose CC compared with patients who chose dialysis but had not yet started, but similar compared with patients on dialysis. Mental health outcomes were similar between patients who chose CC or dialysis, including before and after dialysis start. In patients who chose dialysis, the burden of kidney disease and impact on daily life increased after dialysis start. Conclusions The available data, while heterogeneous, suggest that in selected older patients, CC has the potential to achieve similar HRQoL and symptoms compared with a dialysis pathway. High-quality prospective studies are needed to confirm these provisional findings.

scholarly journals Quality Of Life And Health Related Quality Of Life Among End-Stage Kidney Disease Patients: Methodology Assessment

2020 ◽  
Vol 6 (3) ◽  
pp. 1-11
Author(s):  
Issa Al Salmi ◽  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Related Quality ◽  
Health Related ◽  
End Stage ◽  
The Impact

End-Stage Kidney Disease (ESKD) is a serious and irreversible condition. Understanding the impact of ESKD and its treatment on an individual's Quality of Life (QoL) is important.

scholarly journals Quality Of Life And Health-Related Quality Of Life Among End-Stage Kidney Disease Patients: Testing The Concepts And Assessing The Measures

2020 ◽  
Vol 6 (3) ◽  
pp. 1-24
Author(s):  
Issa Al Salmi ◽  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Life Quality ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Western Countries ◽  
Related Quality ◽  
Health Related ◽  
End Stage

Little is known about how patients with End-Stage Kidney Disease (ESKD) view their life quality, yet this is an outcome of increasing importance. Most research in this area has been conducted within a certain Western countries’ context using measures that have not been validated within our region context.

scholarly journals Quality Of Life And End Stage Kidney Disease: Conceptual And Theoretical Issues

2020 ◽  
Vol 6 (3) ◽  
pp. 1-14
Author(s):  
Issa Al Salmi ◽  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Theoretical Development ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Related Quality ◽  
Health Related ◽  
End Stage ◽  
Theoretical Issues

Quality of Life (QoL) and Health-Related Quality of Life (HRQoL) are multidimensional concepts. Several tools have been developed to measure these concepts. The aim of this narrative review is to gain a general understanding of QoL concepts, track its theoretical development, and identify the theoretical framework underpinning the concept.

scholarly journals Health-Related Quality of Life according to Renal Function: Results from a Nationwide Health Interview and Examination Survey

2021 ◽  
pp. 1-10
Author(s):  
Liv Faulhaber ◽  
Stefan Herget-Rosenthal ◽  
Hannes Jacobs ◽  
Falk Hoffmann
Keyword(s):  
Kidney Disease ◽  
State Of Health ◽  
General State ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Related Quality ◽  
Health Related ◽  
End Stage ◽  
Physical Hrqol

<b><i>Background:</i></b> Most studies on health-related quality of life (HRQoL) in chronic kidney disease (CKD) focus on patients with end-stage kidney disease although they represent a small proportion of patients with CKD. We aimed to analyze HRQoL according to glomerular filtration rate (GFR) categories in a population-based sample of adults living in Germany. <b><i>Methods:</i></b> Data from the German health interview and examination survey conducted from 2008 to 2011 were used. Participants with valid interview and examination data aged 40–79 years were included (<i>n</i> = 5,159). Serum creatinine levels were used to calculate estimated GFR via the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. We classified kidney function in GFR categories according to the Kidney Disease Improving Global Outcomes Initiative (KDIGO) guidelines on CKD: G1 (high): ≥90 mL/min/1.73 m<sup>2</sup>, G2 (normal): 60–89 mL/min/1.73 m<sup>2</sup>, G3a (mildly decreased): 45–59 mL/min/1.73 m<sup>2</sup>, G3b (moderately decreased): 30–44 mL/min/1.73 m<sup>2</sup>, G4/5 (severely decreased/end-stage kidney disease): &#x3c;30 mL/min/1.73 m<sup>2</sup>. HRQoL was evaluated with the Short Form Health Survey (SF-36). Different multivariate linear and logistic regression models were used to analyze the association of HRQoL with GFR categories. <b><i>Results:</i></b> Overall, 5.9% had a GFR &#x3c;60 mL/min/1.73 m<sup>2</sup> (corresponding to categories G3a, G3b, and G4/5). Compared to category G2 linear regression showed a decline in physical HRQoL in categories G3a (−2.34, <i>p</i> = 0.004), G3b (−5.37, <i>p</i> = 0.009), and G4/5 (−4.82, <i>p</i> = 0.117). No decline in mental HRQoL was detected with increasing GFR categories. Categories G3a to G4/5 were significantly associated with a low perceived general state of health (G3a: odds ratio [OR] = 2.03, <i>p</i> = 0.001; G3b: OR = 3.01, <i>p</i> = 0.009; G4/5: OR = 8.70, <i>p</i> = 0.016) when compared to category G2. <b><i>Conclusion:</i></b> In a representative sample of adults living in Germany, both physical HRQoL and the perceived general state of health are already significantly reduced in category G3a.

scholarly journals Effect of Inotropes on Patient-Reported Health Status in End-Stage Heart Failure

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
John-Ross D. Clarke ◽  
Ralph Riello ◽  
Larry A. Allen ◽  
Mitchell A. Psotka ◽  
John R. Teerlink ◽  
...  
Keyword(s):  
Health Status ◽  
Health Related Quality ◽  
Reduced Ejection Fraction ◽  
Randomized Controlled ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
Reported Health ◽  
End Stage

Background: A growing population of patients with end-stage heart failure (HF) with reduced ejection fraction has limited treatment options to improve their quality and quantity of life. Although positive inotropes have failed to show survival benefit, these agents may enhance patient-reported health status, that is, symptoms, functional status, and health-related quality of life. We sought to review the available clinical trial data on positive inotrope use in patients with end-stage HF and to summarize evidence supporting the use of these agents to improve health status of patients with end-stage HF. Methods: A literature review of randomized controlled trials examining the use of positive inotropy in HF with reduced ejection fraction was conducted. We searched MEDLINE, SCOPUS, and Web of Science between January 1980 to December 2018 for randomized controlled trials that used as their main outcome measures the effects of inotrope therapy on (1) morbidity/mortality, (2) symptoms, (3) functional status, or (4) health-related quality of life. Inotropes of interest included adrenergic agents, phosphodiesterase inhibitors, calcium sensitizers, myosin activators, and SERCA2a (sarcoplasmic reticulum Ca 2+ -ATPase) modulators. Results: Twenty-two out of 26 inotrope randomized controlled trials measured the effect of inotropes on at least one patient-reported health status domain. Among the 22 studies with patient-related health status outcomes, 11 (50%) gauged symptom response, 15 (68%) reported functional capacity changes, and 12 (54%) reported health-related quality of life measures. Fourteen (64%) of these trials noted positive outcomes in at least one health status domain measured; 11 (79%) of these positive studies used agents that worked through phosphodiesterase inhibition. Conclusions: There has been a lack of standardization surrounding measurement of patient-centered outcomes in studies of inotropes for end-stage HF with reduced ejection fraction. The degree to which positive inotropes can improve patient-reported health status and the adverse risk they pose remains unknown.

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