scholarly journals Better health-related quality of life in kidney transplant patients compared to chronic kidney disease patients with similar renal function

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257981
Author(s):  
Jung-Hwa Ryu ◽  
Tai Yeon Koo ◽  
Han Ro ◽  
Jang-Hee Cho ◽  
Myung-Gyu Kim ◽  
...  

Renal functional deterioration is associated with physical and mental burdens for kidney transplant (KT) and chronic kidney disease (CKD) patients. However, the change in health-related quality of life (HRQOL) over time in KT patients compared to that of native CKD patients has not been evaluated. We addressed this issue using KT patients registered in the KNOW-KT cohort study and patients at CKD stage 1–3 registered in the KNOW-CKD cohort study. HRQOL scores were assessed using the Kidney Disease Quality of Life Short Form at baseline, 2-, and 4-years follow-up in 842 KT patients and at baseline and 5-year follow-up in 1,355 CKD patients. SF-36 scores declined at the 4-year follow-up, whereas CKD-targeted scores showed no change in the KT group. In contrast, CKD-targeted scores as well as SF-36 scores were decreased at the 5-year follow-up in CKD patients. When prognostic factors were analyzed for longitudinal HRQOL data over time, renal functions, diabetes, cardiovascular and cerebrovascular diseases, hemoglobin level, marital status, income, employment, and health care were significant prognostic factors. Furthermore, KT was an independent prognostic factor for better HRQOL. These results highlight that KT can offer a better HRQOL than that of CKD patients, even when renal function is similar.

2021 ◽  
Author(s):  
Jung-Hwa Ryu ◽  
Tai Yeon Koo ◽  
Han Ro ◽  
Jang-Hee Cho ◽  
Cheol Woong Jung ◽  
...  

Abstract Renal functional deterioration is associated with physical and mental burdens for kidney transplant (KT) and chronic kidney disease (CKD) patients. However, the change in health-related quality of life (HRQOL) over time in KT patients compared to that of pre-dialysis CKD patients has not been evaluated. We addressed this issue using KT patients registered in the KNOW-KT cohort study and patients at CKD stage 1–3 registered in the KNOW-CKD cohort study. HRQOL scores were assessed using the Kidney Disease Quality of Life Short Form at baseline, 2-, and 4-years follow-up in 842 KT patients and at baseline and 5-year follow-up in 1,355 CKD patients. SF-36 scores declined at the 4-year follow-up, whereas CKD-targeted scores showed no change in the KT group. In contrast, CKD-targeted scores as well as SF-36 scores were decreased at the 5-year follow-up in CKD patients. When prognostic factors were analyzed for longitudinal HRQOL data over time, renal functions, diabetes, cardiovascular and cerebrovascular diseases, hemoglobin level, marital status, income, employment, and health care were significant prognostic factors. Furthermore, KT was an independent prognostic factor for better HRQOL. These results highlight that KT can offer a better HRQOL than that of CKD patients, even when renal function is similar.


2013 ◽  
Vol 18 (5) ◽  
pp. 697-703 ◽  
Author(s):  
Reiko Okubo ◽  
Hirayasu Kai ◽  
Masahide Kondo ◽  
Chie Saito ◽  
Keigyou Yoh ◽  
...  

2019 ◽  
Vol 13 (1) ◽  
pp. 85-94 ◽  
Author(s):  
Andrew C Nixon ◽  
Theodoros M Bampouras ◽  
Neil Pendleton ◽  
Sandip Mitra ◽  
Mark E Brady ◽  
...  

Abstract Background Understanding how frailty affects health-related quality of life (HRQOL) in those with chronic kidney disease (CKD) could assist in the development of management strategies to improve outcomes for this vulnerable patient group. This study aimed to evaluate the relationship between frailty and HRQOL in patients with CKD Stages 4 and 5 (G4–5) and those established on haemodialysis (G5D). Methods Ninety participants with chronic kidney disease (CKD G4–5D) were recruited between December 2016 and December 2017. Frailty was assessed using the Frailty Phenotype, which included assessments of unintentional weight loss, weakness (handgrip strength), slowness (walking speed), physical activity and self-perceived exhaustion. HRQOL was assessed using the RAND 36-Item Health Survey Version 1.0 (SF-36). Results Nineteen (21%) patients were categorized as frail. Frailty, when adjusted for age, gender, dialysis dependence and comorbidity, had a significant effect on five of the eight SF-36 domains: physical functioning, role limitations due to emotional problems, energy/fatigue, social functioning and pain. Regression modelling best explained the variation in the physical functioning domain (adj. R2 = 0.27, P < 0.001), with frailty leading to a 26-point lower score. Exhaustion was the only Frailty Phenotype component that had a significant effect on scores across all SF-36 domains. Conclusions Frailty is independently associated with worse HRQOL in patients with CKD G4–5D, with self-perceived exhaustion being the most significant Frailty Phenotype component contributing to HRQOL. Efforts should be made to identify frail patients with CKD so that management strategies can be offered that aim to improve morbidity, mortality and patient-reported outcomes, including HRQOL and fatigue.


2021 ◽  
pp. 1-24
Author(s):  
Daniela Viramontes-Hörner ◽  
Zoe Pittman ◽  
Nicholas M Selby ◽  
Maarten W Taal

Abstract Health-related quality of life (HRQoL) is severely impaired in persons receiving dialysis. Malnutrition has been associated with some measures of poor HRQoL in cross-sectional analyses in dialysis populations, but no studies have assessed the impact of malnutrition and dietary intake on change in multiple measures of HRQoL over time. We investigated the most important determinants of poor HRQoL and the predictors of change in HRQoL over time using several measures of HRQoL. We enrolled 119 haemodialysis and 31 peritoneal dialysis patients in this prospective study. Nutritional assessments (Subjective Global Assessment [SGA], anthropometry and 24-hour dietary recalls) and HRQoL questionnaires (Short Form-36 [SF-36] mental [MCS] and physical component scores [PCS] and European QoL-5 Dimensions [EQ5D] health state [HSS] and visual analogue scores [VAS]) were performed at baseline, 6 and 12 months. Mean age was 64(14) years. Malnutrition was present in 37% of the population. At baseline, malnutrition assessed by SGA was the only factor independently (and negatively) associated with all four measures of HRQoL. No single factor was independently associated with decrease in all measures of HRQoL over 1 year. However, prevalence/development of malnutrition over one year was an independent predictor of 1-year decrease in EQ5D HSS and 1-year decrease in fat intake independently predicted the 1-year decline in SF-36 MCS and PCS, and EQ5D VAS. These findings strengthen the importance of monitoring for malnutrition and providing nutritional advice to all persons on dialysis. Future studies are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.


2021 ◽  
Author(s):  
Rose K Sia ◽  
Denise S Ryan ◽  
Daniel I Brooks ◽  
Janice M Kagemann ◽  
Kraig S Bower ◽  
...  

ABSTRACT Purpose The purpose of this study was to assess visual and health-related quality of life (QOL) among U.S. military service members who sustained combat ocular trauma (COT) with or without associated traumatic brain injury (TBI). Methods This was a single-center, prospective observational study of U.S. service members (n = 88) with COT who were treated at Walter Reed National Military Medical Center. Participants completed the National Eye Institute Visual Function Questionnaire (VFQ-25) at enrollment and at follow-up (>1 year) and supplemental surveys: Neurobehavioral Symptom Inventory, the Medical Outcomes 36-item Short Form Survey (SF-36), and Mayo-Portland Adaptability Inventory. Results Initial and follow-up VFQ-25 showed a statistically significant increase in median scores for near activities (initial: 75.0, follow-up 83.3; P = .004) and peripheral vision (initial: 50.0, follow-up: 75.0; P = .009) and in composite scores (initial: 79.5, follow-up: 79.8; P = .022). Comparing those who did (n = 78) and did not (n = 8) have a TBI history, there were no significant differences in median change in VFQ-25 composite scores (with TBI: 2.3 vs. no TBI: 10.7; P = .179). Participants with a TBI history had a significantly lower median SF-36 General Health score (with TBI: 67.5 vs. no TBI: 92.5; P = .009) Conclusions Vision-related QOL of COT patients is generally good in the long term. However, those with both COT and a history of TBI conditions showed significantly worse functioning in several domains than those without TBI. As TBI is a common finding in COT, this association is an important factor impacting this population’s overall clinical presentation and daily functions.


Author(s):  
Nishantha Kumarasinghe

Background: The significant increase in the burden of chronic kidney disease of unknown etiology (CKDu) of Sri Lanka has led to evaluate the factors related to physical, social and mental aspects of health-related quality of life (HRQOL) in CKDu patients. Methods: The quality of life of 84 CKDu patients (stages 1-5) were assessed by means of the Kidney Disease Quality of Life Short-Form survey (KDQOL™-36) Version 1.3 along with biomarkers and patient demographics. The estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula. Results: KDQOL™-36 scores impaired substantially across all stages of CKDu and comparatively lower scores were present in later stages of the disease than the initial stages. The mental composite summary (MCS) scores were more impaired when compared to physical composite summary (PCS) scores during the early stage of the disease. Poor KDQOL™-36 scores were present in males than in females with a significant difference in MCS and social support scales. Biochemical parameters showed a significant correlation with the majority of KDQOL™-36 dimensions while urine albumin to creatinine ratio did not. Conclusion: CKDu patients in any stage of the disease despite their age and gender have a significant physical and mental health burden. Thereby, early assessment of health-related quality of life will help to identify high-risk patients, and modifying these factors may provide a better active and healthy lifestyle.


Author(s):  
Achsa Thomas ◽  
Julia S. Jacob ◽  
Merin Abraham ◽  
Blessy M. Thomas ◽  
Purnima Ashok

Introduction: End Stage Renal Disease (ESRD) is the last stage of Chronic Kidney Disease (CKD), where kidneys solely functions at 10 to 15 percent of their normal capacity. Efficacious treatment for ESRD is renal replacement therapies like dialysis and renal transplantation. Health related quality of life (HRQoL) is a neglected aspect of CKD care. Objective: To assess the acute complications and quality of life in hemodialysis patients. Methods: This prospective observational study was conducted for 6 months, 90 patients undergoing hemodialysis were enrolled in the study. Acute complications were assessed during and post dialysis and Health Related Quality of Life were analysed using KDQoL-36TM questionnaire. Result: Among patients assessed; majority of the patients belonged to the age group 30 to 60 years. Acute complications were evaluated and oedema was found in maximum patients followed by muscle cramps, loss of appetite, itching etc. Based on KDQoL-36TM questionnaire, physical functions was mainly affected due to the disease. Oedema and muscle cramps had an impact on the patients physical and mental functioning whereas educational status and addictions showed significance in all domains of KDQOL-36TM. Conclusion: CKD patients undergoing hemodialysis has an intense effect on HRQoL. A better understanding on QOL issues will enable providers to deliver better patient centred care and enhance the overall well-being of the patients.


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