Work

Longitudinal Assessment of Health-Related Quality of Life in Adults with CKD

Year: 2025

Type: article

Abstract: KEY POINTS: Dialysis linked with poorer quality of life compared with transplant patients and patients with CKD. Quality of life trends were similar in both domain-specific and overall quality-of-life measures. BACKGROUND: There are sparse data about the change in health-related quality of life (HRQoL) with the temporal progression of CKD. In this study, we assessed the association between change in CKD stages, overall and domain-specific quality of life and determined the factors that were associated with this change. METHODS: Data were sourced from a multicenter study that included 1290 adult patients aged 18 years and older across six centers in Australia. Three-level EuroQol five-dimensional questionnaire was collected at baseline and 2 and 4 years. Changes in CKD stages were treated as a time-varying exposure; generalized estimating equations were used to model the changes in HRQoL. RESULTS: With reference to patients with CKD (G3-5), patients treated with dialysis had a reduction of 0.06 (-0.09 to -0.04) in overall HRQoL scores over the 4 years and experienced higher odds of reporting lower HRQoL across all domains: mobility (1.91 [1.53-2.38]), self-care (2.30 [1.67-3.16]), usual activity (2.70 [2.18-3.38]), pain (1.19 [0.97-1.46]), and anxiety (1.40 [1.12-1.75]). Transplant recipients showed no significant decline in overall HRQoL ( P = 0.13), but had increased odds of reduced mobility (1.74 [1.40-2.18]) and usual activity (1.35 [1.07-1.71]). Female sex, smoking, prevalent diabetes mellitus, lower educational attainment, and Middle Eastern ethnicity were associated with lower HRQoL. CONCLUSIONS: Patients on maintenance dialysis, but not transplant recipients, experienced a significant decline in overall HRQoL (0.06) over the 4 years compared with patients with CKD (G3-5). These utility-based HRQoL estimates are essential for future economic evaluations in kidney trials.

Source: Kidney360

DOI: 10.34067/kid.0000001009