Health-related quality of life in chronic kidney disease patients

Chronic kidney disease (CKD) can significantly lessen patients' quality of life, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). Certain types of patients - women, diabetics, and those with a history of heart complications - are most affected.

These findings indicate that medical care for CKD patients should include strategies to lessen the negative impact of CKD on quality of life.

Quality of life for CKD patients is a frequently overlooked yet critical consideration when evaluating patients' overall health. Quality of life includes measures such as physical function, social activity, cognition, emotion, energy, sleep patterns, health perception, and general life satisfaction, and is linked to risks of hospitalization and premature death for CKD patients. Given the high mortality and hospitalization rates in CKD patients, it is important to gain a better understanding of CKD patients health-related quality of life.

To explore this issue, Salim Mujais, MD (Astellas Pharma Global Development), and Frederic Finkelstein, MD (Hospital of St. Raphael), and their colleagues administered questionnaires on health-related quality of life to 1,186 CKD patients at six month intervals. They found that health-related quality of life scores declined progressively with more advanced stages of CKD. Female gender, the presence of diabetes, and a history of heart problems (such as congestive heart failure or heart attack) were also associated with reduced health-related quality of life.

The presence of anemia (a deficiency of red blood cells) and the use of heart medications called beta blockers were also associated with lower scores.

"Kidney diseases affect the quality of life of individuals, and some individuals in particular - such as women - are more vulnerable to having their quality of life negatively impacted by these diseases and their progression," said Dr. Mujais. The researchers noted that certain interventions may help lessen the impact of CKD on health-related quality of life. For example, the questionnaires revealed that CKD has a significant effect on sleep, and there are a number of treatment options that address sleep disturbances.

The authors report no financial disclosures. Study co-authors include Ken Story, PhD, Catherine Franek (Baxter Healthcare Corporation); John Brouillette, MD (Nephrology Associates); Tomoko Takano, MD (McGill University, Canada); Steven Soroka, MD (Dalhousie University, Canada); and David Mendelssohn, MD (Humber River Regional Hospital, Canada).

The article, entitled "Health-related Quality of Life in CKD Patients: Correlates and Evolution over Time," will appear online at http://cjasn.asnjournals.org/ on July 30, 2009, doi 10.2215/CJN.05541008.

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