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Gepubliceerd in: Quality of Life Research 8/2019

01-04-2019

The impact of progressive chronic kidney disease on health-related quality-of-life: a 12-year community cohort study

Auteurs: Melanie L. R. Wyld, Rachael L. Morton, Phil Clayton, Muh Geot Wong, Meg Jardine, Kevan Polkinghorne, Steve Chadban

Gepubliceerd in: Quality of Life Research | Uitgave 8/2019

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Abstract

Purpose

Quality-of-life is poor in end-stage kidney disease; however, the relationships between earlier stages of chronic kidney disease (CKD) and are poorly understood. This study explored longitudinal quality-of-life changes in a community-based CKD cohort and assessed associations between CKD and quality-of-life over time, and between baseline quality-of-life and CKD outcomes.

Methods

We used the Australian diabetes, obesity and lifestyle study—a nationally representative, prospective cohort with data collected at baseline, year 5 and year 12—to examine the relationships between CKD stage, quality-of-life and outcomes. Linear mixed regression, cox proportional hazards, Kaplan–Meier and competing risks analyses were used.

Results

Of 1112 participants with CKD and baseline quality-of-life data, the physical component summary (PCS) score was significantly lower than for the general population (p = 0.01 age and sex adjusted), while the mental component summary (MCS) score was no different (p = 0.9 age and sex adjusted). In our unadjusted mixed effects model, more advanced kidney disease was associated with lower PCS and higher MCS at baseline (p < 0.001 and p < 0.01, respectively); however, this effect was no longer significant after adjustment for demographic and clinical variables. The rate of decline in PCS over the period of follow-up was greatest for those with more advanced kidney disease (p < 0.001 in unadjusted model, p = 0.007 in adjusted model). There was no association between change in MCS over the period of follow-up and severity of kidney disease in either the unadjusted or adjusted model (p = 0.7 and p = 0.1, respectively). Lower PCS, but not MCS, was associated with increased cardiovascular and increased all-cause mortality even after adjustment for key demographic and clinical variables (p < 0.001).

Conclusions

Physical, but not mental, quality-of-life is significantly impaired in CKD, and continues to decline with disease progression.
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Metagegevens
Titel
The impact of progressive chronic kidney disease on health-related quality-of-life: a 12-year community cohort study
Auteurs
Melanie L. R. Wyld
Rachael L. Morton
Phil Clayton
Muh Geot Wong
Meg Jardine
Kevan Polkinghorne
Steve Chadban
Publicatiedatum
01-04-2019
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 8/2019
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-019-02173-1