Evolution of Quality of Life in Chronic Kidney Disease Stage 4–5 Patients Transitioning to Dialysis and Transplantation

Abstract

<b><i>Introduction:</i></b> Chronic kidney disease (CKD) has a profound effect on patients’ health-related quality of life (QoL). Longitudinal studies on QoL in CKD are scarce and have explored selected patients on renal replacement therapy (RRT). We studied the evolution of QoL in patients with advanced CKD transitioning to dialysis and transplantation in a prospective follow-up study. <b><i>Methods:</i></b> A total of 100 participants of the Chronic Arterial Disease, Quality of Life, and Mortality in Chronic Kidney Injury (CADKID) study were enrolled in the study. Kidney Disease Quality of Life Short Form, biochemistry, and echocardiography were obtained at baseline and after a median interval of 33 (range 12–85) months. <b><i>Results:</i></b> At the time of the follow-up QoL assessment, 32 patients were not receiving RRT, 30 were on hemodialysis (HD), 19 on peritoneal dialysis (PD), and 19 had received a kidney transplant. Among kidney transplant recipients (KTRs), “Burden of Kidney Disease” and “General Health” domains improved compared to patients who initiated HD (<i>p</i> < 0.0001 and <i>p</i> = 0.007, respectively), PD (<i>p</i> = 0.0005 and <i>p</i> = 0.03, respectively), or remained in predialysis care (<i>p</i> = 0.009 and <i>p</i> = 0.003, respectively) while “Effects of Kidney Disease” improved compared to those who started HD (<i>p</i> = 0.004) or PD (<i>p</i> = 0.002). The change in Short Form-36 (SF-36) Physical Component Summary was not different between patients on different treatment modalities. Higher plasma albumin and cholesterol levels were associated with improved QoL in “Symptoms/Problems” (<i>r</i> = 0.28, <i>p</i> = 0.005, and <i>r</i> = 0.30, <i>p</i> = 0.004, respectively) and “Effects of Kidney Disease” (<i>r</i> = 0.27, <i>p</i> = 0.008, and <i>r</i> = 0.24, <i>p</i> = 0.03, respectively). <b><i>Conclusion:</i></b> QoL improved in KTRs in kidney disease-specific domains compared to patients initiating dialysis or those without RRT. Plasma albumin and lipids were associated with QoL over time.

Exploring the impact of cognitive impairments on treatment compliance and quality of life in patients with Continuous Ambulatory Peritoneal Dialysis (CAPD)

“…The concept and goals of modern dialysis are very clear: to improve the long-term survival rate and quality of life of dialysis patients as much as possible. [ 21 ] SF-36 is a widely used quantitative scale specifically designed to evaluate the quality of life of dialysis and kidney disease patients, and its results can reasonably and comprehensively reflect the quality of life of dialysis patients. [ 22 ] We used this scale to evaluate the quality of life of CAPD patients in our center, and the results showed that patients in the cognitive impairment group had lower scores than those in the control group with normal cognition in terms of physical function, general health, social function, emotional function, and mental health ( P < .05).…”

Attachment and parental bond: impact on psychopathology, mental health and quality of life of hemodialysis patients: a cross-sectional study

“…A score of 50 represents the normal reference value for each dimension and for the two global indices. The validity and reliability for SF 36 have been confirmed in patients with chronic kidney disease and in kidney transplant recipients [ 13 , 30 , 31 ]. Also, with regard to our sample of hemodialysis patients, the SF-36 showed good reliability (α = 0.92).…”

Changes in the Quality of Life and Nutrition Markers in Transition From End-Stage Kidney Disease to Kidney Transplantation: Insights From a Vietnamese Cohort

“…Additionally, nutritional factors, such as diabetes, hemoglobin [1,5], albumin, lipids profile [6], and creatinine level [11], were associated with QoL over time. Despite the associations, the precise impact of nutritional changes on the QoL trajectory of KTRs remains insufficiently explored in the current literature.…”

“…Prior studies, using tools such as the 36-Item Short-Form Health Survey (SF-36), have extensively analyzed recipients' QoL in the transition from hemodialysis or peritoneal dialysis to kidney transplantation and concluded that there was a significant improvement in the overall rating of QoL [ 5 , 6 ]. These studies predominantly reported enhancements in physical health components [ 7 , 8 ] and perceptions of overall health [ 2 , 8 , 9 ] following transplantation.…”

“…These studies predominantly reported enhancements in physical health components [ 7 , 8 ] and perceptions of overall health [ 2 , 8 , 9 ] following transplantation. However, long-term assessments reveal nuances, with some studies indicating sustained [ 6 ] or diminished [ 5 ]. QoL post-transplantation is partly attributable to factors such as post-transplantation CKD and psychosocial burdens [ 5 , 10 , 11 ].…”