Health-related Quality of Life Among Patients With Chronic Kidney Disease of Unknown Etiology (CKDu) of an Agricultural Community in Kebithigollawa, Sri Lanka  

Abstract

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. METHOD – 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. Patients were divided into four groups according to their eGFR; group A with eGFR range 90-60 ml/min/1.73 m2, group B with eGFR range 30–59 ml/min/1.73m2, group C with eGFR range 15–29 ml/min/1.73m2 and group D with eGFR<15 ml/min/1.73m2. RESULTS – The KDQOL™-36 scores impaired substantially across all stages of CKDu and comparatively lower scores were present in latter 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 disease. Poor KDQOL™-36 scores were present in males than in females. A significant variance in scores was not observed between the gender and younger (<65 years) and elderly (≥65 years) populations. Biochemical parameters showed a statistically significant correlation with majority of KDQOL™-36 dimensions while interestingly urine albumin to creatinine ratio did not. CONCLUSION - Our findings reveals that CKDu patients in any stage of the disease despite their age and gender have a significant physical and mental health burden, and this burden is alarmingly increased among patients as the disease worsens. Thereby, early assessment of health related quality of life will help to identify high risk patients and modifying these factors may provide better active and a healthy lifestyle.