Humanistic burden and economic impact of chronic kidney disease: a systematic literature review

Abstract

<ns4:p><ns4:bold>Background:</ns4:bold> Chronic kidney disease (CKD) is increasing in prevalence worldwide. Progression of CKD to end-stage renal disease (ESRD) can result in the requirement for renal replacement therapy, which incurs considerable healthcare costs and imposes restrictions on patients’ daily living. This systematic review was conducted to inform understanding of the humanistic and economic burden of CKD by collecting quality of life (QoL), symptom burden, and cost and resource use data, with a focus on the impact of disease progression.</ns4:p><ns4:p> <ns4:bold>Methods: </ns4:bold>Embase, MEDLINE, the Cochrane Library, and conference proceedings were searched in May 2017 according to predefined inclusion criteria. Data were extracted for full publications reporting either QoL or symptom burden (published 2007–2017; reporting data from ≥ 100 patients) or costs and resource use (published 2012–2017). Relevant QoL studies were those that used the 6-dimension or 8-, 12-, or 36-item Short-Form Health Surveys, 5-dimension EuroQol questionnaire, Healthy Days/Health-Related Quality of Life questionnaire, or Kidney Disease Quality of Life Questionnaire.</ns4:p><ns4:p> <ns4:bold>Results: </ns4:bold>Data were extracted from 95 studies reporting QoL data, 47 studies reporting cost and resource use data, and eight studies reporting descriptions of symptoms; 12 studies (seven QoL; five costs/resource use) reported data for patients with and without CKD, and 15 studies (seven QoL; eight costs/resource use) reported data by disease stage. Patients with CKD, including those with ESRD, had worse QoL than those with normal kidney function, and incurred higher healthcare costs. Disease progression was associated with cost increases, particularly for later stages and in patients receiving dialysis. Increasing CKD severity was also associated with reductions in QoL, although not all studies identified showed a consistent decrease with increasing disease stage.</ns4:p><ns4:p> <ns4:bold>Conclusions: </ns4:bold>The presence of CKD and CKD progression are associated with reductions in patients’ QoL and increased economic impact. This may be mitigated by interventions that slow progression.</ns4:p>

Factors associated with quality of life among chronic kidney disease patients in Nepal: a cross-sectional study

“…A meta-analysis that used information from 109 articles reported that CKD patients who were in the end stage had poorer QOL than those who were in the early stage of the disease. Finally, a systematic literature review reported that CKD patients in the late stages had poorer QOL than CKD patients with in the early stages of the disease [42]. A study performed in the State of Palestine [30] and Greece [43] confirmed that the QOL of CKD patients was affected by the stage of the disease.…”

Chronic Kidney Disease among Diabetes Patients in Ethiopia: A Systematic Review and Meta-Analysis

“…Early detection and treatment of possible risk factors are readily available and often inexpensive. Patients with CKD often suffer from an increased risk of cardiovascular mortality [ 20 ], ischemic heart disease [ 21 ], stroke [ 22 ], peripheral vascular disease [ 23 ], gout [ 24 ], depression and anxiety [ 25 , 26 ], and reductions in patients' quality of life and markedly increases health care costs [ 27 ]. Patients with CKD may eventually progress to end-stage kidney disease (ESKD), which is associated with a high burden of disease and significant costs of treatment [ 28 ].…”

ECHOs of Medication Non-Adherence in Hypertensive Patients: A Systematic Review

“…[33] It is measured using a 6-dimension or 8-, 12-, or 36-item Short-Form Health Surveys, 5-dimension EuroQol questionnaire or Health-Related QoL questionnaire. [34] Reduced Quality of life When hypertension is controlled intensively to maintain the BP values below <140/<90, more serious adverse events occur. It could also lead to a very low pressure.…”