Nonmedical Factors and Health-Related Quality of Life in CKD in India

Modi, Gopesh K.; Yadav, Ashok Kumar; Ghosh, Arpita; Kamboj, K.; Kaur, Prabhjot; Kumar, Vivek; Bhansali, Shobhit; Prasad, Narayan; Sahay, Manisha; Parameswaran, Sreejith; Varughese, Santosh; Gang, Sishir; Singh, Shivendra Kumar; Sircar, Dipankar; Gopalakrishnan, Natarajan; Jaryal, Ajay; Vikrant, Sanjay; Agarwal, Seema Baid; Jha, Vivekanand

doi:10.2215/cjn.06510619

Cited by 21 publications

(11 citation statements)

References 17 publications

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“…Meanwhile, the results of stepwise multiple regression models showed that financial burden was an independent predictor of QOL. This was consistent with the study of Modi et al 41 With the increase of medical insurance coverage in China, patients can reimburse most of expenses. However, for these patients with lower socioeconomic status, characterized by lower education, worse financial situation, or lack of employment, still cannot afford therapy, which can affect their adherence.…”

Section: Discussionsupporting

confidence: 92%

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Chronic Pain and Quality of Life in Maintenance Hemodialysis Patients in China: A Multicenter, Cross-Sectional Study

Rao¹,

Zeng²,

Wang³

et al. 2022

JPR

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Purpose Patients undergoing maintenance hemodialysis (MHD) frequently experience chronic pain, which can severely affect their quality of life (QOL). The objective of this study was to evaluate the prevalence of chronic pain in MHD patients and examine the factors associated with QOL. Patients and Methods A cross-sectional questionnaire-based survey was conducted between October 2020 and April 2021, 1204 MHD patients from nine hemodialysis units were screened for chronic pain in Chengdu, China, and 296 MHD patients with chronic pain were enrolled in this study. We analyzed data on clinicodemographic characteristics, pain interference and severity (Brief Pain Inventory), QOL (Medical Outcomes Study 36-item Short Form Health Survey - mental component summary [MCS] and physical component summary [PCS]), pain self-efficacy (Pain Self-Efficacy Questionnaire), and social support (Social Support Rating Scale). Results The prevalence of chronic pain in MHD patients was 26.74% in this study. The most common areas of pain were lower back (63.5%), lower limbs (55.0%), and head (33.5%), 36.5% did not implement any measures to relieve it. Of the patients who did receive pain treatment or medication, 56.9% reported that the measures they took had less than half of the pain relief. MHD patients with chronic pain had poor QOL based on scores on the MCS (53 ± 16.76) and PCS (40.56 ± 13.81). Stepwise multiple regression identified age, financial strain, pain interference, social support, and pain self-efficacy as independent predictors of QOL. Pain self-efficacy was significantly associated with social support ( r = 0.5, p < 0.01), MCS ( r = 0.69, p < 0.01), and PCS ( r = 0.8, p < 0.01). The mediating effects of pain self-efficacy were 70.31% on the relationship between social support and MCS, and 75.62% on the relationship between social support and PCS. Conclusion Chronic pain is prevalent and undermanaged in Chinese MHD patients, resulting in worse QOL. Healthcare providers should focus on pain management and the impact of psychosocial factors on patient QOL. Further research should deepen our understanding of how pain self-efficacy mediates the relationship between social support and QOL.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Chronic Pain and Quality of Life in Maintenance Hemodialysis Patients in China: A Multicenter, Cross-Sectional Study

Rao¹,

Zeng²,

Wang³

et al. 2022

JPR

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“…The baseline characteristics show unique features that differentiate this population from patients with CKD enrolled in other cohort studies. Given the high and growing disease burden, a relatively rapid rate of progression, the high cost of care and the impact on quality of life [ 39 ], data from this study will provide important information to help the national strategy to manage CKD in India. In addition to defining outcomes and finding factors that associate with adverse outcomes in patients with CKD in low-resource settings, the ICKD study offers opportunities for international comparisons to further the goals of the global nephrology community.…”

Section: Discussionmentioning

confidence: 99%

The Indian Chronic Kidney Disease (ICKD) study: baseline characteristics

Kumar

Yadav

Sethi

et al. 2021

Clinical Kidney Journal

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Background Chronic kidney disease (CKD) is an important cause of morbidity and mortality worldwide. There is lack of information on epidemiology and progression of CKD in low-middle income countries. The Indian Chronic Kidney Disease (ICKD) study aims to identify factors that associate with CKD progression, and development of kidney failure and cardiovascular disease (CVD) in Indian CKD patients . Methods ICKD study is prospective, multicentric, cohort study enrolling patients with estimated glomerular filtration rate (eGFR) 15-60 ml/min/1.73m2 or > 60 ml/min/1.73m2 with proteinuria. Clinical details and biological samples are collected at annual visit. We analysed the baseline characteristics including socio-demographic details, risk factors, disease characteristics and laboratory measurements. In addition, we compared characteristics between urban and rural participants. Results A total of 4056 patients have been enrolled till March 31, 2020. The age was 50.3 ±11.8 years, 67.2% were males, 2/3 lived in rural areas and median eGFR was 40 ml/min/1.73m2. About 87% were hypertensive, 37% had diabetes, 22% had CVD, 6.7% had past history of acute kidney injury and 23% reported prior use of alternative drugs. Diabetic kidney disease, chronic interstitial nephritis and CKD-cause unknown were the leading causes. Rural participants had more occupational exposure and tobacco use but lower educational status and income. CIN and unknown categories were leading causes in rural participants. Conclusions The ICKD study is the only large cohort study of patients with mild-to-moderate CKD in a lower-middle income country. Baseline characteristics of study population reveal differences as compared to other cohorts.

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“…The PF, RF, BP, and GH subscales were summarized in a physical component summary (PCS), while the VT, SF, RE and MH subscales were summarized in a mental component summary (MCS). We defined low HRQOL as an SF-36 score > one standard deviation (SD) below the mean, referring to previous studies with CKD patients 17 , 18 . Likewise, we defined low physical health and low mental health as PCS scores and MCS scores > one SD below the mean, respectively.…”

Section: Methodsmentioning

confidence: 99%

Depression is a main determinant of health-related quality of life in patients with diabetic kidney disease

Kim

Jeon

Lee

et al. 2022

Sci Rep

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Low health-related quality of life (HRQOL) is associated with adverse outcomes in diabetic kidney disease (DKD) patients. We examined the modifiable factors associated with low HRQOL in these patients. We enrolled 141 DKD patients. HRQOL was assessed with the Short Form 36 (SF-36) questionnaire. Low HRQOL was defined as a score > one standard deviation below the mean. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS-D and HDAS-A, respectively). The patients’ median age was 65 years, and 73% were men. The prevalence rates of anxiety and depression were 8% (n = 11) and 17% (n = 24), respectively. Forty (28%) patients were identified as poor sleepers, and 40 (28%) had low physical activity levels. Anxiety, depression, and poor sleep quality were negatively correlated with SF-36 scores. Higher levels of physical activity and the estimated glomerular filtration rate (eGFR) were correlated with higher SF-36 scores, which indicated better health status. Higher depression scores (HADS-D scores) were associated with low HRQOL, independent of factors including age, sex, smoking status, comorbidities, eGFR, anemia, sleep quality, anxiety levels, and physical activity levels (odds ratio, 1.43; 95% confidence interval, 1.17–1.75). Among the clinical and psycho-physical factors, depression was a main determinant of low HRQOL in DKD patients.

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Nonmedical Factors and Health-Related Quality of Life in CKD in India

Cited by 21 publications

References 17 publications

Chronic Pain and Quality of Life in Maintenance Hemodialysis Patients in China: A Multicenter, Cross-Sectional Study

Chronic Pain and Quality of Life in Maintenance Hemodialysis Patients in China: A Multicenter, Cross-Sectional Study

The Indian Chronic Kidney Disease (ICKD) study: baseline characteristics

Depression is a main determinant of health-related quality of life in patients with diabetic kidney disease

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