Psychosocial Health and Lifestyle Behaviors in Young Adults Receiving Renal Replacement Therapy Compared to the General Population: Findings From the SPEAK Study

Abstract

Patients in late adolescence and early adulthood receiving renal replacement therapy (RRT) face disruption to normal activities, which affects well-being. We aimed to define psychosocial and lifestyle outcomes for young adults on RRT compared to the general population. Study Design: We undertook a cross-sectional survey (the SPEAK [Surveying Patients Experiencing Young Adult Kidney Failure] Study) using validated measures and general population comparator data from the Health Survey for England and Avon Longitudinal Study of Parents and Children. Additional clinical information was obtained from the UK Renal Registry.

Associations with Wellbeing and Medication Adherence in Young Adults Receiving Kidney Replacement Therapy

“…Further, there is large potential for health and health care improvements for young adults because of their longer life expectancy compared with older adults receiving KRT. Psychologic problems may be under-recognized; using the GHQ-12 as a screening tool, 31% of young adults on KRT had psychologic morbidity, but only 17% reported their condition affected their mental health (2). Therefore, opportunities to identify and improve mental health may be being missed.…”

“…We designed a cross-sectional online self-completion survey for participants aged 16-30 years old receiving KRT in the UK, after an initial pilot. The survey comprised questions (in English) from validated health surveys (reported elsewhere [2]) with comparable normative data. Additional scales and tools covering aspects of chronic disease were also included (described in Supplemental Table 1).…”

“…The main reasons for study nonparticipation (data available from 48 sites) were (1) no response to the invitation letter (14%), (2) participation declined (9%), and (3) the participant could not be contacted (6%). The survey response rate was 64% (625 out of 976) and has been described previously (2). There were 2072 young adults known to the UKRR who did not participate, so our sample comprises 21% of the total eligible population.…”

“…The cohort comprised 417 (71%) patients with transplants and 173 (29%) on dialysis, and has been previously described (2). Survey participants were 51% men and 74% white, with a median age of 25 years.…”

“…ESKD affects the psychosocial health of young adults aged 16-30 years receiving kidney replacement therapy (KRT). A recent systematic review demonstrated lower quality of life (QoL) compared with the general population, particularly for patients on dialysis (1,2). We have previously reported that young adults on KRT have lower mental wellbeing and were twice as likely to have psychologic morbidity (defined by a score $4 on the 12-item General Health Questionnaire [GHQ-12]) compared with the age-and sex-matched general population, again more pronounced for patients on dialysis (2).…”