The impact of progressive chronic kidney disease on health-related quality-of-life: a 12-year community cohort study

Wyld, Melanie; Morton, Rachael L.; Clayton, Phil; Jardine, Meg; Polkinghorne, Kevan R.; Chadban, Steve

doi:10.1007/s11136-019-02173-1

Cited by 32 publications

(26 citation statements)

References 30 publications

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“…This finding was despite the significant decline in mental HRQOL during follow-up for all participants. A study from the AusDiab cohort previously reported that a physical decline in HRQOL is dependent on baseline eGFR values [12]. However, we found no association between baseline eGFR and changes in HRQOL over time.…”

Section: Discussioncontrasting

confidence: 92%

“…These domains are then aggregated into two component summary scores; physical health (PCS) and mental health component summaries (MCS), with higher scores reflecting greater self-reported HRQOL. Change in HRQOL was examined using the difference between baseline and follow-up MCS and PCS scores, with score differences of ≥5 considered clinically significant [12].…”

Section: Covariatesmentioning

confidence: 99%

“…Factors associated with medication nonadherence were examined using binary logistic regression, with effect sizes reported using odds ratios (ORs) and 95% confidence intervals (CIs). Factors were included in the final model based on a p-value < 0.1 on univariate analyses or set a priori based on clinical importance and previous research [2,11,12]. The decision-making and information-seeking scales were treated in these analyses both as continuous and categorical variables.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…These outcome measures are particularly relevant in patients with advanced CKD, as they inform treatment goals and modalities [9]. Nevertheless, there is limited data on patient-centred outcomes in people with advanced CKD [9][10][11], particularly in those not receiving renal replacement therapy [12]. More importantly, the relationship between HRQOL and medication-related factors, such as medication burden and adherence, is relatively under-examined in this patient group [13].…”

Section: Introductionmentioning

confidence: 99%

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Medication Adherence, Burden and Health-Related Quality of Life in Adults with Predialysis Chronic Kidney Disease: A Prospective Cohort Study

Tesfaye

McKercher²,

Peterson

et al. 2020

IJERPH

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This study examines the associations between medication adherence and burden, and health-related quality of life (HRQOL) in predialysis chronic kidney disease (CKD). A prospective study targeting adults with advanced CKD (estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2) and not receiving renal replacement therapy was conducted in Tasmania, Australia. The actual medication burden was assessed using the 65-item Medication Regimen Complexity Index, whereas perceived burden was self-reported using a brief validated questionnaire. Medication adherence was assessed using a four-item Morisky-Green-Levine Scale (MGLS) and the Tool for Adherence Behaviour Screening (TABS). The Kidney Disease and Quality of Life Short-Form was used to assess HRQOL. Of 464 eligible adults, 101 participated in the baseline interview and 63 completed a follow-up interview at around 14 months. Participants were predominantly men (67%), with a mean age of 72 (SD 11) years and eGFR of 21 (SD 6) mL/min/1.73 m2. Overall, 43% and 60% of participants reported medication nonadherence based on MGLS and TABS, respectively. Higher perceived medication burden and desire for decision-making were associated with nonadherent behaviour. Poorer HRQOL was associated with higher regimen complexity, whereas nonadherence was associated with a decline in physical HRQOL over time. Medication nonadherence, driven by perceived medication burden, was prevalent in this cohort, and was associated with a decline in physical HRQOL over time.

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Section: Discussioncontrasting

confidence: 92%

Section: Covariatesmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Medication Adherence, Burden and Health-Related Quality of Life in Adults with Predialysis Chronic Kidney Disease: A Prospective Cohort Study

Tesfaye

McKercher²,

Peterson

et al. 2020

IJERPH

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“…In a prospective evaluation of QoL among African-American patients with hypertensive CKD, lower physical and mental composite scores of SF-36 were associated with a composite outcome of cardiovascular events and death [4]. In an Australian study of mainly CKD stage 1-3 patients, lower baseline PCS was associated with increased cardiovascular and all-cause mortality [19]. Our finding is in line with these observations.…”

Section: Discussionsupporting

confidence: 88%

Quality of Life Is Associated with Cardiac Biomarkers, Echocardiographic Indices, and Mortality in CKD Stage 4–5 Patients Not on Dialysis

et al. 2020

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Introduction: Patients with CKD have an impaired health-related quality of life (QoL). Most studies have been conducted on dialysis patients, and less is known about QoL and its determinants in predialysis patients. We studied the association between QoL and comorbidities, cardiac biomarkers, echocardiography, and mortality in patients with CKD stage 4–5 not on dialysis. Methods: A total of 140 patients enrolled in the Chronic Arterial Disease, Quality of Life and Mortality in Chronic Kidney Injury (CADKID) study filled the Kidney Disease Quality of Life Short Form (KDQOL-SF) at the beginning of the study. Echocardiography and biochemical parameters were obtained at baseline. Patients were followed up for at least 2 years or until death. Results: The median age was 66 years, and 51 (36%) patients were female. The median estimated glomerular filtration rate was 13 mL/min per 1.73 m2. Obesity, diabetes, atrial fibrillation, and congestive heart failure were associated with lower QoL scores in multiple KDQOL-SF domains. Cardiac biomarkers, troponin T (p = 0.02), N-terminal pro-B-type natriuretic peptide (p = 0.006), and the echocardiographic parameter of cardiac systolic function left ventricular global longitudinal strain (p = 0.02) were significant predictors of lower physical component summary (PCS) score in multivariable regression models after controlling for age, BMI, and diabetes. A low PCS score predicted mortality in a multivariable Cox proportional hazards model [HR 0.96 (95% CI 0.92–0.99), p = 0.03]. QoL was not associated with kidney disease progression. Conclusion: Impaired QoL in CKD stage 4–5 patients not on dialysis is associated with cardiac biomarker levels, echocardiographic indices, and mortality.

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Community Social Capital and Population Health Outcomes

Linde,

Egede

2023

JAMA Netw Open

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ImportanceWhile the association between economic connectedness and social mobility has now been documented, the potential linkage between community-level economic connectedness and population health outcomes remains unknown.ObjectiveTo examine the association between community social capital measures (defined as economic connectedness, social cohesion, and civic engagement) and population health outcomes (defined across prevalence of diabetes, hypertension, high cholesterol, kidney disease, and obesity).Design, Setting, and ParticipantsThis cross-sectional study included communities defined at the zip code tabulation area (ZCTA) level in all 50 US states. Data were collected from January 2021 to December 2022.Main Outcomes and MeasuresMultivariable regression analyses were used to examine the association between population health outcomes and social capital. Adjusted analyses controlled for area demographic variables and county fixed effects. Heterogeneities within the associations based on the racial and ethnic makeup of communities were also examined.ResultsIn this cross-sectional study of 17 800 ZCTAs, across 50 US states, mean (SD) economic connectedness was 0.88 (0.32), indicating friendship sorting on income; the mean (SD) support ratio was 0.90 (0.10), indicating that 90% of ties were supported by a common friendship tie; and the mean (SD) volunteering rate was 0.08 (0.03), indicating that 8% of individuals within a given community were members of volunteering associations. Mean (SD) ZCTA diabetes prevalence was 10.8% (2.9); mean (SD) high blood pressure prevalence was 33.2% (6.2); mean (SD) high cholesterol prevalence was 32.7% (4.2), mean (SD) kidney disease prevalence was 3.0% (0.7), and mean (SD) obesity prevalence was 33.4% (5.6). Regression analyses found that a 1% increase in community economic connectedness was associated with significant decreases in prevalence of diabetes (−0.63%; 95% CI, −0.67% to −0.60%); hypertension (−0.31%; 95% CI, −0.33% to −0.29%); high cholesterol (−0.14%; 95% CI, −0.15% to −0.12%); kidney disease (−0.48%; 95% CI, −0.50% to −0.46%); and obesity (−0.28%; 95% CI, −0.29% to −0.27%). Second, a 1% increase in the community support ratio was associated with significant increases in prevalence of diabetes (0.21%; 95% CI, 0.16% to 0.26%); high blood pressure (0.16%; 95% CI, 0.13% to 0.19%); high cholesterol (0.16%; 95% CI, 0.13% to 0.19%); kidney disease (0.17%; 95% CI, 0.13% to 0.20%); and obesity (0.08%; 95% CI, 0.06% to 0.10%). Third, a 1% increase in the community volunteering rate was associated with significant increases in prevalence of high blood pressure (0.02%; 95% CI, 0.01% to 0.02%); high cholesterol (0.03%; 95% CI, 0.02% to 0.03%); and kidney disease (0.02%; 95% CI, 0.01% to 0.02%). Additional analyses found that the strength of these associations varied based on the majority racial and ethnic population composition of communities.Conclusions and RelevanceIn this study, higher economic connectedness was significantly associated with better population health outcomes; however, higher community support ratios and volunteering rates were both significantly associated with worse population health. Associations also differed by majority racial and ethnic composition of communities.

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The impact of progressive chronic kidney disease on health-related quality-of-life: a 12-year community cohort study

Cited by 32 publications

References 30 publications

Medication Adherence, Burden and Health-Related Quality of Life in Adults with Predialysis Chronic Kidney Disease: A Prospective Cohort Study

Medication Adherence, Burden and Health-Related Quality of Life in Adults with Predialysis Chronic Kidney Disease: A Prospective Cohort Study

Quality of Life Is Associated with Cardiac Biomarkers, Echocardiographic Indices, and Mortality in CKD Stage 4–5 Patients Not on Dialysis

Community Social Capital and Population Health Outcomes

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