The Relationship Between Chronic Kidney Disease, Symptoms and Health‐Related Quality of Life: A Systematic Review

Yapa, Harith Eranga; Purtell, Louise; Chambers, Shirley; Bonner, Ann

doi:10.1111/jorc.12303

Cited by 31 publications

(31 citation statements)

References 35 publications

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“…Former studies clearly showed that end-stage renal disease and dialysis are associated with low QoL [15,16,40,41], and few studies reported that even early stages of CKD may significantly affect QoL [17][18][19][20]. Our findings are clearly different from that reported in a recent cross-sectional analysis of the Irish Longitudinal Study on Ageing showing that creatinine-based eGFR may contribute little to QoL [42].…”

Section: Discussioncontrasting

confidence: 99%

“…The few studies investigating the impact of early stages of CKD on QoL show that QoL may be poorer than that of the general population, but better than for CKD patients on dialysis [18,19]. In a recent systematic review, Yapa et al [20] showed that health-related QoL may worsen when CKD symptoms (e.g. fatigue, exhaustion and drowsiness) appear.…”

Section: Introductionmentioning

confidence: 99%

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Impaired kidney function is associated with lower quality of life among community-dwelling older adults

et al. 2020

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Background Quality of life (QoL) refers to the physical, psychological, social and medical aspects of life that are influenced by health status and function. The purpose of this study was to measure the self-perceived health status among the elderly population across Europe in different stages of Chronic Kidney Disease (CKD). Methods Our series consisted of 2255 community-dwelling older adults enrolled in the Screening for Chronic Kidney Disease (CKD) among Older People across Europe (SCOPE) study. All patients underwent a comprehensive geriatric assessment (CGA), including included demographics, clinical and physical assessment, number of medications taken, family arrangement, Geriatric Depression Scale (GDS), Cumulative Illness Rating Scale, History of falls, Lower urinary tract symptoms, and Short Physical Performance Battery (SPPB). Estimated glomerular filtration rate (eGFR) was calculated by Berlin Initiative Study (BIS) equation. Quality of life was assessed by Euro Qol questionnaire (Euro-Qol 5D) and EQ-Visual Analogue Scale (EQ-VAS). The association between CKD (eGFR < 60, < 45 ml or < 30 ml/min/1.73m2) and low EQoL-VAS was investigated by multivariable logistic regression models. Results CKD was found to be significantly associated with low EQoL-VAS in crude analysis (OR = 1.47, 95%CI = 1.16–1.85 for eGFR< 60; OR = 1.38, 95%CI = 1.08–1.77 for eGFR< 45; OR = 1.57, 95%CI = 1.01–2.44). Such association was no longer significant only when adjusting for SPPB (OR = 1.20, 95%CI = 0.93–1.56 for eGFR< 60; OR = 0.87, 95%CI = 0.64–1.18 for eGFR< 45; OR = 0.84, 95%CI = 0.50–1.42), CIRS and polypharmacy (OR = 1.16, 95%CI = 0.90–1.50 for eGFR< 60; OR = 0.86, 95%CI = 0.64–1.16 for eGFR< 45; OR = 1.11, 95%CI = 0.69–1.80) or diabetes, hypertension and chronic obstructive pulmonary disease (OR = 1.28, 95%CI = 0.99–1.64 for eGFR< 60; OR = 1.16, 95%CI = 0.88–1.52 for eGFR< 45; OR = 1.47, 95%CI = 0.92–2.34). The association between CKD and low EQoL-VAS was confirmed in all remaining multivariable models. Conclusions CKD may significantly affect QoL in community-dwelling older adults. Physical performance, polypharmacy, diabetes, hypertension and COPD may affect such association, which suggests that the impact of CKD on QoL is likely multifactorial and partly mediated by co-occurrent conditions/risk factors.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impaired kidney function is associated with lower quality of life among community-dwelling older adults

et al. 2020

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“…As highlighted in a recent systematic review (Yapa et al, 2020), more studies are needed to investigate how symptoms and HRQoL change across the CKD trajectory. This study, therefore, aimed to compare symptom burden and HRQoL and to examine the relationship between these at CKD G3b, G4, G5 and G5D.…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…Although the participants in these two studies were limited to those with CKD G4, G5 and G5D, both studies found that a decrease in HRQoL when symptoms increased. As highlighted in a recent systematic review (Yapa et al, 2020), more studies are needed to investigate how symptoms and HRQoL change across the CKD trajectory. This study, therefore, aimed to compare symptom burden and HRQoL and to examine the relationship between these at CKD G3b, G4, G5 and G5D.…”

Section: Introductionmentioning

confidence: 99%

Alterations in symptoms and health‐related quality of life as kidney function deteriorates: A cross‐sectional study

Yapa

Purtell

Chambers

et al. 2021

Journal of Clinical Nursing

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Aims and objectives To compare symptoms and health‐related quality of life and to examine the relationship between these as kidney function deteriorates. Background Chronic kidney disease is a global health problem, and while knowledge of symptom burden and health‐related quality of life is understood in kidney failure (previously end‐stage kidney disease), there is limited understanding about symptoms and health‐related quality of life across the chronic kidney disease trajectory. Design Cross‐sectional design reported using the STROBE guidelines. Methods Eight hundred eighty‐six adults with varying levels of kidney function (chronic kidney disease grades 3b–5 including those receiving dialysis) completed the renal version of the Integrated Palliative care Outcome Scale and the Quality of Life Short Form‐36 version 2. Socio‐demographic and renal characteristics were also collected. Data were analysed using descriptive and inferential statistics. Results Participants had a mean age of 57 years and were mostly male. Regardless of chronic kidney disease grade, pain, poor mobility, weakness, anxiety and depression were the most prevalent and severe symptoms reported. Health‐related quality of life was significantly associated with physical and psychological symptom scores. As kidney function deteriorated, both physical and mental health‐related quality of life decreased, and prevalence and severity of symptoms increased. Conclusions There is substantial symptom burden irrespective of chronic kidney disease grade, which overwhelmingly affects health‐related quality of life. Early identification by nurses would enable proactive management plans to be implemented. Relevance to clinical practice Nurses, whether in specialist renal services or in primary healthcare, are ideally placed to regularly assess symptoms and health‐related quality of life in those with chronic kidney disease. Timely assessment could assist in the targeting of earlier interventions designed to reduce symptom burden and to increase health‐related quality of life.

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“…HR-QOL is defined as an individual or group’s perceived physical and mental health over the duration of a disease 11 . Since HR-QOL is relative to the severity of the patient’s perceived symptoms, HR-QOL itself can be a clinical outcome indicator 12 . CKD is a disease with particularly low HR-QOL.…”

Section: Introductionmentioning

confidence: 99%

Low serum adiponectin level is associated with better physical health-related quality of life in chronic kidney disease

Kim

Han²,

Kim

et al. 2021

Sci Rep

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Hyperadiponectemia is paradoxically associated with renal disease progression and mortality in chronic kidney disease (CKD). Its association with health-related quality of life (HR-QOL) is unknown. This study aimed to verify the association between adiponectin and HR-QOL in Korean pre-dialysis CKD cohort. This cross-sectional study analyzed 1551 pre-dialysis CKD patients from KNOW-CKD (KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease). Participants were categorized into three tertiles (T1–T3) according to adiponectin levels. HR-QOL was assessed using SF-36. High physical component summary (PCS) and mental component summary (MCS) were defined as highest quartile of each score. Multivariate logistic regression was used to analyze odds ratio (OR) and 95% confidence interval (CI) for high PCS and MCS. Prevalence of high PCS were 33.3%, 27.5%, and 17.0% and that of high MCS were 31.7%, 24.8%, and 21.3% for T1, T2, and T3 (both p for trend < 0.001). The adjusted OR [95% CI] of T1 and T2 in reference to T3 were 1.56 [1.09–2.23] and 1.19 [0.85–1.68] for high PCS and 1.19 [0.85–1.68] and 0.94 [0.68–1.29] for high MCS. Serum adiponectin level was inversely associated with physical HR-QOL in Korean pre-dialysis CKD patients. This relationship was independent of various cardiovascular risk factors.

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The Relationship Between Chronic Kidney Disease, Symptoms and Health‐Related Quality of Life: A Systematic Review

Cited by 31 publications

References 35 publications

Impaired kidney function is associated with lower quality of life among community-dwelling older adults

Impaired kidney function is associated with lower quality of life among community-dwelling older adults

Alterations in symptoms and health‐related quality of life as kidney function deteriorates: A cross‐sectional study

Low serum adiponectin level is associated with better physical health-related quality of life in chronic kidney disease

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