Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2010 Mar;19(2):153-9.
doi: 10.1097/MNH.0b013e328335f939.

Health-related quality of life outcomes in chronic kidney disease

Ritu K Soni  1 , Steven D Weisbord, Mark L Unruh
Affiliations
Review

Health-related quality of life outcomes in chronic kidney disease

Ritu K Soni et al. Curr Opin Nephrol Hypertens. 2010 Mar.

Abstract

Purpose of review: Patients with chronic kidney disease (CKD) endure compromised health-related quality of life (HRQOL). Although the link between HRQOL and increased mortality in patients with end-stage renal disease (ESRD) is well documented, less is known about the relationship between CKD and HRQOL. This article reviews the recent evidence on HRQOL, its correlates and proposed intervention strategies to improve HRQOL in CKD.

Recent findings: A growing body of literature indicates that various comorbid conditions related to CKD play a substantial role in impaired HRQOL in CKD. Hypertension, both a cause and complication of CKD, negatively affects HRQOL due to associated comorbidities, side effects from antihypertensive medications and awareness of the diagnosis. Anemia has been associated with HRQOL, but concerns about the safety of erythropoietin-stimulating agents (ESAs) have led to more conservative anemia treatment. Frailty, symptom burden and depression are also major contributory factors to HRQOL in CKD.

Summary: Certain determinants of HRQOL in CKD, namely anemia and depression, are treatable. Early identification and correction may improve overall well being of patients. Clinical trials are required to demonstrate whether treatment interventions benefit HRQOL in this high-risk population. Furthermore, whether integration of HRQOL assessment into routine clinical practice will improve HRQOL outcomes remains to be determined.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Factors contributing to health-related quality of life in chronic kidney disease (ORIGINAL)
Figure 2
Figure 2
Examples of several domains of the health-related quality of life (HRQOL) showing the progressive decline in scores with the more advanced stages of chronic kidney disease (CKD). Statistical significant values are for the trend across the three CKD stages.
Figure 3
Figure 3
Changes from baseline to Year 1 in Short Form Survey Instrument (SF-36) Health related Quality of Life Scores with erythropoietin treatment for anemic CKD patients in the CREATE Study [33*]. Group 1: Target hemoglobin range 13–15 g/dL. Group 2: Target hemoglobin range 10.5–11.5 g/dL. Positive changes indicate improvement in, and negative changes worsening of, the health related quality of life.
See this image and copyright information in PMC

References

    1. Mujais SK, Story K, Brouillette J, et al. Health-related quality of life in CKD Patients: correlates and evolution over time. Clin J Am Soc Nephrol. 2009 Aug;4(8):1293–1301. This is one of the few large scale studies documenting the impaired HRQOL in CKD. Furthermore, HRQOL declined over time. Age, co-morbidities, hemoglobin and albumin level were the main predictors of HRQOL. - PMC - PubMed
    1. Finkelstein FO, Wuerth D, Finkelstein SH. Health related quality of life and the CKD patient: challenges for the nephrology community. Kidney Int. 2009 Aug 12; - PubMed
    1. O’Shaughnessy DV, Elder GJ. Review article: Patient-level outcomes: the missing link. Nephrology (Carlton) 2009 Jun;14( 4):443–451. - PubMed
    1. Liem YS, Bosch JL, Hunink MG. Preference-based quality of life of patients on renal replacement therapy: a systematic review and meta-analysis. Value Health. 2008 Jul–Aug;11(4):733–741. - PubMed
    1. Tamura MK. Incidence, management, and outcomes of end-stage renal disease in the elderly. Curr Opin Nephrol Hypertens. 2009 May;18( 3):252–257. - PMC - PubMed

Publication types