Biopsychosocial Factors Associated with Activities of Daily Living Limitations in Chronic Kidney Disease Patients: Insights from the Brazilian Population

Abstract

Chronic kidney disease (CKD) can impair activities of daily living (ADL), reducing quality of life. The influence of biopsychosocial factors on ADL limitations among CKD patients remains unclear. This study aims to investigate associations between these factors and ADL limitations among CKD patients in the Brazilian population. We analyzed data from 839 individuals diagnosed with CKD obtained from the National Health Survey. The outcome was the presence or absence of limitations in ADL caused by CKD. Biopsychosocial factors included clinical and health status, self-perceived behavior, contextual social support, lifestyle, and household characteristics. Cox regression was employed to adjust interactions between these factors, with the prevalence ratio used as a measure of effect (α ≤ 5%). From the analyzed sample, 373 CKD patients (40.7%; 95% CI: 35.4-46.1%) reported experiencing limitations in ADL. These limitations were associated with individual and contextual factors, including lack of private health insurance, residing in a rural area, poorer self-perceived health, presence of depressive symptoms, physical/mental disabilities, use of medications, and undergoing hemodialysis. Limitations in ADL among individuals with CKD are associated with biopsychosocial factors in the Brazilian population, emphasizing the necessity for public policies that support enhanced therapeutic management and address behavioral health.

Keywords: chronic kidney disease; chronic limitation of activity; public policy; quality of life.