BACKGROUND AND OBJECTIVES: Low health-related quality of life is associated with increased mortality in patients with ESRD. However, little is known about demographic and clinical factors associated with health-related quality of life or its effect on outcomes in adults with CKD. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: Data from 3837 adult participants with mild to severe CKD enrolled in the prospective observational Chronic Renal Insufficiency Cohort and Hispanic Chronic Renal Insufficiency Cohort Studies were analyzed. Health-related quality of life was assessed at baseline with the Kidney Disease Quality of Life-36 and its five subscales: mental component summary, physical component summary, burden of kidney disease (burden), effects of kidney disease (effects), and symptoms and problems of kidney disease (symptoms). Low health-related quality of life was defined as baseline score >1 SD below the mean. Using Cox proportional hazards analysis, the relationships between low health-related quality of life and the following outcomes were examined: (1) CKD progression (50% eGFR loss or incident ESRD), (2) incident cardiovascular events, and (3) all-cause death. RESULTS: Younger age, women, low education, diabetes, vascular disease, congestive heart failure, obesity, and lower eGFR were associated with low baseline health-related quality of life (P<0.05). During a median follow-up of 6.2 years, there were 1055 CKD progression events, 841 cardiovascular events, and 694 deaths. Significantly higher crude rates of CKD progression, incident cardiovascular events, and all-cause death were observed among participants with low health-related quality of life in all subscales (P<0.05). In fully adjusted models, low physical component summary, effects, and symptoms subscales were independently associated with a higher risk of incident cardiovascular events and death, whereas low mental component summary was independently associated with a higher risk of death (P<0.05). Low health-related quality of life was not associated with CKD progression. CONCLUSIONS: Low health-related quality of life across several subscales was independently associated with a higher risk of incident cardiovascular events and death but not associated with CKD progression.
BACKGROUND AND OBJECTIVES: Low health-related quality of life is associated with increased mortality in patients with ESRD. However, little is known about demographic and clinical factors associated with health-related quality of life or its effect on outcomes in adults with CKD. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: Data from 3837 adult participants with mild to severe CKD enrolled in the prospective observational Chronic Renal Insufficiency Cohort and Hispanic Chronic Renal Insufficiency Cohort Studies were analyzed. Health-related quality of life was assessed at baseline with the Kidney Disease Quality of Life-36 and its five subscales: mental component summary, physical component summary, burden of kidney disease (burden), effects of kidney disease (effects), and symptoms and problems of kidney disease (symptoms). Low health-related quality of life was defined as baseline score >1 SD below the mean. Using Cox proportional hazards analysis, the relationships between low health-related quality of life and the following outcomes were examined: (1) CKD progression (50% eGFR loss or incident ESRD), (2) incident cardiovascular events, and (3) all-cause death. RESULTS: Younger age, women, low education, diabetes, vascular disease, congestive heart failure, obesity, and lower eGFR were associated with low baseline health-related quality of life (P<0.05). During a median follow-up of 6.2 years, there were 1055 CKD progression events, 841 cardiovascular events, and 694 deaths. Significantly higher crude rates of CKD progression, incident cardiovascular events, and all-cause death were observed among participants with low health-related quality of life in all subscales (P<0.05). In fully adjusted models, low physical component summary, effects, and symptoms subscales were independently associated with a higher risk of incident cardiovascular events and death, whereas low mental component summary was independently associated with a higher risk of death (P<0.05). Low health-related quality of life was not associated with CKD progression. CONCLUSIONS: Low health-related quality of life across several subscales was independently associated with a higher risk of incident cardiovascular events and death but not associated with CKD progression.
Authors: Rachel L Perlman; Fredric O Finkelstein; Lei Liu; Erik Roys; Margaret Kiser; George Eisele; Sally Burrows-Hudson; Joseph M Messana; Nathan Levin; Sanjay Rajagopalan; Friedrich K Port; Robert A Wolfe; Rajiv Saran Journal: Am J Kidney Dis Date: 2005-04 Impact factor: 8.860
Authors: Anna Porter; Michael J Fischer; Deborah Brooks; Marino Bruce; Jeanne Charleston; William H Cleveland; Donna Dowie; Marquetta Faulkner; Jennifer Gassman; Tom Greene; Leena Hiremath; Cindy Kendrick; John W Kusek; Denyse Thornley-Brown; Xuelei Wang; Keith Norris; Mark Unruh; James Lash Journal: Transl Res Date: 2011-10-12 Impact factor: 7.012
Authors: Antonio Alberto Lopes; Jennifer L Bragg-Gresham; Sudtida Satayathum; Keith McCullough; Trinh Pifer; David A Goodkin; Donna L Mapes; Eric W Young; Robert A Wolfe; Philip J Held; Friedrich K Port Journal: Am J Kidney Dis Date: 2003-03 Impact factor: 8.860
Authors: Ana C Ricardo; Eileen Hacker; Claudia M Lora; Lynn Ackerson; Karen B DeSalvo; Alan Go; John W Kusek; Lisa Nessel; Akinlolu Ojo; Raymond R Townsend; Dawei Xie; Carol E Ferrans; James P Lash Journal: Ethn Dis Date: 2013 Impact factor: 1.847
Authors: James P Lash; Alan S Go; Lawrence J Appel; Jiang He; Akinlolu Ojo; Mahboob Rahman; Raymond R Townsend; Dawei Xie; Denise Cifelli; Janet Cohan; Jeffrey C Fink; Michael J Fischer; Crystal Gadegbeku; L Lee Hamm; John W Kusek; J Richard Landis; Andrew Narva; Nancy Robinson; Valerie Teal; Harold I Feldman Journal: Clin J Am Soc Nephrol Date: 2009-06-18 Impact factor: 8.237
Authors: Julie M Paik; Elisabetta Patorno; Min Zhuo; Lily G Bessette; Cassandra York; Nileesa Gautam; Dae Hyun Kim; Seoyoung C Kim Journal: Pharmacoepidemiol Drug Saf Date: 2021-12-23 Impact factor: 2.890
Authors: Kirsten S Dorans; Julie A Wright Nunes; Douglas E Schaubel; Daohang Sha; Sarah J Schrauben; Robert G Nelson; Panduranga S Rao; Debbie L Cohen; Lawrence J Appel; James P Lash; Mahboob Rahman; Harold I Feldman Journal: Kidney360 Date: 2022-05-24
Authors: Mary Hannan; Sajid Ansari; Natalie Meza; Amanda H Anderson; Anand Srivastava; Sushrut Waikar; Jeanne Charleston; Matthew R Weir; Jonathan Taliercio; Edward Horwitz; Milda R Saunders; Katherine Wolfrum; Harold I Feldman; James P Lash; Ana C Ricardo Journal: Clin J Am Soc Nephrol Date: 2020-11-11 Impact factor: 8.237