Melanie L R Wyld1,2, Rachael L Morton3, Phil Clayton4,5, Muh Geot Wong6, Meg Jardine6,7, Kevan Polkinghorne8, Steve Chadban9,10,5. 1. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Melanie.Wyld@health.nsw.gov.au. 2. Royal Prince Alfred Hospital, Sydney, NSW, Australia. Melanie.Wyld@health.nsw.gov.au. 3. NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia. 4. Royal Adelaide Hospital, Adelaide, Australia. 5. Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Royal Adelaide Hospital, Adelaide, Australia. 6. The George Institute for Global Health, Sydney, NSW, Australia. 7. Concord Repatriation Hospital, Sydney, NSW, Australia. 8. Monash Medical Centre and Monash University, Clayton, VIC, Australia. 9. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. 10. Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Abstract
PURPOSE: Quality-of-life is poor in end-stage kidney disease; however, the relationships between earlier stages of chronic kidney disease (CKD) and are poorly understood. This study explored longitudinal quality-of-life changes in a community-based CKD cohort and assessed associations between CKD and quality-of-life over time, and between baseline quality-of-life and CKD outcomes. METHODS: We used the Australian diabetes, obesity and lifestyle study-a nationally representative, prospective cohort with data collected at baseline, year 5 and year 12-to examine the relationships between CKD stage, quality-of-life and outcomes. Linear mixed regression, cox proportional hazards, Kaplan-Meier and competing risks analyses were used. RESULTS: Of 1112 participants with CKD and baseline quality-of-life data, the physical component summary (PCS) score was significantly lower than for the general population (p = 0.01 age and sex adjusted), while the mental component summary (MCS) score was no different (p = 0.9 age and sex adjusted). In our unadjusted mixed effects model, more advanced kidney disease was associated with lower PCS and higher MCS at baseline (p < 0.001 and p < 0.01, respectively); however, this effect was no longer significant after adjustment for demographic and clinical variables. The rate of decline in PCS over the period of follow-up was greatest for those with more advanced kidney disease (p < 0.001 in unadjusted model, p = 0.007 in adjusted model). There was no association between change in MCS over the period of follow-up and severity of kidney disease in either the unadjusted or adjusted model (p = 0.7 and p = 0.1, respectively). Lower PCS, but not MCS, was associated with increased cardiovascular and increased all-cause mortality even after adjustment for key demographic and clinical variables (p < 0.001). CONCLUSIONS: Physical, but not mental, quality-of-life is significantly impaired in CKD, and continues to decline with disease progression.
PURPOSE: Quality-of-life is poor in end-stage kidney disease; however, the relationships between earlier stages of chronic kidney disease (CKD) and are poorly understood. This study explored longitudinal quality-of-life changes in a community-based CKD cohort and assessed associations between CKD and quality-of-life over time, and between baseline quality-of-life and CKD outcomes. METHODS: We used the Australian diabetes, obesity and lifestyle study-a nationally representative, prospective cohort with data collected at baseline, year 5 and year 12-to examine the relationships between CKD stage, quality-of-life and outcomes. Linear mixed regression, cox proportional hazards, Kaplan-Meier and competing risks analyses were used. RESULTS: Of 1112 participants with CKD and baseline quality-of-life data, the physical component summary (PCS) score was significantly lower than for the general population (p = 0.01 age and sex adjusted), while the mental component summary (MCS) score was no different (p = 0.9 age and sex adjusted). In our unadjusted mixed effects model, more advanced kidney disease was associated with lower PCS and higher MCS at baseline (p < 0.001 and p < 0.01, respectively); however, this effect was no longer significant after adjustment for demographic and clinical variables. The rate of decline in PCS over the period of follow-up was greatest for those with more advanced kidney disease (p < 0.001 in unadjusted model, p = 0.007 in adjusted model). There was no association between change in MCS over the period of follow-up and severity of kidney disease in either the unadjusted or adjusted model (p = 0.7 and p = 0.1, respectively). Lower PCS, but not MCS, was associated with increased cardiovascular and increased all-cause mortality even after adjustment for key demographic and clinical variables (p < 0.001). CONCLUSIONS: Physical, but not mental, quality-of-life is significantly impaired in CKD, and continues to decline with disease progression.
Authors: Sarah K McKenzie; Fiona Imlach Gunasekara; Ken Richardson; Kristie Carter Journal: J Epidemiol Community Health Date: 2013-11-15 Impact factor: 3.710
Authors: Richard Norman; Rosalie Viney; John Brazier; Leonie Burgess; Paula Cronin; Madeleine King; Julie Ratcliffe; Deborah Street Journal: Med Decis Making Date: 2013-09-11 Impact factor: 2.583
Authors: Donna L Mapes; Antonio Alberto Lopes; Sudtida Satayathum; Keith P McCullough; David A Goodkin; Francesco Locatelli; Shunichi Fukuhara; Eric W Young; Kiyoshi Kurokawa; Akira Saito; Jürgen Bommer; Robert A Wolfe; Philip J Held; Friedrich K Port Journal: Kidney Int Date: 2003-07 Impact factor: 10.612
Authors: Steven J Chadban; Esther M Briganti; Peter G Kerr; David W Dunstan; Timothy A Welborn; Paul Z Zimmet; Robert C Atkins Journal: J Am Soc Nephrol Date: 2003-07 Impact factor: 10.121
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: PLoS Med Date: 2007-10-16 Impact factor: 11.069
Authors: Patrizia Natale; Suetonia C Palmer; Allison Jaure; Elisabeth M Hodson; Marinella Ruospo; Tess E Cooper; Deirdre Hahn; Valeria M Saglimbene; Jonathan C Craig; Giovanni Fm Strippoli Journal: Cochrane Database Syst Rev Date: 2022-08-25
Authors: Anoushka Krishnan; Armando Teixeira-Pinto; Wai H Lim; Kirsten Howard; Jeremy R Chapman; Antoni Castells; Simon D Roger; Michael J Bourke; Petra Macaskill; Gabrielle Williams; Charmaine E Lok; Fritz Diekmann; Nicholas Cross; Shaundeep Sen; Richard D M Allen; Steven J Chadban; Carol A Pollock; Robin Turner; Allison Tong; Jean Y H Yang; Narelle Williams; Eric Au; Anh Kieu; Laura James; Anna Francis; Germaine Wong; Jonathan C Craig Journal: Kidney Int Rep Date: 2020-10-03
Authors: Carinna Hockham; Lexia Bao; Anushree Tiku; Sunil V Badve; Aminu K Bello; Meg J Jardine; Vivekanand Jha; Tadashi Toyama; Mark Woodward; Min Jun Journal: Clin Kidney J Date: 2022-01-31
Authors: Wubshet H Tesfaye; Charlotte McKercher; Gregory M Peterson; Ronald L Castelino; Matthew Jose; Syed Tabish R Zaidi; Barbara C Wimmer Journal: Int J Environ Res Public Health Date: 2020-01-06 Impact factor: 3.390
Authors: C G N Voorend; M van Oevelen; M Nieberg; Y Meuleman; C F M Franssen; H Joosten; N C Berkhout-Byrne; A C Abrahams; S P Mooijaart; W J W Bos; M van Buren Journal: BMC Geriatr Date: 2021-11-19 Impact factor: 3.921
Authors: Ana Carolina Contente Braga de Souza; Maria Clara Neres Iunes de Oliveira; Gabriela Nascimento de Lemos; Emanuele Rocha da Silva; Ícaro José Araújo de Souza; Wanderson Maia da Silva; Angélica Leite de Alcântara; Nivin Mazen Said; Lorena Vilhena de Moraes; João Felício Abrahão Neto; Simone Rodrigues Dos Passos; Ádria Aline Alves Monteiro; Natércia Neves Marques de Queiroz; Franciane Trindade Cunha de Melo; Karem Miléo Felício; Lilian de Souza D'Albuquerque Silva; Daniela Lopes Gomes; Neyla Arroyo Lara Mourão; Pedro Paulo Freire Piani; Isabel Jane Campos Lobato; João Soares Felício Journal: Diabetol Metab Syndr Date: 2022-03-28 Impact factor: 3.320
Authors: Isabella Busa; José M Ordóñez-Mena; Yaling Yang; Jane Wolstenholme; Stavros Petrou; Clare J Taylor; Chris A O'Callaghan; Simon D S Fraser; Maarten W Taal; Richard J McManus; Jennifer A Hirst; F D Richard Hobbs Journal: PLoS One Date: 2022-10-14 Impact factor: 3.752