Gopesh K Modi1, Ashok K Yadav2, Arpita Ghosh3, Kajal Kamboj4, Prabhjot Kaur4, Vivek Kumar4, Shobhit Bhansali4, Narayan Prasad5, Manisha Sahay6, Sreejith Parameswaran7, Santosh Varughese8, Sishir Gang9, Shivendra Singh10, Dipankar Sircar11, Natarajan Gopalakrishnan12, Ajay Jaryal13, Sanjay Vikrant13, Seema Baid-Agrawal14, Vivekanand Jha15,16,17. 1. Nephrology, Samarpan Kidney Institute and Research Center, Bhopal, India. 2. Departments of Experimental Medicine and Biotechnology and. 3. George Institute for Global Health, University of New South Wales, New Delhi, India. 4. Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. 5. Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. 6. Department of Nephrology, Osmania Medical College, Osmania General Hospital, Hyderabad, India. 7. Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. 8. Department of Nephrology, Christian Medical College, Vellore, India. 9. Department of Nephrology, Muljibhai Patel Urological Hospital, Nadiad, India. 10. Department of Nephrology, Institute of Medical Science, Banaras Hindu University, Varanasi, India. 11. Department of Nephrology, Institute of Post Graduate Medical Education and Research, Kolkata, India. 12. Department of Nephrology, Rajiv Gandhi Government General Hospital, Chennai, India. 13. Department of Nephrology, Indira Gandhi Medical College, Shimla, India. 14. Department of Nephrology and Transplant Center, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. 15. George Institute for Global Health, University of New South Wales, New Delhi, India; vjha@georgeinstitute.org.in. 16. Manipal Academy of Higher Education, Manipal, Karnataka, India; and. 17. University of Oxford, Oxford, United Kingdom.
Abstract
BACKGROUND AND OBJECTIVES: Patient-reported outcomes have gained prominence in the management of chronic noncommunicable diseases. Measurement of health-related quality of life is being increasingly incorporated into medical decision making and health care delivery processes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Indian Chronic Kidney Disease Study is a prospective cohort of participants with mild to moderate CKD. Baseline health-related quality of life scores, determined by the standardized Kidney Disease Quality of Life 36 item instrument, are presented for the inception cohort (n=2919). Scores are presented on five subscales: mental component summary, physical component summary, burden, effect of kidney disease, and symptom and problems; each is scored 0-100. The associations of socioeconomic and clinical parameters with the five subscale scores and lower quality of life (defined as subscale score <1 SD of the sample mean) were examined. The main socioeconomic factors studied were sex, education, occupation, and income. The key medical factors studied were age, eGFR, diabetes, hypertension, and albuminuria. RESULTS: The mean (SD) subscale scores were physical component summary score, 43±9; mental component summary score, 48±10; burden, 61±33; effects, 87±13; and symptoms, 90±20. Among the socioeconomic variables, women, lower education, and lower income were negatively associated with reduced scores across all subscales. For instance, the respective β-coefficients (SD) for association with the physical component summary subscale were -2.6 (-3.4 to -1.8), -1.5 (-2.2 to -0.7), and -1.6 (-2.7 to -0.5). Medical factors had inconsistent or no association with subscale scores. The quality of life scores also displayed regional variations. CONCLUSIONS: In this first of its kind analysis from India, predominantly socioeconomic factors were associated with quality of life scores in patients with CKD.
BACKGROUND AND OBJECTIVES:Patient-reported outcomes have gained prominence in the management of chronic noncommunicable diseases. Measurement of health-related quality of life is being increasingly incorporated into medical decision making and health care delivery processes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Indian Chronic Kidney Disease Study is a prospective cohort of participants with mild to moderate CKD. Baseline health-related quality of life scores, determined by the standardized Kidney Disease Quality of Life 36 item instrument, are presented for the inception cohort (n=2919). Scores are presented on five subscales: mental component summary, physical component summary, burden, effect of kidney disease, and symptom and problems; each is scored 0-100. The associations of socioeconomic and clinical parameters with the five subscale scores and lower quality of life (defined as subscale score <1 SD of the sample mean) were examined. The main socioeconomic factors studied were sex, education, occupation, and income. The key medical factors studied were age, eGFR, diabetes, hypertension, and albuminuria. RESULTS: The mean (SD) subscale scores were physical component summary score, 43±9; mental component summary score, 48±10; burden, 61±33; effects, 87±13; and symptoms, 90±20. Among the socioeconomic variables, women, lower education, and lower income were negatively associated with reduced scores across all subscales. For instance, the respective β-coefficients (SD) for association with the physical component summary subscale were -2.6 (-3.4 to -1.8), -1.5 (-2.2 to -0.7), and -1.6 (-2.7 to -0.5). Medical factors had inconsistent or no association with subscale scores. The quality of life scores also displayed regional variations. CONCLUSIONS: In this first of its kind analysis from India, predominantly socioeconomic factors were associated with quality of life scores in patients with CKD.
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