Nicholas C Chesnaye1, Yvette Meuleman2, Esther N M de Rooij2, Ellen K Hoogeveen2,3, Friedo W Dekker2, Marie Evans4, Agneta A Pagels5,6, Fergus J Caskey7, Claudia Torino8, Gaetana Porto9, Maciej Szymczak10, Christiane Drechsler11, Christoph Wanner11, Kitty J Jager12. 1. European Renal Association-European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands n.c.chesnaye@amsterdamumc.nl. 2. Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Nephrology, Jeroen Bosch Hospital, Den Bosch, The Netherlands. 4. Renal Unit, Department of Clinical Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. 5. Department of Medicine, Karolinska Institute, Stockholm, Sweden. 6. Department of Nephrology, Karolinska University Hospital, Stockholm, Sweden. 7. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom. 8. Institute of Clinical Physiology-National Research Council, Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria, Italy. 9. Grande Ospedale Metropolitano, Bianchi Melacrino Morelli, Reggio Calabria, Italy. 10. Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland. 11. Division of Nephrology, University Hospital of Wurzburg, Wurzburg, Germany. 12. European Renal Association-European Dialysis and Transplant Association Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Abstract
BACKGROUND AND OBJECTIVES: The effect of sex on longitudinal health-related quality of life remains unknown in CKD. Here we assess differences in the sex-specific evolution of health-related quality of life in older men and women with advanced CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The European Quality Study on Treatment in Advanced Chronic Kidney Disease is a European observational prospective cohort study in referred patients with CKD and an incident eGFR<20 ml/min per 1.73 m2 who are ≥65 years of age not on dialysis. Health-related quality of life was measured using the 36-Item Short Form Survey at 3- to 6-month intervals between April 2012 and September 2020, providing Physical Component Summary and Mental Component Summary scores. Trajectories were modeled by sex using linear mixed models, and sex differences in health-related quality-of-life slope were explored. RESULTS: We included 5345 health-related quality-of-life measurements in 1421 participants. At baseline, women had considerably lower mean Physical Component Summary (42) and Mental Component Summary (60) compared with men (Physical Component Summary: 55; Mental Component Summary: 69; P<0.001). However, during follow-up, Physical Component Summary and Mental Component Summary scores declined approximately twice as fast in men (Physical Component Summary: 2.5 per year; 95% confidence interval, 1.8 to 3.1; Mental Component Summary: 2.7 per year; 95% confidence interval, 2.0 to 3.4) compared with in women (Physical Component Summary: 1.1 per year; 95% confidence interval, 0.1 to 2.0; Mental Component Summary: 1.6 per year; 95% confidence interval, 0.7 to 2.6). This difference was partly attenuated after adjusting for important covariates, notably eGFR decline. Higher serum phosphate, lower hemoglobin, and the presence of preexisting diabetes were associated with lower Physical Component Summary and Mental Component Summary scores in men but to a lesser extent in women. CONCLUSIONS: Among older men and women with advanced CKD, women had lower health-related quality of life at baseline, but men experienced a more rapid decline in health-related quality of life over time.
BACKGROUND AND OBJECTIVES: The effect of sex on longitudinal health-related quality of life remains unknown in CKD. Here we assess differences in the sex-specific evolution of health-related quality of life in older men and women with advanced CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The European Quality Study on Treatment in Advanced Chronic Kidney Disease is a European observational prospective cohort study in referred patients with CKD and an incident eGFR<20 ml/min per 1.73 m2 who are ≥65 years of age not on dialysis. Health-related quality of life was measured using the 36-Item Short Form Survey at 3- to 6-month intervals between April 2012 and September 2020, providing Physical Component Summary and Mental Component Summary scores. Trajectories were modeled by sex using linear mixed models, and sex differences in health-related quality-of-life slope were explored. RESULTS: We included 5345 health-related quality-of-life measurements in 1421 participants. At baseline, women had considerably lower mean Physical Component Summary (42) and Mental Component Summary (60) compared with men (Physical Component Summary: 55; Mental Component Summary: 69; P<0.001). However, during follow-up, Physical Component Summary and Mental Component Summary scores declined approximately twice as fast in men (Physical Component Summary: 2.5 per year; 95% confidence interval, 1.8 to 3.1; Mental Component Summary: 2.7 per year; 95% confidence interval, 2.0 to 3.4) compared with in women (Physical Component Summary: 1.1 per year; 95% confidence interval, 0.1 to 2.0; Mental Component Summary: 1.6 per year; 95% confidence interval, 0.7 to 2.6). This difference was partly attenuated after adjusting for important covariates, notably eGFR decline. Higher serum phosphate, lower hemoglobin, and the presence of preexisting diabetes were associated with lower Physical Component Summary and Mental Component Summary scores in men but to a lesser extent in women. CONCLUSIONS: Among older men and women with advanced CKD, women had lower health-related quality of life at baseline, but men experienced a more rapid decline in health-related quality of life over time.
Authors: Moniek W M van de Luijtgaarden; Fergus J Caskey; Christoph Wanner; Nicholas C Chesnaye; Maurizio Postorino; Cynthia J Janmaat; Anirudh Rao; Claudia Torino; Marian Klinger; Christiane Drechsler; Olof Heimburger; Maciej Szymczak; Marie Evans; Friedo W Dekker; Kitty J Jager Journal: Nephrol Dial Transplant Date: 2019-07-01 Impact factor: 5.992
Authors: Agneta A Pagels; Birgitta Klang Söderkvist; Charlotte Medin; Britta Hylander; Susanne Heiwe Journal: Health Qual Life Outcomes Date: 2012-06-18 Impact factor: 3.186
Authors: Edward Zimbudzi; Clement Lo; Sanjeeva Ranasinha; Helena Teede; Tim Usherwood; Kevan R Polkinghorne; Greg Fulcher; Martin Gallagher; Steven Jan; Alan Cass; Rowan Walker; Grant Russell; Greg Johnson; Peter G Kerr; Sophia Zoungas Journal: BMJ Open Diabetes Res Care Date: 2020-01
Authors: Esther N M de Rooij; Yvette Meuleman; Johan W de Fijter; Saskia Le Cessie; Kitty J Jager; Nicholas C Chesnaye; Marie Evans; Agneta A Pagels; Fergus J Caskey; Claudia Torino; Gaetana Porto; Maciej Szymczak; Christiane Drechsler; Christoph Wanner; Friedo W Dekker; Ellen K Hoogeveen Journal: Clin J Am Soc Nephrol Date: 2022-07-28 Impact factor: 10.614