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Kidney Week

Abstract: FR-PO335

Self-Rated Health Is Associated with Functional Limitations in Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Lee, Jacqueline, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Abdel-Kader, Khaled, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Yabes, Jonathan, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Jhamb, Manisha, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
Background

In patients with chronic kidney disease (CKD), self-rated health (SRH, “In general, how do you perceive your health?”) is associated with mortality. However, it is unclear how functional status associates with SRH. This study assessed the relationship between the SRH and functional status limitations in a cohort of patients with stages 3-5 CKD.

Methods

Adult patients with CKD seen at a nephrology outpatient clinic in Western Pennsylvania from Sept 2015 to Dec 2016 were invited to complete a survey as part of a quality improvement project. The survey included questions on patient’s SRH (Likert scale, 1=Poor, 2=Fair, 3=Good, 4=Very Good, 5=Excellent) and activities of daily living (ADLs, Yes/No response). The five standardized ADL questions assessed physical- (ambulation, dressing, shopping) and cognitive- (executive and memory) based ADLs. The association of SRH with limitations to 3 or more total ADLs, physical ADL limitations only, or cognitive ADL limitations only were assessed using chi-square analysis.

Results

SRH was completed by 1310 participants (mean age 60 years), out of which 41% reported poor-to-fair health. Overall, 71% of those with poor-to-fair SRH had at least one ADL limitation. In the total cohort, the most commonly reported ADL limitation was difficulty with ambulation at 34%. Ambulatory limitations were seen in 58% of participants with poor-to-fair SRH versus 17% in persons with good-to-excellent SRH. Persons with poor-to-fair SRH were more likely to report ≥3 limitations of ADLs (26% vs. 3%, p < 0.001), ≥1 physical limitation (61% vs. 18%, p < 0.001), and ≥1 cognitive limitation (35% vs. 13%, p < 0.001), compared to those with good-to-excellent SRH, respectively. Older adults (age ≥65) were more likely to report good-to-excellent SRH compared to younger adults (63% vs. 56%, p = 0.008); however, in those with 31% of good-to-excellent older adults had at least one ADL limitation versus 22% of younger adults.

Conclusion

Lower self-perception of health is associated with a larger number of functional limitations in patients with CKD. Older CKD patients have better SRH despite a higher functional limitations burden and potentially greater frailty. Lower SRH may identify patients who could benefit from additional healthcare resources (e.g., physical therapy and rehabilitation) to improve person-centered outcomes.

Funding

  • Clinical Revenue Support