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Kidney Week

Abstract: FR-PO327

Health-Related Quality of Life Is Associated with Disease Progression in Adults with Advanced CKD Not on Renal Replacement Therapy

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Jose, Matthew D., Royal Hobart Hospital, Hobart, Tasmania, Australia
  • Mckercher, Charlotte M., University of Tasmania, Hobart, Tasmania, Australia

Group or Team Name

  • Tasmanian CKD Study Investigators
Background

Chronic kidney disease (CKD) is associated with reduced health-related quality of life (HRQOL). However, the association between HRQOL and disease progression prior to renal replacement therapy (RRT) is unclear. We examined the influence of HRQOL on disease progression in adults with Stage IV CKD (eGFR 15-29mls/min/1.73m2) not on RRT.

Methods

Overall, 172 adults living in Tasmania, Australia provided data at baseline (2010-2012, 2016-2018). Of these, 152 participants attended a clinic where the Kidney Disease Quality of Life–Short Form was completed. Disease progression was examined using i) percentage annual change in eGFR [(eGFR at follow-up/eGFR at baseline)^(1/years elapsed between measurement)-1]*100 and ii) progression to CKD Stage V (eGFR<15mls/min/1.73m2) or death. Generalized linear models were used to examine associations between HRQOL and disease progression adjusted for sociodemographic variables, comorbidities and laboratory factors.

Results

Overall, participants were predominantly male (63%) with a mean age of 72.2±10.2 years. At baseline, mean eGFR was 22.1±4.2 mls/min/1.73m2and serum creatinine was 242.3±56.4 µmol/L. Mean annual decline in eGFR was -4.2 mls/min/1.73m2. Mean percentage annual change in eGFR was 8.8% with 61 (35%) participants progressing to CKD Stage V or death. Mean time to outcome was 446±289 days. Mean mental component summary (MCS) was 50.9±10.3 and physical component summary (PCS) was 38.6±10.4. Mean subscale scores were 81.8±17.5 for cognitive functioning and 74.0±24.9 for burden of disease. Improved cognitive functioning was positively associated with % annual change in eGFR (β=0.46, 95% CI 0.05-0.88, R2=0.04,p<0.05). Both improved cognitive functioning (OR 0.98, 95% CI 0.95-0.99, R2=0.23, p<0.05) and lower burden of disease (OR 0.98, 95% CI 0.96-0.99, R2=0.24, p<0.05) were associated with lower odds of CKD Stage V or death. Baseline MCS and PCS were not associated with disease progression.

Conclusion

HRQOL involving self-reported cognitive functioning and burden of disease is associated with disease progression in adults with Stage IV CKD. Identifying modifiable risk factors is an important step in reducing the risk of RRT and premature death in this patient population and improving quality of life.

Funding

  • Private Foundation Support