Kidney Week

Abstract: FR-PO0263

Quality of Life (QOL), Kidney, and Survival Outcomes in Patients with CKD: CKD Japan Cohort (CKD-JAC) 2 Study

Session Information

• CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Yoshida, Yui, Tokyo Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Bunkyo, Tokyo, Japan

Yui Yoshida, MD, PhD

• Imaizumi, Takahiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan

Takahiro Imaizumi, MD, PhD

• Maruyama, Shoichi, Nagoya Daigaku Igakubu Fuzoku Byoin, Nagoya, Aichi Prefecture, Japan

Shoichi Maruyama, MD, PhD

• Nishi, Hiroshi, Tokyo Daigaku, Bunkyo, Tokyo, Japan

Hiroshi Nishi, MD, PhD

• Isaka, Yoshitaka, Osaka Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Suita, Osaka Prefecture, Japan

Yoshitaka Isaka, MD, PhD

• Hasegawa, Takeshi, Showa Daigaku, Shinagawa, Tokyo, Japan

Takeshi Hasegawa, MD, PhD, MPH

Background

Large-scale studies examining QOL at each stage of CKD remain limited, and most of these are cross-sectional. We compared QOL across CKD stages at baseline and investigated longitudinal changes in QOL as well as survival and dialysis initiation in a multicenter prospective cohort.

Methods

We included 2,385 predialysis adult patients with an eGFR of 10-59 mL/min/1.73m². At baseline, all participants completed the KDQOL-SF, and a subset repeated the assessment at 2 and 3.5 years. Survival, cardiovascular diseases (CVD), and dialysis initiation were prospectively followed for a median of 4.6 years and compared using Poisson regression analysis. A mixed-effect model was used to compare the time-dependent changes of KDQOL-SF summary score in each eGFR category.

Results

At baseline, the median age was 62 years old, and 62.8% were male. The distribution of CKD stages was as follows: 249 (10%) in G3a, 843 (35%) in G3b, 921 (39%) in G4, and 372 (16%) in G5. 23% of patients had a history of CVD, 35% had diabetes mellitus, and 91% were on antihypertensive therapy.
The median values of physical component summary (PCS) and mental component summary (MCS) of the KDQOL-SF were 47 (IQR, 43-51) and 50 (IQR, 45-55) at baseline in the overall cohort. PCS was lower in stage G4 than in G3a, whereas MCS did not differ across CKD stages. In addition to the physical functioning-related subscales, several kidney disease-specific subscales also decline from stage G4 onward, particularly symptoms, burden of kidney disease, effects of kidney disease, and work status.
During the follow-up period, 846 (36%) patients started dialysis, 139 (6%) died, and 246 (10%) experienced CVD events. The incidence rates of all outcomes showed a significant increasing trend with advancing CKD stage at baseline.
PCS showed a significantly greater decline over time in patients with CKD stages G4/G5 than in those with G3a, whereas no such differences were observed for MCS.

Conclusion

During the follow-up period, the incidence rates of all outcomes showed an increasing trend with advancing CKD stage at baseline. In parallel, a greater decline in PCS was observed with higher baseline CKD stage, whereas MCS did not differ.
As CKD advances, healthcare providers should pay attention not only to the prevention and management of complications but also to the potential decline in QOL, especially in physical functions.

Funding

• Commercial Support – Kyowa Kirin Co., Ltd.