Impairment of kidney function and reduced quality-of-life in older people: a cross-sectional study

Nitsch, Dorothea, Mann, Andrea G., Bulpitt, Christopher, Roderick, Paul J. and Fletcher, A (2011) Impairment of kidney function and reduced quality-of-life in older people: a cross-sectional study. Age and Ageing, 40 (3), 381-387. (doi:10.1093/ageing/afr024). (PMID:21427113)

Abstract

Objective: to assess the association of kidney function with quality-of-life in community-dwelling older adults aged 75 years or more in the UK.

Design: cross-sectional study.

Setting: primary care; 12 UK general practices participating in a cluster trial of health screening.

Subjects: estimated glomerular filtration rate (eGFR, ml/min/1.73 m2) using the four-variable modified diet in renal disease equation was derived in 1,195 men and 1,772 women with available bloods, these were 92% of 3,211 study participants who consented to interviews and 73% of those invited into the original cluster trial of health screening.

Main outcome measures: interviews by trained fieldworker using the Sickness Impact Profile (home management, mobility, self-care, social interaction), and the Philadelphia Geriatric Morale Scale. Higher scores imply worse quality-of-life in a given domain.

Results: in age- and co-morbidity-adjusted analyses there was an association of eGFR <45 and the highest scores (defined as ?median) of mobility (men: odds ratio (OR) 2.91, 95% confidence interval (CI) 1.56–5.41; women: OR 1.73, 95% CI 1.02–2.94), home management (men: OR 1.49, 95% CI 1.09–2.04; women: OR 3.50, 95% CI 1.18–10.35), social interaction (men: OR 3.34, 95% CI 1.73–6.45; women: 2.64, 95% CI 1.61–4.33) when compared with those with eGFR ?60 and who reported no problems. Men with eGFR <45 had low morale (OR 2.45, 95% CI 1.02–5.87) but this was not found for women (OR 1.40, 95% CI 0.65–3.04), whereas women (but not men) with eGFR <45 reported problems with body care (women: OR 1.68; 95% CI 1.25–2.27: men: OR 0.89, 95% CI 0.55–1.46).

Conclusions: an eGFR <45 is associated with poorer quality-of-life at older age. More research is needed to identify modifiable causes to improve quality-of-life in older people with such a degree of kidney function impairment

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Contributors

Author: Paul J. Roderick

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