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Quality of life in older adults with chronic kidney disease and transient changes in renal function: findings from the Oxford Renal Cohort

Quality of life in older adults with chronic kidney disease and transient changes in renal function: findings from the Oxford Renal Cohort
Quality of life in older adults with chronic kidney disease and transient changes in renal function: findings from the Oxford Renal Cohort
Background: Quality of life (QoL) is an important measure of disease burden and general health perception. The relationship between early chronic kidney disease (CKD) and QoL remains poorly understood. The Oxford Renal Study (OxRen) cohort comprises 1063 adults aged ≥60 years from UK primary care practices screened for early CKD, grouped according to existing or screen-detected CKD diagnoses, or biochemistry results indicative of reduced renal function (referred to as transient estimated glomerular filtration rate (eGFR) reduction).

Objectives: This study aimed to compare QoL in participants known to have CKD at recruitment to those identified as having CKD through a screening programme.

Methods: Health profile data and multi-attribute utility scores were reported for two generic questionnaires: 5-level EuroQol-5 Dimension (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A). QoL was compared between patients with existing and screen-detected CKD; those with transient eGFR reduction served as the reference group in univariable and multivariable linear regression.

Results: Mean and standard deviation utility scores were not significantly different between the subgroups for EQ-5D-5L (screen-detected:0.785±0.156, n = 480, transient:0.779±0.157, n = 261, existing CKD:0.763±0.171, n = 322, p = 0.216) or ICECAP-A (screen-detected:0.909±0.094, transient:0.904±0.110, existing CKD:0.894±0.115, p = 0.200). Age, smoking status, and number of comorbidities were identified as independent predictors of QoL in this cohort.

Conclusion: QoL of participants with existing CKD diagnoses was not significantly different from those with screen-detected CKD or transient eGFR reduction and was similar to UK mean scores for the same age, suggesting that patient burden of early CKD is minor. Moreover, CKD-related comorbidities contribute more significantly to disease burden in earlier stages of CKD than renal function per se. Larger prospective studies are required to define the relationship between QoL and CKD progression more precisely. These data also confirm the essentially asymptomatic nature of CKD, implying that routine screening or case finding are required to diagnose it.
1932-6203
Busa, Isabella
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Ordóñez-Mena, Jose
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Yang, Yaling
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Wolstenholme, Jane
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Petrou, Stavros
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Taylor, Clare J.
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O’Callaghan, Chris A.
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Fraser, Simon
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Taal, Maarten
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McManus, Richard J.
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Hirst, Jennifer A.
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Hobbs, F.D.Richard
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Busa, Isabella
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Ordóñez-Mena, Jose
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Yang, Yaling
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Wolstenholme, Jane
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Petrou, Stavros
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Taylor, Clare J.
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O’Callaghan, Chris A.
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Fraser, Simon
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Taal, Maarten
8081a518-58bf-4e0e-aa9e-144acce42d85
McManus, Richard J.
76c479d9-9990-4e03-830a-cf60fc9fcb21
Hirst, Jennifer A.
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Hobbs, F.D.Richard
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Busa, Isabella, Ordóñez-Mena, Jose, Yang, Yaling, Wolstenholme, Jane, Petrou, Stavros, Taylor, Clare J., O’Callaghan, Chris A., Fraser, Simon, Taal, Maarten, McManus, Richard J., Hirst, Jennifer A. and Hobbs, F.D.Richard (2022) Quality of life in older adults with chronic kidney disease and transient changes in renal function: findings from the Oxford Renal Cohort. PLoS ONE. (doi:10.1371/journal.pone.0275572).

Record type: Article

Abstract

Background: Quality of life (QoL) is an important measure of disease burden and general health perception. The relationship between early chronic kidney disease (CKD) and QoL remains poorly understood. The Oxford Renal Study (OxRen) cohort comprises 1063 adults aged ≥60 years from UK primary care practices screened for early CKD, grouped according to existing or screen-detected CKD diagnoses, or biochemistry results indicative of reduced renal function (referred to as transient estimated glomerular filtration rate (eGFR) reduction).

Objectives: This study aimed to compare QoL in participants known to have CKD at recruitment to those identified as having CKD through a screening programme.

Methods: Health profile data and multi-attribute utility scores were reported for two generic questionnaires: 5-level EuroQol-5 Dimension (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A). QoL was compared between patients with existing and screen-detected CKD; those with transient eGFR reduction served as the reference group in univariable and multivariable linear regression.

Results: Mean and standard deviation utility scores were not significantly different between the subgroups for EQ-5D-5L (screen-detected:0.785±0.156, n = 480, transient:0.779±0.157, n = 261, existing CKD:0.763±0.171, n = 322, p = 0.216) or ICECAP-A (screen-detected:0.909±0.094, transient:0.904±0.110, existing CKD:0.894±0.115, p = 0.200). Age, smoking status, and number of comorbidities were identified as independent predictors of QoL in this cohort.

Conclusion: QoL of participants with existing CKD diagnoses was not significantly different from those with screen-detected CKD or transient eGFR reduction and was similar to UK mean scores for the same age, suggesting that patient burden of early CKD is minor. Moreover, CKD-related comorbidities contribute more significantly to disease burden in earlier stages of CKD than renal function per se. Larger prospective studies are required to define the relationship between QoL and CKD progression more precisely. These data also confirm the essentially asymptomatic nature of CKD, implying that routine screening or case finding are required to diagnose it.

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Accepted/In Press date: 19 September 2022
e-pub ahead of print date: 14 October 2022

Identifiers

Local EPrints ID: 470752
URI: http://eprints.soton.ac.uk/id/eprint/470752
ISSN: 1932-6203
PURE UUID: e6681ebf-8e8d-4b19-bb34-5b5be0183407
ORCID for Simon Fraser: ORCID iD orcid.org/0000-0002-4172-4406

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Date deposited: 19 Oct 2022 16:50
Last modified: 20 Oct 2022 01:40

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Contributors

Author: Isabella Busa
Author: Jose Ordóñez-Mena
Author: Yaling Yang
Author: Jane Wolstenholme
Author: Stavros Petrou
Author: Clare J. Taylor
Author: Chris A. O’Callaghan
Author: Simon Fraser ORCID iD
Author: Maarten Taal
Author: Richard J. McManus
Author: Jennifer A. Hirst
Author: F.D.Richard Hobbs

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