Health-related quality of life in different stages of chronic kidney disease

Introduction: Improved survival of chronic kidney disease (CKD) patients has led to an increased focus on health-related quality of life (HRQoL) for evaluating treatment effectiveness and assessing health outcomes of these patients. Objective: To evaluate HRQoL in patients in different stages of CKD and to explore possible correlating and influencing factors. Methods: Cross-sectional design with 200 patients from India in CKD stages 1-5 assessed for HRQoL through 36-item short-form together with biomarkers. Patients were divided into four groups according to their estimated Glomerular Filtration Rate (eGFR); group A with GFR range > 90 ml/min/1.73 m(2), group B with GFR range 30-59 ml/min/1.73 m(2), group C with GFR range 15-29 ml/min/1.73 m(2) and group D with GFR < 15 ml/min/1.73 m(2). Results: HRQoL scores in all dimensions impaired progressively and significantly across renal function levels and CKD stages. A statistically significant decreasing trend in physical composite summary and mental composite summary scores was found in patients from group A to D (P<0.001). Patients with eGFR < 30 ml/min/1.73 m(2), Diabetes Mellitus, Cardio vascular disease (CVD), C-reactive protein (CRP) >= 5 mg/l, Hemoglobin <= 90 g/l, erythrocyte sedimentation rate >= 20 and mean arterial pressure >= 100 mm hg had significantly lower scores on all HRQoL dimensions. Among these CRP, reduced GFR and CVD were the most important predictors of impaired HRQoL. Conclusion: Considering the worldwide growing prevalence of CKD and increasing importance of HRQoL in chronic diseases, improving our knowledge about HRQoL and its predictors in CKD patients is important. Assessment of HRQoL early in disease course will help to identify high risk patients in whom modifying these factors may help them lead an active and healthy life.