Health-related quality of life in patients with chronic kidney disease

ABSTRACT

Introduction: In the last three decades, health systems have continued to pay increasing attention to the quality of life (QOL) due to definitional changes in the concept of health and disease. The health-related quality of life (HRQOL) in patients with chronic kidney disease (CKD) is significantly affected, regardless of the stage of CKD.

Areas covered: We attempt to thoroughly explore how CKD affects HRQOL domains with a quick primer on HRQOL assessment instruments in patients with CKD. Also, we pointed out the factors affecting HRQOL in patients with CKD as well as the clinical application of HRQOL in CKD management.

Expert opinion: The general population enjoys higher HRQOL than patients with CKD in all domains. Similarly, pre-dialysis and kidney-transplant patients have better HRQOL than dialysis population. There are many factors which negatively impact HRQOL in CKD which include for example depression, anxiety, and cognitive impairment for the social domain, inactivity, and frailty for the physical domain as well as lack of social support and extroversion in the social domain. Additionally, social disparities and CKD-related factors would influence HRQOL. Of note, there is no global standard HRQOL assessment tool. Finally, HRQOL should be included in future CKD management guidelines.

KEYWORDS:

• CKD
• dialysis
• ESRD
• frailty
• HRQOL
• QOL
• social disparities
• KDQOL-36

Article highlights

• CKD is a global health burden.

• HRQOL is lower in patients with CKD than in the general population.

• HRQOL is a good predictor of morbidity and mortality in CKD.

• There is no standard tool for HRQOL assessment.

• HRQOL is lower in hemodialysis than in peritoneal dialysis.

• Renal transplantation is associated with higher HRQOL than in dialysis.

• There is a wide array of HRQOL influencing factors, some are modifiable, and some are not.

• HRQOL is used as a determining factor in CKD management.

Acknowledgements

We would like to thank Sara Güzel from the European Medical Students’ Association (EMSA) in Iasi, Romania for her contribution in creating the figures for this article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.