학술논문
Health-Related Quality of Life, Depressive Symptoms, and Kidney Transplant Access in Advanced CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) StudyPlain-Language Summary
Document Type
article
Author
Meera Nair Harhay; Wei Yang; Daohang Sha; Jason Roy; Boyang Chai; Michael J. Fischer; L. Lee Hamm; Peter D. Hart; Chi-yuan Hsu; Yonghong Huan; Anne M. Huml; Radhakrishna Reddy Kallem; Manjula Kurella Tamura; Anna C. Porter; Ana C. Ricardo; Anne Slaven; Sylvia E. Rosas; Raymond R. Townsend; Peter P. Reese; James P. Lash; Sanjeev Akkina; Lawrence J. Appel, MD, MPH; Harold I. Feldman, MD, MSCE; Alan S. Go, MD; Jiang He, MD, PhD; John W. Kusek, PhD; Panduranga Rao, MD; Mahboob Rahman, MD
Source
Kidney Medicine, Vol 2, Iss 5, Pp 600-609.e1 (2020)
Subject
Language
English
ISSN
2590-0595
Abstract
Rationale & Objective: Among individuals with chronic kidney disease (CKD), poor self-reported health is associated with adverse outcomes including hospitalization and death. We sought to examine the association between health-related quality-of-life (HRQoL) and depressive symptoms in advanced CKD and subsequent access to the kidney transplant waiting list. Study Design: Prospective cohort study. Setting & Population: 1,676 Chronic Renal Insufficiency Cohort (CRIC) study participants with estimated glomerular filtration rates ≤ 30 mL/min/1.73 m2 at study entry or during follow-up. Exposures: HRQoL ascertained by 5 scales of the Kidney Disease Quality of Life-36 Survey (Physical Component Summary [PCS], Mental Component Summary, Symptoms, Burdens, and Effects), with higher scores indicating better HRQoL, and depressive symptoms ascertained using the Beck Depression Inventory. Outcomes: Time to kidney transplant wait-listing and time to pre-emptive wait-listing. Analytic Approach: Time-to-event analysis using Cox proportional hazards regression. Results: During a median follow-up of 5.1 years, 652 (39%) participants were wait-listed, of whom 304 were preemptively wait-listed. Adjusted for demographics, comorbid conditions, estimated glomerular filtration rate slope, and cognitive function, participants with the highest scores on the Burden and Effects scales, respectively, had lower rates of wait-listing than those with the lowest scores on the Burden (wait-listing adjusted hazard ratio [aHR], 0.70; 95% CI, 0.57-0.85; P