학술논문
Health-Related Quality of Life, Depressive Symptoms, and Kidney Transplant Access in Advanced CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study
Document Type
article
Author
Harhay, Meera Nair; Yang, Wei; Sha, Daohang; Roy, Jason; Chai, Boyang; Fischer, Michael J; Hamm, L Lee; Hart, Peter D; Hsu, Chi-yuan; Huan, Yonghong; Huml, Anne M; Kallem, Radhakrishna Reddy; Tamura, Manjula Kurella; Porter, Anna C; Ricardo, Ana C; Slaven, Anne; Rosas, Sylvia E; Townsend, Raymond R; Reese, Peter P; Lash, James P; Akkina, Sanjeev; Investigators, CRIC Study; Appel, Lawrence J; Feldman, Harold I; Go, Alan S; He, Jiang; Kusek, John W; Rao, Panduranga; Rahman, Mahboob
Source
Kidney Medicine. 2(5)
Subject
Language
Abstract
Rationale & objectiveAmong 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 designProspective cohort study.Setting & population1,676 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.ExposuresHRQoL 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.OutcomesTime to kidney transplant wait-listing and time to pre-emptive wait-listing.Analytic approachTime-to-event analysis using Cox proportional hazards regression.ResultsDuring 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