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
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 advanc...
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-09-01
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| Series: | Kidney Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590059520301655 |
| _version_ | 1818242322438029312 |
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| 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 |
| author_facet | 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 |
| author_sort | Meera Nair Harhay |
| collection | DOAJ |
| description | 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 < 0.001) and Effects scales (wait-listing aHR, 0.74; 95% CI, 0.59-0.92; P = 0.007). Participants with fewer depressive symptoms (ie, Beck Depression Inventory score < 14) had lower wait-listing rates than those with more depressive symptoms (aHR, 0.81; 95% CI, 0.66-0.99; P = 0.04). Participants with lower Burden and Effects scale scores and those with higher Symptoms and PCS scores had higher pre-emptive wait-listing rates (aHR in highest tertile of PCS relative to lowest tertile, 1.58; 95% CI, 1.12-2.23; P = 0.01). Limitations: Unmeasured confounders. Conclusions: Self-reported health in late-stage CKD may influence the timing of kidney transplantation. |
| first_indexed | 2024-12-12T13:43:23Z |
| format | Article |
| id | doaj.art-269f809eb3f1459499c3eeb0be6dc43c |
| institution | Directory Open Access Journal |
| issn | 2590-0595 |
| language | English |
| last_indexed | 2024-12-12T13:43:23Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney Medicine |
| spelling | doaj.art-269f809eb3f1459499c3eeb0be6dc43c2022-12-22T00:22:44ZengElsevierKidney Medicine2590-05952020-09-0125600609.e1Health-Related Quality of Life, Depressive Symptoms, and Kidney Transplant Access in Advanced CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) StudyPlain-Language SummaryMeera Nair Harhay0Wei Yang1Daohang Sha2Jason Roy3Boyang Chai4Michael J. Fischer5L. Lee Hamm6Peter D. Hart7Chi-yuan Hsu8Yonghong Huan9Anne M. Huml10Radhakrishna Reddy Kallem11Manjula Kurella Tamura12Anna C. Porter13Ana C. Ricardo14Anne Slaven15Sylvia E. Rosas16Raymond R. Townsend17Peter P. Reese18James P. Lash19Sanjeev Akkina20Lawrence J. Appel, MD, MPHHarold I. Feldman, MD, MSCEAlan S. Go, MDJiang He, MD, PhDJohn W. Kusek, PhDPanduranga Rao, MDMahboob Rahman, MDDepartment of Medicine, Drexel University College of Medicine, Philadelphia, PA; Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA; Tower Health Transplant Institute, Tower Health System, West Reading, Philadelphia, PA; Address for Correspondence: Meera Nair Harhay, MD, MSCE, Drexel University College of Medicine, New College Bldg, 245 N 15th St, Mail Stop 437, Philadelphia, PA 19102.Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PADepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PADepartment of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MADepartment of Medicine, University of Illinois at Chicago, Chicago; Medical Service, Jesse Brown VA Medical Center, Chicago; Center of Management for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, ILDepartment of Medicine, Tulane University School of Medicine, New Orleans, LADivision of Nephrology, John H. Stroger, Jr. Hospital of Cook County, Chicago, ILDivision of Nephrology, University of California, San Francisco, San Francisco; Division of Research, Kaiser Permanente Northern California, Oakland, CARenal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PACase Western Reserve University and MetroHealth Medical Center, Cleveland, OHRenal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PADivision of Nephrology, Stanford University School of Medicine, Palo Alto, CADepartment of Medicine, University of Illinois at Chicago, Chicago; Jesse Brown Veteran’s Affairs Medical Center, Chicago, ILDepartment of Medicine, University of Illinois at Chicago, ChicagoMetroHealth Medical Center, Cleveland, OHKidney and Hypertension Unit, Joslin Diabetes Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Nephrology Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MARenal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PADepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Renal-Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PADepartment of Medicine, University of Illinois at Chicago, ChicagoDepartment of Medicine, Loyola University Medical Center, Maywood, ILRationale & 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 < 0.001) and Effects scales (wait-listing aHR, 0.74; 95% CI, 0.59-0.92; P = 0.007). Participants with fewer depressive symptoms (ie, Beck Depression Inventory score < 14) had lower wait-listing rates than those with more depressive symptoms (aHR, 0.81; 95% CI, 0.66-0.99; P = 0.04). Participants with lower Burden and Effects scale scores and those with higher Symptoms and PCS scores had higher pre-emptive wait-listing rates (aHR in highest tertile of PCS relative to lowest tertile, 1.58; 95% CI, 1.12-2.23; P = 0.01). Limitations: Unmeasured confounders. Conclusions: Self-reported health in late-stage CKD may influence the timing of kidney transplantation.http://www.sciencedirect.com/science/article/pii/S2590059520301655Kidney Transplantquality-of-lifewait-listingdepression |
| spellingShingle | 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 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 Kidney Medicine Kidney Transplant quality-of-life wait-listing depression |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Kidney Transplant quality-of-life wait-listing depression |
| url | http://www.sciencedirect.com/science/article/pii/S2590059520301655 |
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