Use of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United States

Abstract Background Health-related quality of life (HRQOL) is a key outcome for dialysis patients, and its assessment is mandated by the Centers for Medicaid and Medicare Services. The Kidney Disease Quality of Life (KDQOL-36™) survey is widely used for this assessment. KDQOL-36™ completion rates, a...

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Main Authors: Dena E. Cohen, Andrew Lee, Scott Sibbel, Deborah Benner, Steven M. Brunelli, Francesca Tentori
Format: Article
Language:English
Published: BMC 2019-04-01
Series:BMC Nephrology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12882-019-1295-0
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author Dena E. Cohen
Andrew Lee
Scott Sibbel
Deborah Benner
Steven M. Brunelli
Francesca Tentori
author_facet Dena E. Cohen
Andrew Lee
Scott Sibbel
Deborah Benner
Steven M. Brunelli
Francesca Tentori
author_sort Dena E. Cohen
collection DOAJ
description Abstract Background Health-related quality of life (HRQOL) is a key outcome for dialysis patients, and its assessment is mandated by the Centers for Medicaid and Medicare Services. The Kidney Disease Quality of Life (KDQOL-36™) survey is widely used for this assessment. KDQOL-36™ completion rates, and the distributions of scores and item responses, have not been examined in a large, nationally representative cohort of dialysis patients. Methods This retrospective, observational study considered 413,951 survey opportunities contributed by adult patients who received dialysis at a large dialysis organization in the United States during calendar years 2014, 2015, and 2016 and were not Veterans Affairs beneficiaries. Results During the study period, 240,343 unique patients completed a total of 330,412 surveys (overall completion rate 79.8%). Mean domain scores on the physical component summary (PCS), mental component summary (MCS), burden of kidney disease (BKD), symptoms and problems of kidney disease (SPKD), and effects of kidney disease (EKD) subscales were 36.6, 49.0, 51.3, 78.1, and 73.0, respectively. Scores were similar across dialysis modalities. Patient perceptions of general health were not correlated (R < 0.05) with PCS or SPKD. The SPKD showed ceiling effects: among patients treated with in-center hemodialysis, for all 12 items, < 10% of patients were “extremely bothered,” while > 65% of patients reported being “not at all” or only “somewhat bothered;” for 3 items, > 85% of patients gave these latter two responses. Interdialytic weight gain was not correlated with patient-reported shortness of breath, PCS, or SPKD. Conclusions Survey completion rates for the KDQOL-36™ were high, and scores were similar across dialysis modalities. Ceiling effects were observed for SPKD. Revision of the KDQOL-36™ to address factors that are most important to contemporary dialysis patients may be warranted.
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spelling doaj.art-5181f6dc658045a0823227c02999cd802022-12-21T19:07:41ZengBMCBMC Nephrology1471-23692019-04-012011910.1186/s12882-019-1295-0Use of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United StatesDena E. Cohen0Andrew Lee1Scott Sibbel2Deborah Benner3Steven M. Brunelli4Francesca Tentori5DaVita Clinical ResearchDaVita Clinical ResearchDaVita Clinical ResearchDaVita, Inc.DaVita Clinical ResearchDaVita Clinical ResearchAbstract Background Health-related quality of life (HRQOL) is a key outcome for dialysis patients, and its assessment is mandated by the Centers for Medicaid and Medicare Services. The Kidney Disease Quality of Life (KDQOL-36™) survey is widely used for this assessment. KDQOL-36™ completion rates, and the distributions of scores and item responses, have not been examined in a large, nationally representative cohort of dialysis patients. Methods This retrospective, observational study considered 413,951 survey opportunities contributed by adult patients who received dialysis at a large dialysis organization in the United States during calendar years 2014, 2015, and 2016 and were not Veterans Affairs beneficiaries. Results During the study period, 240,343 unique patients completed a total of 330,412 surveys (overall completion rate 79.8%). Mean domain scores on the physical component summary (PCS), mental component summary (MCS), burden of kidney disease (BKD), symptoms and problems of kidney disease (SPKD), and effects of kidney disease (EKD) subscales were 36.6, 49.0, 51.3, 78.1, and 73.0, respectively. Scores were similar across dialysis modalities. Patient perceptions of general health were not correlated (R < 0.05) with PCS or SPKD. The SPKD showed ceiling effects: among patients treated with in-center hemodialysis, for all 12 items, < 10% of patients were “extremely bothered,” while > 65% of patients reported being “not at all” or only “somewhat bothered;” for 3 items, > 85% of patients gave these latter two responses. Interdialytic weight gain was not correlated with patient-reported shortness of breath, PCS, or SPKD. Conclusions Survey completion rates for the KDQOL-36™ were high, and scores were similar across dialysis modalities. Ceiling effects were observed for SPKD. Revision of the KDQOL-36™ to address factors that are most important to contemporary dialysis patients may be warranted.http://link.springer.com/article/10.1186/s12882-019-1295-0Quality of lifeESRDDialysis
spellingShingle Dena E. Cohen
Andrew Lee
Scott Sibbel
Deborah Benner
Steven M. Brunelli
Francesca Tentori
Use of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United States
BMC Nephrology
Quality of life
ESRD
Dialysis
title Use of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United States
title_full Use of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United States
title_fullStr Use of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United States
title_full_unstemmed Use of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United States
title_short Use of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United States
title_sort use of the kdqol 36™ for assessment of health related quality of life among dialysis patients in the united states
topic Quality of life
ESRD
Dialysis
url http://link.springer.com/article/10.1186/s12882-019-1295-0
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