Quality of life in older adults with chronic kidney disease and transient changes in renal function: Findings from the Oxford Renal cohort

Isabella Busa; José M.  Ordóñez-Mena; Yaling Yang; Jane Wolstenholme; Stavros Petrou; Clare J. Taylor; Chris A. O’Callaghan; Simon D. S. Fraser; Maarten W. Taal; Richard J. Mcmanus; Jennifer A. Hirst; F. D. Richard Hobbs

doi:10.1371/journal.pone.0275572

Quality of life in older adults with chronic kidney disease and transient changes in renal function: Findings from the Oxford Renal cohort

Isabella Busa^*, José M. Ordóñez-Mena, Yaling Yang, Jane Wolstenholme, Stavros Petrou, Clare J. Taylor, Chris A. O’Callaghan, Simon D. S. Fraser, Maarten W. Taal, Richard J. Mcmanus, Jennifer A. Hirst, F. D. Richard Hobbs

^*Corresponding author for this work

Applied Health Research

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Abstract

BACKGROUND: Quality of life (QoL) is an important measure of disease burden and general health perception. The relationship between early chronic kidney disease (CKD) and QoL remains poorly understood. The Oxford Renal Study (OxRen) cohort comprises 1063 adults aged ≥60 years from UK primary care practices screened for early CKD, grouped according to existing or screen-detected CKD diagnoses, or biochemistry results indicative of reduced renal function (referred to as transient estimated glomerular filtration rate (eGFR) reduction).

OBJECTIVES: This study aimed to compare QoL in participants known to have CKD at recruitment to those identified as having CKD through a screening programme.

METHODS: Health profile data and multi-attribute utility scores were reported for two generic questionnaires: 5-level EuroQol-5 Dimension (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A). QoL was compared between patients with existing and screen-detected CKD; those with transient eGFR reduction served as the reference group in univariable and multivariable linear regression.

RESULTS: Mean and standard deviation utility scores were not significantly different between the subgroups for EQ-5D-5L (screen-detected:0.785±0.156, n = 480, transient:0.779±0.157, n = 261, existing CKD:0.763±0.171, n = 322, p = 0.216) or ICECAP-A (screen-detected:0.909±0.094, transient:0.904±0.110, existing CKD:0.894±0.115, p = 0.200). Age, smoking status, and number of comorbidities were identified as independent predictors of QoL in this cohort.

CONCLUSION: QoL of participants with existing CKD diagnoses was not significantly different from those with screen-detected CKD or transient eGFR reduction and was similar to UK mean scores for the same age, suggesting that patient burden of early CKD is minor. Moreover, CKD-related comorbidities contribute more significantly to disease burden in earlier stages of CKD than renal function per se. Larger prospective studies are required to define the relationship between QoL and CKD progression more precisely. These data also confirm the essentially asymptomatic nature of CKD, implying that routine screening or case finding are required to diagnose it.

Original language	English
Article number	e0275572
Number of pages	15
Journal	PLOS One
Volume	17
Issue number	10
DOIs	https://doi.org/10.1371/journal.pone.0275572
Publication status	Published - 14 Oct 2022

Bibliographical note

Funding:
This research was funded by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (OUHT BRC) (grant reference: BRC-1215-20008). JAH, JMOM and FDRH are partly supported by the NIHR Biomedical Research Centre, Oxford. JMOM and FDRH also receive support from the NIHR Applied Research Collaboration (ARC) Oxford Thames Valley. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Keywords

Aged
Cross-Sectional Studies
Humans
Kidney/physiology
Quality of Life
Renal Insufficiency, Chronic/diagnosis
Surveys and Questionnaires

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Busa, I., Ordóñez-Mena, J. M., Yang, Y., Wolstenholme, J., Petrou, S., Taylor, C. J., O’Callaghan, C. A., Fraser, S. D. S., Taal, M. W., Mcmanus, R. J., Hirst, J. A., & Hobbs, F. D. R. (2022). Quality of life in older adults with chronic kidney disease and transient changes in renal function: Findings from the Oxford Renal cohort. PLOS One, 17(10), Article e0275572. https://doi.org/10.1371/journal.pone.0275572

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title = "Quality of life in older adults with chronic kidney disease and transient changes in renal function: Findings from the Oxford Renal cohort",

abstract = "BACKGROUND: Quality of life (QoL) is an important measure of disease burden and general health perception. The relationship between early chronic kidney disease (CKD) and QoL remains poorly understood. The Oxford Renal Study (OxRen) cohort comprises 1063 adults aged ≥60 years from UK primary care practices screened for early CKD, grouped according to existing or screen-detected CKD diagnoses, or biochemistry results indicative of reduced renal function (referred to as transient estimated glomerular filtration rate (eGFR) reduction).OBJECTIVES: This study aimed to compare QoL in participants known to have CKD at recruitment to those identified as having CKD through a screening programme.METHODS: Health profile data and multi-attribute utility scores were reported for two generic questionnaires: 5-level EuroQol-5 Dimension (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A). QoL was compared between patients with existing and screen-detected CKD; those with transient eGFR reduction served as the reference group in univariable and multivariable linear regression.RESULTS: Mean and standard deviation utility scores were not significantly different between the subgroups for EQ-5D-5L (screen-detected:0.785±0.156, n = 480, transient:0.779±0.157, n = 261, existing CKD:0.763±0.171, n = 322, p = 0.216) or ICECAP-A (screen-detected:0.909±0.094, transient:0.904±0.110, existing CKD:0.894±0.115, p = 0.200). Age, smoking status, and number of comorbidities were identified as independent predictors of QoL in this cohort.CONCLUSION: QoL of participants with existing CKD diagnoses was not significantly different from those with screen-detected CKD or transient eGFR reduction and was similar to UK mean scores for the same age, suggesting that patient burden of early CKD is minor. Moreover, CKD-related comorbidities contribute more significantly to disease burden in earlier stages of CKD than renal function per se. Larger prospective studies are required to define the relationship between QoL and CKD progression more precisely. These data also confirm the essentially asymptomatic nature of CKD, implying that routine screening or case finding are required to diagnose it.",

keywords = "Aged, Cross-Sectional Studies, Humans, Kidney/physiology, Quality of Life, Renal Insufficiency, Chronic/diagnosis, Surveys and Questionnaires",

author = "Isabella Busa and Ord{\'o}{\~n}ez-Mena, {Jos{\'e} M.} and Yaling Yang and Jane Wolstenholme and Stavros Petrou and Taylor, {Clare J.} and O{\textquoteright}Callaghan, {Chris A.} and Fraser, {Simon D. S.} and Taal, {Maarten W.} and Mcmanus, {Richard J.} and Hirst, {Jennifer A.} and Hobbs, {F. D. Richard}",

note = "Funding: This research was funded by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (OUHT BRC) (grant reference: BRC-1215-20008). JAH, JMOM and FDRH are partly supported by the NIHR Biomedical Research Centre, Oxford. JMOM and FDRH also receive support from the NIHR Applied Research Collaboration (ARC) Oxford Thames Valley. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.",

year = "2022",

month = oct,

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doi = "10.1371/journal.pone.0275572",

language = "English",

volume = "17",

journal = "PLOS One",

issn = "1932-6203",

publisher = "Public Library of Science (PLOS)",

number = "10",

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Busa, I, Ordóñez-Mena, JM, Yang, Y, Wolstenholme, J, Petrou, S, Taylor, CJ, O’Callaghan, CA, Fraser, SDS, Taal, MW, Mcmanus, RJ, Hirst, JA & Hobbs, FDR 2022, 'Quality of life in older adults with chronic kidney disease and transient changes in renal function: Findings from the Oxford Renal cohort', PLOS One, vol. 17, no. 10, e0275572. https://doi.org/10.1371/journal.pone.0275572

TY - JOUR

T1 - Quality of life in older adults with chronic kidney disease and transient changes in renal function

T2 - Findings from the Oxford Renal cohort

AU - Busa, Isabella

AU - Ordóñez-Mena, José M.

AU - Yang, Yaling

AU - Wolstenholme, Jane

AU - Petrou, Stavros

AU - Taylor, Clare J.

AU - O’Callaghan, Chris A.

AU - Fraser, Simon D. S.

AU - Taal, Maarten W.

AU - Mcmanus, Richard J.

AU - Hirst, Jennifer A.

AU - Hobbs, F. D. Richard

N1 - Funding: This research was funded by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (OUHT BRC) (grant reference: BRC-1215-20008). JAH, JMOM and FDRH are partly supported by the NIHR Biomedical Research Centre, Oxford. JMOM and FDRH also receive support from the NIHR Applied Research Collaboration (ARC) Oxford Thames Valley. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

PY - 2022/10/14

Y1 - 2022/10/14

N2 - BACKGROUND: Quality of life (QoL) is an important measure of disease burden and general health perception. The relationship between early chronic kidney disease (CKD) and QoL remains poorly understood. The Oxford Renal Study (OxRen) cohort comprises 1063 adults aged ≥60 years from UK primary care practices screened for early CKD, grouped according to existing or screen-detected CKD diagnoses, or biochemistry results indicative of reduced renal function (referred to as transient estimated glomerular filtration rate (eGFR) reduction).OBJECTIVES: This study aimed to compare QoL in participants known to have CKD at recruitment to those identified as having CKD through a screening programme.METHODS: Health profile data and multi-attribute utility scores were reported for two generic questionnaires: 5-level EuroQol-5 Dimension (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A). QoL was compared between patients with existing and screen-detected CKD; those with transient eGFR reduction served as the reference group in univariable and multivariable linear regression.RESULTS: Mean and standard deviation utility scores were not significantly different between the subgroups for EQ-5D-5L (screen-detected:0.785±0.156, n = 480, transient:0.779±0.157, n = 261, existing CKD:0.763±0.171, n = 322, p = 0.216) or ICECAP-A (screen-detected:0.909±0.094, transient:0.904±0.110, existing CKD:0.894±0.115, p = 0.200). Age, smoking status, and number of comorbidities were identified as independent predictors of QoL in this cohort.CONCLUSION: QoL of participants with existing CKD diagnoses was not significantly different from those with screen-detected CKD or transient eGFR reduction and was similar to UK mean scores for the same age, suggesting that patient burden of early CKD is minor. Moreover, CKD-related comorbidities contribute more significantly to disease burden in earlier stages of CKD than renal function per se. Larger prospective studies are required to define the relationship between QoL and CKD progression more precisely. These data also confirm the essentially asymptomatic nature of CKD, implying that routine screening or case finding are required to diagnose it.

AB - BACKGROUND: Quality of life (QoL) is an important measure of disease burden and general health perception. The relationship between early chronic kidney disease (CKD) and QoL remains poorly understood. The Oxford Renal Study (OxRen) cohort comprises 1063 adults aged ≥60 years from UK primary care practices screened for early CKD, grouped according to existing or screen-detected CKD diagnoses, or biochemistry results indicative of reduced renal function (referred to as transient estimated glomerular filtration rate (eGFR) reduction).OBJECTIVES: This study aimed to compare QoL in participants known to have CKD at recruitment to those identified as having CKD through a screening programme.METHODS: Health profile data and multi-attribute utility scores were reported for two generic questionnaires: 5-level EuroQol-5 Dimension (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A). QoL was compared between patients with existing and screen-detected CKD; those with transient eGFR reduction served as the reference group in univariable and multivariable linear regression.RESULTS: Mean and standard deviation utility scores were not significantly different between the subgroups for EQ-5D-5L (screen-detected:0.785±0.156, n = 480, transient:0.779±0.157, n = 261, existing CKD:0.763±0.171, n = 322, p = 0.216) or ICECAP-A (screen-detected:0.909±0.094, transient:0.904±0.110, existing CKD:0.894±0.115, p = 0.200). Age, smoking status, and number of comorbidities were identified as independent predictors of QoL in this cohort.CONCLUSION: QoL of participants with existing CKD diagnoses was not significantly different from those with screen-detected CKD or transient eGFR reduction and was similar to UK mean scores for the same age, suggesting that patient burden of early CKD is minor. Moreover, CKD-related comorbidities contribute more significantly to disease burden in earlier stages of CKD than renal function per se. Larger prospective studies are required to define the relationship between QoL and CKD progression more precisely. These data also confirm the essentially asymptomatic nature of CKD, implying that routine screening or case finding are required to diagnose it.

KW - Aged

KW - Cross-Sectional Studies

KW - Humans

KW - Kidney/physiology

KW - Quality of Life

KW - Renal Insufficiency, Chronic/diagnosis

KW - Surveys and Questionnaires

U2 - 10.1371/journal.pone.0275572

DO - 10.1371/journal.pone.0275572

M3 - Article

C2 - 36240168

SN - 1932-6203

VL - 17

JO - PLOS One

JF - PLOS One

IS - 10

M1 - e0275572

ER -

Quality of life in older adults with chronic kidney disease and transient changes in renal function: Findings from the Oxford Renal cohort

Abstract

Bibliographical note

Keywords

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