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Health-Related Quality of Life, Depressive Symptoms, and Kidney Transplant Access in Advanced CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study
Journal article   Open access   Peer reviewed

Health-Related Quality of Life, Depressive Symptoms, and Kidney Transplant Access in Advanced CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

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, …
Kidney medicine, v 2(5), pp 600-609
Sep 2020
PMID: 33089138
url
https://doi.org/10.1016/j.xkme.2020.06.010View
Published, Version of Record (VoR)CC BY-NC-ND V4.0 Open

Abstract

depression Kidney Transplant quality-of-life wait-listing
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. Prospective cohort study. 1,676 Chronic Renal Insufficiency Cohort (CRIC) study participants with estimated glomerular filtration rates≤30mL/min/1.73m2 at study entry or during follow-up. 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. Time to kidney transplant wait-listing and time to pre-emptive wait-listing. Time-to-event analysis using Cox proportional hazards regression. 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). Unmeasured confounders. Self-reported health in late-stage CKD may influence the timing of kidney transplantation. [Display omitted]

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Collaboration types
Domestic collaboration
Web of Science research areas
Urology & Nephrology
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