1. Health-Related Quality of Life, Depressive Symptoms, and Kidney Transplant Access in Advanced CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study
- Author
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Boyang Chai, Raymond R. Townsend, James P. Lash, Alan S. Go, Peter Hart, Daohang Sha, Yonghong Huan, Anna C. Porter, Radhakrishna R. Kallem, Chi-yuan Hsu, L. Lee Hamm, Jiang He, Panduranga S. Rao, Ana C. Ricardo, Wei Yang, Meera N. Harhay, Manjula Kurella Tamura, Anne M. Huml, Sylvia E. Rosas, Lawrence J. Appel, Mahboob Rahman, John W. Kusek, Harold I. Feldman, Anne Slaven, Sanjeev Akkina, Peter P. Reese, Michael J. Fischer, and Jason Roy
- Subjects
medicine.medical_specialty ,Kidney Disease ,Population ,Renal and urogenital ,Renal function ,Clinical Research ,Internal medicine ,Behavioral and Social Science ,Internal Medicine ,medicine ,education ,Prospective cohort study ,Kidney transplantation ,Original Research ,education.field_of_study ,Transplantation ,business.industry ,Depression ,Hazard ratio ,Beck Depression Inventory ,wait-listing ,Kidney Transplant ,Organ Transplantation ,medicine.disease ,Mental Health ,Good Health and Well Being ,Nephrology ,quality-of-life ,depression ,Cohort ,CRIC Study Investigators ,business ,Kidney disease - Abstract
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, Visual abstract
- Published
- 2020