Metabolic Control and the Symptoms/Problems Domain of Kidney Disease-Specific Quality of Life in Patients Receiving Kidney Replacement Therapy
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Background
Health-related quality of life (HRQoL) is an important outcome in patients with chronic kidney disease (CKD) receiving kidney replacement therapy (KRT), but the relationship between comprehensive metabolic control and the Symptoms/Problems domain of kidney disease-specific HRQoL remains uncertain.
Objective
To evaluate the association between composite metabolic control and the Symptoms/Problems domain of the Kidney Disease Quality of Life-36 (KDQOL-36) in patients with stage 5 CKD receiving KRT, and to explore the relationship between individual metabolic parameters and the continuous Symptoms/Problems score.
Materials and Methods
We conducted an observational, cross-sectional, analytical study of 177 adults receiving hemodialysis or peritoneal dialysis at a nephrology unit in Chihuahua, Mexico. Metabolic control included blood pressure, glycated hemoglobin (HbA1c), total cholesterol, and triglycerides. Adequate control was defined as achievement of at least three of four study-defined operational thresholds. The KDQOL-36 Symptoms/Problems score was analyzed as a continuous variable and categorized as low, moderate, or high according to the study protocol. Group comparisons, Spearman correlations, Pearson chi-square tests, and ordinal logistic regression were performed.
Results
Adequate metabolic control was present in 106 patients (59.9%). No, statistically significant association was observed between achievement of at least three of four study-defined operational thresholds and Symptoms/Problems score category (χ 2 =3.983; p=0.137; Cramer’s V=0.150). None of the individual metabolic parameters differed significantly across Symptoms/Problems score categories or showed significant correlations with the continuous score. In ordinal logistic regression, adequate metabolic control yielded an odds ratio of 1.81 (95% CI: 0.98-3.35; p=0.057) after adjustment for age, sex, time receiving KRT, and KRT modality.
Conclusions
No, statistically significant association was identified between the operational definition of metabolic control used in this study and the KDQOL-36 Symptoms/Problems domain in patients with stage 5 CKD receiving KRT. The findings support evaluating HRQoL multidimensionally and warrant confirmation in larger longitudinal studies.
Categories
Family/General Practice, Internal Medicine, Nephrology
