Factors associated with quality of life in predialysis chronic kidney disease. Review of literature

Abstract

Health-related quality of life (QoL) is one of the main patient-reported outcomes. Monitoring QoL in patients with chronic kidney disease (CKD) can be considered one of the approaches to the implementation of the principles of personalized medicine in clinical nephrology. The review provides a brief description of the questionnaires most used to assess QoL in patients with CKD and summarizes the results of studies of factors related to QoL at predialysis stages. It is customary to distinguish sociodemographic, clinical, and psychological factors associated with health-related QoL. Being female, smoking, low levels of education and income, the presence of coronary heart or cerebrovascular diseases, depression, and anxiety were shown to be associated with a decrease in QoL of patients with predialysis CKD. As for other clinical and socio-demographic factors, the literature data are not so unambiguous. Thus, several studies have demonstrated that a decrease in glomerular filtration rate, albumin and hemoglobin levels, the presence of diabetes, and an increase in age and creatinine level negatively affect the parameters of the physical component of QoL. At the same time, a significant number of studies have not found a relationship between these variables and the parameters of the psychosocial component of QoL, which is explained by the dependence of this QoL component primarily on the characteristics of the emotional state and personality. Of the psychological factors associated with QoL in patients with CKD treated conservatively, the attention of researchers was focused mainly on the level of depression. Only a few studies have analyzed other psychological variables (personality traits, coping strategies, effects of psychosocial interventions) related to QoL in patients with predialysis CKD. Identification and systematization of potentially modifiable factors affecting patients’ QoL set the directions for the prevention and correction of reduced QoL