Quality of Life in Pre-Dialysis Chronic Kidney Disease: Influence of Gender, Stage, Symptom Burden, and Comorbidities
PDF (английский)

Ключевые слова

Chronic kidney disease
quality of life
KDQOL-36
gender
CKD stages
symptom burden
comorbidities

Как цитировать

«Quality of Life in Pre-Dialysis Chronic Kidney Disease: Influence of Gender, Stage, Symptom Burden, and Comorbidities» (2026) One Health & Risk Management , 7(3), сс. 39–52. doi:10.38045/ohrm.2026.3.04.

Аннотация

Introduction. Chronic kidney disease (CKD) negatively affects health-related quality of life (HRQoL) even in the pre-dialysis stages. However, data regarding gender- and stage-related differences in Eastern European CKD populations remain sparse compared to major international cohorts like CRIC and DOPPS. In this study, Low quality of life (low QoL) was defined as a Physical Component Summary (PCS) score below the 25th percentile of the cohort distribution.

Materials and Methods. This cross-sectional study included 989 adults with CKD stages I–V undergoing conservative management. HRQoL was evaluated using the KDQOL-36™ questionnaire. We performed gender and CKD stage comparisons, Pearson correlations, and multivariate logistic regression to identify predictors of low QoL. Symptom burden was assessed via structured patient interviews, complemented by the KDQOL-36™ symptom domain to ensure standardized reporting.

Results. The mean patient age was 58.3 ± 12.5 years, and 52.8% were male. The mean PCS and Mental Component Summary (MCS) scores were 40.2 ± 10.8 and 43.5 ± 11.2, respectively. Women had lower PCS scores than men (38.0 vs. 41.0; p < 0.05) and a higher prevalence of fatigue (95.0% vs. 85.0%) and dysuria (70.8% vs. 52.6%; p < 0.001). QoL declined progressively with advancing CKD stage (PCS 44.2 in stages I–II vs. 34.5 in stages IV–V; p < 0.001), and PCS correlated positively with eGFR (r ≈ 0.45; p < 0.001). Independent predictors of low QoL included advanced CKD stage (OR 2.72), diabetes (OR 1.94), anemia (OR 1.80), hypoalbuminemia (OR 1.70), a disease duration of >5 years (OR 1.50), and female sex (OR 1.38).

Conclusions. HRQoL is substantially impaired in pre-dialysis CKD, particularly among women and patients with advanced disease, highlighting the need for targeted, patient-centered interventions.

https://doi.org/10.38045/ohrm.2026.3.04
PDF (английский)

Библиографические ссылки

Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022;12(1):7-11. https://doi.org/10.1016/j.kisu.2021.11.003.

Foreman KJ, Marquez N, Dolgert A, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–2040 for 195 countries and territories. Lancet. 2018;392(10159):2052-2090. https://doi.org/10.1016/S0140-6736(18)31694-5.

Bikbov B, Purcell C, Levey AS, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-733. https://doi.org/10.1016/S0140-6736(20)30045-3.

Pagels AA, Söderkvist BK, Medin C, Hylander B, Heiwe S. Health-related quality of life in different stages of chronic kidney disease and at initiation of dialysis treatment. Health Qual Life Outcomes. 2012;10:71. https://doi.org/10.1186/1477-7525-10-71.

Wyld M, Morton RL, Hayen A, Howard K, Webster AC. A systematic review and meta-analysis of utility-based quality of life in chronic kidney disease treatments. PLoS Med. 2012;9(9):e1001307. https://doi.org/10.1371/journal.pmed.1001307.

Fletcher BR, Damery S, Aiyegbusi OL, et al. Symptom burden and health-related quality of life in chronic kidney disease: a global systematic review and meta-analysis. PLoS Med. 2022;19(4):e1003954. https://doi.org/10.1371/journal.pmed.1003954.

Ricardo AC, Yang W, Sha D, et al. Sex-related disparities in CKD progression. J Am Soc Nephrol. 2019;30(1):137-146. https://doi.org/10.1681/ASN.2018030296.

Vanek L, Gülmez D, Kurnikowski A, et al. Patient and caregiver perspectives on gender disparity in chronic kidney disease: questionnaire survey based on an interview study. Am J Nephrol. 2024;55(5):561-582. https://doi.org/10.1159/000540850.

Kandasamy G, Subramani T, Almanasef M, et al. Determinants of health-related quality of life in patients with chronic kidney disease: a cross-sectional study. Healthcare (Basel). 2025;13(10):1167. https://doi.org/10.3390/healthcare13101167.

Odeyemi A, Oladimeji OM, Ajibare AO, et al. Impact of anemia on the quality of life of chronic kidney disease patients: a single institution experience. West Afr J Med. 2023;40(4):1253–1261.

Van Haalen H, Jackson J, Spinowitz B, Milligan G, Moon R. Impact of chronic kidney disease and anemia on health-related quality of life and work productivity: analysis of multinational real-world data. BMC Nephrol. 2020;21(1):88. https://doi.org/10.1186/s12882-020-01746-4.

Cruz MC, Andrade C, Urrutia M, Draibe S, Nogueira-Martins LA, Sesso RCC. Quality of life in patients with chronic kidney disease. Clinics (Sao Paulo). 2011;66(6):991-995. https://doi.org/10.1590/S1807-59322011000600012.

Rincon Bello A, Ion Titapiccolo J, Berdud Godoy I, et al. Better health-related quality of life is associated with prolonged survival and reduced hospitalization risk among dialysis-dependent chronic kidney disease patients: a historical cohort study. BMC Nephrol. 2024;25(1):163. https://doi.org/10.1186/s12882-024-03835-0.

D’Arrigo G, Marino C, Pizzini P, et al. Quality of life and kidney function in CKD patients: a longitudinal study. Clin Kidney J. 2025;18(4):sfae429. https://doi.org/10.1093/ckj/sfae429.

Elias MA, Van Damme W, Ku GMV, Kadammanavar M, Wouters E. Lived experiences of people with chronic kidney disease on maintenance dialysis: a systematic review and thematic synthesis of qualitative studies. BMC Nephrol. 2025;26(1):52. https://doi.org/10.1186/s12882-025-03952-4.

Riehl-Tonn VJ, MacRae JM, Dumanski SM, et al. Sex and gender differences in health-related quality of life in individuals treated with incremental and conventional hemodialysis. Clin Kidney J. 2024;17(10):sfae273. https://doi.org/10.1093/ckj/sfae273.

Abdel-Kader K, Unruh ML, Weisbord SD. Symptom burden, depression, and quality of life in chronic and end-stage kidney disease. Clin J Am Soc Nephrol. 2009;4(6):1057-1064. https://doi.org/10.2215/CJN.00430109.

Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260-272. https://doi.org/10.1016/S0140-6736(13)60687-X.

Um-E-Kalsoom. Gender role in anxiety, depression and quality of life in chronic kidney disease patients. Pak J Med Sci. 2020;36(2):251-254. https://doi.org/10.12669/pjms.36.2.869.

Hsu HT, Chiang YC, Lai YH, Lin LY, Hsieh HF, Chen JL. Effectiveness of multidisciplinary care for chronic kidney disease: a systematic review. Worldviews Evid Based Nurs. 2021;18(1):33-41. https://doi.org/10.1111/wvn.12483.

Farag YMK, Blasco-Colmenares E, Zhao D, Sanon M, Guallar E, Finkelstein FO. Effect of anemia on physical function and physical activity in CKD: the National Health and Nutrition Examination Survey, 1999–2016. Kidney360. 2023;4(9):1212-1222. https://doi.org/10.34067/KID.0000000000000218.

Davison SN, Rathwell S, Ghosh S, George C, Pfister T, Dennett L. The prevalence and severity of chronic pain in patients with chronic kidney disease: a systematic review and meta-analysis. Can J Kidney Health Dis. 2021;8:2054358121993995. https://doi.org/10.1177/2054358121993995.

Hong YS, Kim H, Zhao D, Cho A. Impact of chronic kidney disease on health-related quality of life in patients with diabetes mellitus: a national representative study. J Clin Med. 2021;10(20):4639. https://doi.org/10.3390/jcm10204639.

Pei M, Aguiar R, Pagels AA, et al. Health-related quality of life as predictor of mortality in end-stage renal disease patients: an observational study. BMC Nephrol. 2019;20(1):144. https://doi.org/10.1186/s12882-019-1318-x.

Alves FC, Sun J, Qureshi AR, et al. The higher mortality associated with low serum albumin is dependent on systemic inflammation in end-stage kidney disease. PLoS One. 2018;13(1):e0190410. https://doi.org/10.1371/journal.pone.0190410.

Лицензия Creative Commons

Это произведение доступно по лицензии Creative Commons «Attribution» («Атрибуция») 4.0 Всемирная.

Copyright (c) 2026 Costina GROZA, Emil CEBAN, Oleg ARNAUT, Boris SASU, Liliana GROPPA