Assessment of Health Related Quality of Life among Chronic Kidney Disease Patients: Challenges for Nephrologists in Pakistan

Abstract

Introduction: During the past few decades, health related quality of life has been considered as an important predictor for positive health outcomes. Health-related quality of life assessment helps in determining the impact of disease on the everyday life of patients. Chronic kidney disease severely affects health related quality of life of patient. Objective: The objective of this study was to assess health related quality of life among patients with chronic kidney diseases in Pakistan. Methodology: A descriptive cross-sectional study design was used. Study respondents included CKD pre-dialysis and dialysis patients with or without comorbidities visiting tertiary care facilities located in twin cities of Pakistan. Sample size was calculated to be 386 pharmacists to achieve 95% confidence level with 5% margin of error. Convenient sampling technique was used to select respondents. A pre- validated questionnaire Kidney Disease Quality of Life questionnaire (KDQoL-36) was used. Data was coded and analyzed using SPSS 21 after collection. Mann-Whitney and Kruskal-Wallis (p ≥ 0.05) tests were according to different demographic variables. Results: The results of the current study showed lowest scores for HRQoL in domain of physical health composite (30.77±11.16) followed by domain of symptoms and problems associated with CKD whereas daily life had the highest scores. The results highlighted that females had better HRQoL in all domains mental health (46.30, ± 8.73), burden of kidney disease (69.47, ± 32.35), symptoms (29.79, ± 31.22) and effect of disease on daily activities (40.96, ± 32.11) while lowest score for physical health (30.90, ± 10.34). Married respondents had better HRQoL among all domains than unmarried patients except for physical health (32.26, ± 10.7). A significant difference (p ≥ 0.05) was observed among different domains of HRQoL of CKD patients with respect to different genders, marital status, age groups and qualification levels. Males had relatively better physical health scores but their daily activities were also affected more by their disease. Married respondents had relatively better HRQoL among all domains than unmarried patients except for physical health. No significant difference (p ≥ 0.05) was observed for different stages of disease. Conclusion: The present study concluded that patients with CKD had poor HRQoL regardless of novel treatments availability. A negative impact was observed across all domains of health related quality of life among chronic kidney disease patients. Necessary programs focusing on health education for patients with low literacy levels should be initiated to increase health awareness and improve mental health among CKD patients.