Quality of life as indicator of poor outcome in hemodialysis: Relation with mortality in different age groups

I. N. Van Loon, M. L. Bots, F. T.J. Boereboom, M. P.C. Grooteman, P. J. Blankestijn, M. A. Van Den Dorpel, M. J. Nubé, P. M. Ter Wee, M. C. Verhaar, M. E. Hamaker

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Physical, cognitive and psychosocial functioning are frequently impaired in dialysis patients and impairment in these domains relates to poor outcome. The aim of this analysis was to compare the prevalence of impairment as measured by the Kidney Disease Quality of Life- Short Form (KDQOL-SF) subscales between the different age categories and to assess whether the association of these subscales with mortality differs between younger and older dialysis patients. Methods: This study included data from 714 prevalent hemodialysis patients, from 26 centres, who were enrolled in the CONvective TRAnsport STudy (CONTRAST NCT00205556, 09-12-2005). Baseline HRQOL domains were evaluated for patients <65 years, 65-74 years and over 75 years. Multivariable Cox proportional hazards analyses were performed to assess the relation between the separate domains and 2-year mortality. Results: Emotional health was higher in patients over the age of 75 compared to younger patients (mean level 71, 73 and 77 for increasing age categories respectively, p = 0.02), whilst physical functioning was significantly lower in older patients (mean level 60, 48 and 40, p < 0.01). A low level of physical functioning (Hazard Ratio (HR) 1.72 [95%Confidence Interval (CI) 1.02-2.73]), emotional health (HR 1.85 [95% 1.30-2.63]), and social functioning (HR 1.59 [95% CI 1.12-2.26]), was individually associated with an increased 2-year mortality within the whole population. The absence of effect modification suggests no evidence for different relations within the older age groups. Conclusions: In dialysis patients, older age is associated with lower levels of physical functioning, whilst the level of emotional health is not associated with age. KDQOL-SF domains physical functioning, emotional health and social functioning are independently associated with mortality in prevalent younger and older hemodialysis patients.

Original languageEnglish
Article number217
JournalBMC Nephrology
Volume18
Issue number1
DOIs
Publication statusPublished - 6 Jul 2017

Cite this

Van Loon, I. N., Bots, M. L., Boereboom, F. T. J., Grooteman, M. P. C., Blankestijn, P. J., Van Den Dorpel, M. A., ... Hamaker, M. E. (2017). Quality of life as indicator of poor outcome in hemodialysis: Relation with mortality in different age groups. BMC Nephrology, 18(1), [217]. https://doi.org/10.1186/s12882-017-0621-7
Van Loon, I. N. ; Bots, M. L. ; Boereboom, F. T.J. ; Grooteman, M. P.C. ; Blankestijn, P. J. ; Van Den Dorpel, M. A. ; Nubé, M. J. ; Ter Wee, P. M. ; Verhaar, M. C. ; Hamaker, M. E. / Quality of life as indicator of poor outcome in hemodialysis : Relation with mortality in different age groups. In: BMC Nephrology. 2017 ; Vol. 18, No. 1.
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title = "Quality of life as indicator of poor outcome in hemodialysis: Relation with mortality in different age groups",
abstract = "Background: Physical, cognitive and psychosocial functioning are frequently impaired in dialysis patients and impairment in these domains relates to poor outcome. The aim of this analysis was to compare the prevalence of impairment as measured by the Kidney Disease Quality of Life- Short Form (KDQOL-SF) subscales between the different age categories and to assess whether the association of these subscales with mortality differs between younger and older dialysis patients. Methods: This study included data from 714 prevalent hemodialysis patients, from 26 centres, who were enrolled in the CONvective TRAnsport STudy (CONTRAST NCT00205556, 09-12-2005). Baseline HRQOL domains were evaluated for patients <65 years, 65-74 years and over 75 years. Multivariable Cox proportional hazards analyses were performed to assess the relation between the separate domains and 2-year mortality. Results: Emotional health was higher in patients over the age of 75 compared to younger patients (mean level 71, 73 and 77 for increasing age categories respectively, p = 0.02), whilst physical functioning was significantly lower in older patients (mean level 60, 48 and 40, p < 0.01). A low level of physical functioning (Hazard Ratio (HR) 1.72 [95{\%}Confidence Interval (CI) 1.02-2.73]), emotional health (HR 1.85 [95{\%} 1.30-2.63]), and social functioning (HR 1.59 [95{\%} CI 1.12-2.26]), was individually associated with an increased 2-year mortality within the whole population. The absence of effect modification suggests no evidence for different relations within the older age groups. Conclusions: In dialysis patients, older age is associated with lower levels of physical functioning, whilst the level of emotional health is not associated with age. KDQOL-SF domains physical functioning, emotional health and social functioning are independently associated with mortality in prevalent younger and older hemodialysis patients.",
keywords = "Dialysis, End-stage renal disease, Frailty, Geriatric nephrology, Quality of life",
author = "{Van Loon}, {I. N.} and Bots, {M. L.} and Boereboom, {F. T.J.} and Grooteman, {M. P.C.} and Blankestijn, {P. J.} and {Van Den Dorpel}, {M. A.} and Nub{\'e}, {M. J.} and {Ter Wee}, {P. M.} and Verhaar, {M. C.} and Hamaker, {M. E.}",
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Quality of life as indicator of poor outcome in hemodialysis : Relation with mortality in different age groups. / Van Loon, I. N.; Bots, M. L.; Boereboom, F. T.J.; Grooteman, M. P.C.; Blankestijn, P. J.; Van Den Dorpel, M. A.; Nubé, M. J.; Ter Wee, P. M.; Verhaar, M. C.; Hamaker, M. E.

In: BMC Nephrology, Vol. 18, No. 1, 217, 06.07.2017.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Quality of life as indicator of poor outcome in hemodialysis

T2 - Relation with mortality in different age groups

AU - Van Loon, I. N.

AU - Bots, M. L.

AU - Boereboom, F. T.J.

AU - Grooteman, M. P.C.

AU - Blankestijn, P. J.

AU - Van Den Dorpel, M. A.

AU - Nubé, M. J.

AU - Ter Wee, P. M.

AU - Verhaar, M. C.

AU - Hamaker, M. E.

PY - 2017/7/6

Y1 - 2017/7/6

N2 - Background: Physical, cognitive and psychosocial functioning are frequently impaired in dialysis patients and impairment in these domains relates to poor outcome. The aim of this analysis was to compare the prevalence of impairment as measured by the Kidney Disease Quality of Life- Short Form (KDQOL-SF) subscales between the different age categories and to assess whether the association of these subscales with mortality differs between younger and older dialysis patients. Methods: This study included data from 714 prevalent hemodialysis patients, from 26 centres, who were enrolled in the CONvective TRAnsport STudy (CONTRAST NCT00205556, 09-12-2005). Baseline HRQOL domains were evaluated for patients <65 years, 65-74 years and over 75 years. Multivariable Cox proportional hazards analyses were performed to assess the relation between the separate domains and 2-year mortality. Results: Emotional health was higher in patients over the age of 75 compared to younger patients (mean level 71, 73 and 77 for increasing age categories respectively, p = 0.02), whilst physical functioning was significantly lower in older patients (mean level 60, 48 and 40, p < 0.01). A low level of physical functioning (Hazard Ratio (HR) 1.72 [95%Confidence Interval (CI) 1.02-2.73]), emotional health (HR 1.85 [95% 1.30-2.63]), and social functioning (HR 1.59 [95% CI 1.12-2.26]), was individually associated with an increased 2-year mortality within the whole population. The absence of effect modification suggests no evidence for different relations within the older age groups. Conclusions: In dialysis patients, older age is associated with lower levels of physical functioning, whilst the level of emotional health is not associated with age. KDQOL-SF domains physical functioning, emotional health and social functioning are independently associated with mortality in prevalent younger and older hemodialysis patients.

AB - Background: Physical, cognitive and psychosocial functioning are frequently impaired in dialysis patients and impairment in these domains relates to poor outcome. The aim of this analysis was to compare the prevalence of impairment as measured by the Kidney Disease Quality of Life- Short Form (KDQOL-SF) subscales between the different age categories and to assess whether the association of these subscales with mortality differs between younger and older dialysis patients. Methods: This study included data from 714 prevalent hemodialysis patients, from 26 centres, who were enrolled in the CONvective TRAnsport STudy (CONTRAST NCT00205556, 09-12-2005). Baseline HRQOL domains were evaluated for patients <65 years, 65-74 years and over 75 years. Multivariable Cox proportional hazards analyses were performed to assess the relation between the separate domains and 2-year mortality. Results: Emotional health was higher in patients over the age of 75 compared to younger patients (mean level 71, 73 and 77 for increasing age categories respectively, p = 0.02), whilst physical functioning was significantly lower in older patients (mean level 60, 48 and 40, p < 0.01). A low level of physical functioning (Hazard Ratio (HR) 1.72 [95%Confidence Interval (CI) 1.02-2.73]), emotional health (HR 1.85 [95% 1.30-2.63]), and social functioning (HR 1.59 [95% CI 1.12-2.26]), was individually associated with an increased 2-year mortality within the whole population. The absence of effect modification suggests no evidence for different relations within the older age groups. Conclusions: In dialysis patients, older age is associated with lower levels of physical functioning, whilst the level of emotional health is not associated with age. KDQOL-SF domains physical functioning, emotional health and social functioning are independently associated with mortality in prevalent younger and older hemodialysis patients.

KW - Dialysis

KW - End-stage renal disease

KW - Frailty

KW - Geriatric nephrology

KW - Quality of life

UR - http://www.scopus.com/inward/record.url?scp=85021772682&partnerID=8YFLogxK

U2 - 10.1186/s12882-017-0621-7

DO - 10.1186/s12882-017-0621-7

M3 - Article

VL - 18

JO - BMC Nephrology

JF - BMC Nephrology

SN - 1471-2369

IS - 1

M1 - 217

ER -